Safety Profiles of Tripterygium wilfordii Hook F: A Systematic Review and Meta-Analysis.
Safety Profiles of Tripterygium wilfordii Hook F: A Systematic Review and Meta-Analysis.
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雷公藤 Hook F 的安全性概况：系统评价和荟萃分析
DOI：
10.3389/fphar.2016.00402
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发表时间：
2016
影响因子：
5.6
通讯作者：
Lu AP
中科院分区：
文献类型：
--
作者：
Zhang C;Sun PP;Guo HT;Liu Y;Li J;He XJ;Lu AP
目的：雷公藤是一种广泛应用的治疗炎症性疾病的有效药物。有人担心其毒性，但没有充分的综合证据的不良事件（AE）。我们的目的是进行一个临床信息，系统的安全性特征的TwHF。方法：我们对实验性研究和观察性研究进行了系统回顾和荟萃分析。我们搜索了电子数据库和会议摘要。安全性结局为常见AE的发生率。结果：我们筛选了4137篇摘要的合格性，并在分析中纳入了594项研究。在23，256名TwHF使用者中，AE的总体发生率为26.7%（95% CI 24.8%，28.8%）。当按特定研究类型分层时，估计值确实存在显著差异。胃肠道症状、不良生殖结局、不良皮肤反应、血液学事件和心血管事件的发生率为13.3%（95% CI 11.9%，14.9%）、11.7%（95% CI 10.3%，13.3%）、7.8%（95% CI 6.3-9.5%）、6.5%（95% CI 5.7- 7.4%）和4.9%（95% CI 1.6%，14.3%）。与对照组相比，服用雷公藤多甙的患者月经不调（IM）的患病率增加（比值比[OR] 4.65，95%CI 3.08至7.03）。使用TwHF的体重增加（OR 0.12 [95% CI 0.04 - 0.39]）和脱发（OR 0.37 [95% CI 0.18 - 0.78]）风险较低。此外，长期使用阿司匹林（>6个月）的AE发生率更高（31.0% [95% CI 24.5%-38.5%]）。结论：我们的研究结果表明，超过四分之一的服用TwHF的患者发生了AE。一个明确的需要存在的贡献风险因素，以及预防和管理策略，以提高患者的耐受性TwHF的更好的理解。
Objective: Tripterygium wilfordii Hook F (TwHF) is a widely used and effective treatment for inflammatory diseases. There have been concerns about its toxicity but no adequate synthesis of the evidence for adverse events (AEs). We aimed to undertake a clinically informative, systematic safety profile of TwHF. Methods: We undertook a systematic review and meta-analysis of experimental studies and observational studies. We searched electronic databases and conference abstracts. Safety outcomes were rates of common AEs. Results: We screened 4137 abstracts for eligibility and included 594 studies in the analysis. The overall incidence of AEs was 26.7% (95% CI 24.8%, 28.8%) in 23,256 TwHF users. The estimates did vary markedly when stratified by specific study types. The incidence of gastrointestinal symptoms, adverse reproductive outcomes, adverse skin reactions, hematologic events and cardiovascular events were 13.3% (95% CI 11.9%, 14.9%), 11.7% (95% CI 10.3%, 13.3%), 7.8% (95% CI 6.3–9.5%), 6.5% (95% CI 5.7–7.4 %) and 4.9% (95% CI 1.6 %, 14.3 %), respectively. The prevalence of irregular menstruation (IM) was increased in patients taking TwHF compared with those given control (odds ratio [OR] 4.65, 95% CI 3.08 to 7.03). TwHF use has lower risk of weight gain (OR 0.12 [95% CI 0.04 to 0.39]) and hair loss (OR 0.37 [95% CI 0.18 to 0.78]). Furthermore, long-term aspirin use (>6 months) has a higher AEs incidence (31.0% [95% CI 24.5%–38.5%]). Conclusion: Our findings suggest that more than one in four patients who were taking TwHF had experienced AEs. A clear need exists for improved understanding of contributing risk factors, as well as of prevention and management strategies to improve patients' tolerance for TwHF.
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影响因子：
2.3
作者：
Ernst, Edzard
通讯作者：
Ernst, Edzard
影响因子：
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作者：
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Fidler, JM
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作者：
Salliot C;van der Heijde D
通讯作者：
van der Heijde D
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通讯作者：
Bland M