氯雷他定治疗儿童哮喘的疗效与安全性评价

Evaluation of efficacy and safety of loratadine in the treatment of childhood asthma

摘要:

目的：评价新一代抗组胺药物氯雷他定治疗儿童哮喘的疗效和安全性，为儿童哮喘的治疗提供临床依据。方法：采用计算机及手工检索方式检索PubMed、MEDLINE、EMBASE、Cochrance、CNKI、CBMdisc等数据库（1990年1月至2010年12月）。对文献质量进行内部真实性评价，并按Cochrane协作网推荐的方法进行系统评价和分析。结果：检索到文献179篇，最终纳入11篇随机对照研究，共有317例哮喘儿童，其中氯雷他定治疗组159例，安慰剂治疗组（对照组）158例。所有纳入文献质量为B级。Meta分析的结果表明，治疗后氯雷他定组的临床评分、4周和8周的一秒用力呼气容积（FEV1）、8周的呼吸流速峰值（PEFR）均明显优于对照组（P<0.01），差异均有统计学意义。而氯雷他定组乏力和心动过速及心悸的发生比率均低于对照组，差异有统计学意义。结论：采用氯雷他定治疗儿童哮喘安全有效，值得在临床进行推广。

Abstract:

OBJECTIVE: To evaluate the efficacy and safety of loratadine, a new generation of antihistaminics, in the treatment of childhood asthma. METHODS: The papers related to loratadine treatment for childhood asthma were searched in the database of PubMed, MEDLINE, EMBASE, Cochrance, CNKI and CBMdisc (January 1990 to December 2010) electronically and manually. According to the Cochrane reviewer’s handbook, the quality of the enrolled papers was assessed and a systematic review was performed. RESULTS: A total of 179 papers were obtained. Eleven randomized controlled trials met the criteria and were included in this study. The 11 trials included 317 children with asthma: 159 cases in the loratadine treatment group and 158 cases in the control group. All included studies belonged to the B class according to the quality evaluation criteria. Meta analysis showed that the clinical symptoms were improved more, the forced expiratory volume in 1 second (FEV1) 4 and 8 weeks posttreatment and the peak expiratory flow rate (PEFR) 8 weeks posttreatment were higher in the loratadine treatment group than in the control group. The treatment-related adverse effects, fatigue, tachycardia and palpitation, occurred less in the loratadine treatment group compared with the control group. CONCLUSIONS: Loratadine is safe and effective for the treatment of childhood asthma.