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[苦碟子注射液药物安全性的系统评价]

[Systematic review of Kudiezi injection drug safety].

作者信息

Gao Shan-Shan, Cui Rui-Zhao, Xie Yan-Ming, Liao Xing, Gao Xiao-Yan, Wang Ji-Dong

机构信息

School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 100102, China.

Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2017 Jun;42(12):2380-2390. doi: 10.19540/j.cnki.cjcmm.20170420.001.

Abstract

To systematically evaluate the safety of Kudiezi injection. Databases such as Cochrane library, Medline, EMbase, Web of Science, Clinical Trials, CBM, CNKI, VIP, Wanfang and Chinese Clinical Trial Register were searched to collect the literature on all the study types of Kudiezi injection. Two researchers screened literature, assessed quality and extracted data according to inclusion and exclusion criteria. All studies were assessed by using internationally recognized methodological quality assessment tools or reporting quality evaluation criteria; Meta-analysis of adverse drug reaction/adverse events (ADR/AE) of Kudiezi injection was performed by using Stata 12.0 software. There were 411 clinical studies included, out of which 315 studies were analyzed finally. 18 072 patients in total used kudiezi injection, and there were 330 cases with ADRs and 13 cases with AEs. The most common ADR related system was the central and peripheral nervous system, with a weighted incidence of 2.9% [95%CI(0.022, 0.036)]. From the current evidence, the overall safety of Kudiezi injection was acceptable. Although data could be collected from all kinds of published reports, there are lack of mechanism experiments or observational studies with large samples of Kudiezi injection. Therefore, it is necessary to carry out further research on the safety of Kudiezi injection. Meanwhile, off label use of Kudiezi injection is common, so it is urgent for relevant governmental departments to formulate drug use specifications and provide better guidance for clinical drug use.

摘要

系统评价苦碟子注射液的安全性。检索Cochrane图书馆、Medline、EMbase、Web of Science、Clinical Trials、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普资讯(VIP)、万方数据库及中国临床试验注册中心等数据库,收集有关苦碟子注射液各种研究类型的文献。两名研究人员根据纳入和排除标准筛选文献、评估质量并提取数据。所有研究均采用国际认可的方法学质量评估工具或报告质量评价标准进行评估;使用Stata 12.0软件对苦碟子注射液的药物不良反应/不良事件(ADR/AE)进行Meta分析。共纳入411项临床研究,最终分析315项研究。总计18072例患者使用了苦碟子注射液,其中发生ADR的有330例,发生AE的有13例。最常见的与ADR相关的系统是中枢和外周神经系统,加权发生率为2.9%[95%CI(0.022,0.036)]。根据现有证据,苦碟子注射液的总体安全性是可以接受的。尽管可从各类发表报告中收集数据,但缺乏苦碟子注射液的机制实验或大样本观察性研究。因此,有必要对苦碟子注射液的安全性开展进一步研究。同时,苦碟子注射液的超说明书用药情况普遍,相关政府部门亟待制定用药规范,为临床用药提供更好的指导。

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