摘要
目的该研究旨在基于重症急性呼吸综合征(SARS)和中东呼吸综合征(MERS)中抗病毒治疗方法进行快速系统评价,进而探索皮下注射α-干扰素用于2019年新型冠状病毒(2019-nCoV)肺炎的临床可能性。方法使用计算机检索中国期刊全文数据库(CNKI)、维普中文科技期刊全文数据库(VIP)、万方数据库(Wangfang Data)、中国生物医文献数据库(CBM)、Cochrane library、PubMed等数据库检索相关研究。此外,检索WHO以及美国和中国疾控中心网站、国家卫生健康委员会网站,对国家发布的相关诊疗方案进行检索,同时把已发表文献的相关参考文献等作为辅助。按照循证药学的方法进行证据评价和数据提取。结果经检索获得1502篇文章,最终纳入11项研究。结果提示:①皮下注射α-干扰素的早期使用,尽可能在确诊冠状病毒感染后48 h使用,随着用药时间与确诊时间的延长,有效率降低,因此尽可能早治疗。②干扰素的各种类型之间治疗效果差异无统计学意义。③皮下注射α-干扰素与利巴韦林联合使用在个别研究中证实有效,但需要警惕其不良反应。不良反应多为可耐受的血红蛋白下降,转氨酶升高,淀粉酶升高,但多数不影响治疗。结论皮下注射α-干扰素可以作为一种试验性疗法用于新型冠状病毒肺炎(尤其是新发感染者)的抗病毒治疗,并应该为此尽快开展随机对照试验和真实世界临床研究,进一步探索α-干扰素用于新型冠状病毒肺炎的临床效应。
Objective To evaluate the antiviral therapies on severe acute respiratory syndrome(SARS)and Middle East respiratory syndrome(MERS)rapidly and systematically,and to explore the clinical feasibility of subcutaneous use of interferon-αin the treatment of SARS-CoV-2.Methods Systematically retrieved relevant clinical studies published in Chinese and English from databases,such as CNKI,VIP,Wangfang,CBM,PubMed,Cochrane Library,et al.In addition,the web site of WHO,Chinese Center for Disease Control and Prevention,Centers for Disease Control and Prevention of United States,and National Health Commission of the People’s Republic of China were retrieved,so as to search the relevant diagnosis,treatment programsand the relevant references.According to evidence-based pharmacy,evidence evaluation and data extraction were carried out.Results A total of 1502 articles were retrieved and 11 studies of them were included finally.The result showed:①The early use of subcutaneous interferon-αshould be within 48 hours after the diagnosis of coronavirus infection.With the prolongation of medication,cure rate will decrease,so the treatment should be as early as possible.②There was no significant difference in therapeutic effect among different types of interferon.③Interferon-αcombined with ribavirin has been proved to be effective in some studies,but their adverse reactions need to be vigilant.Most of the adverse reactions were tolerable,including hemoglobin decreasing,transaminase increasing and amylase increasing.And most of them did not affect the treatment.Conclusion Interferon-αcan be used as an experimental therapy in the antiviral treatment of SARS-CoV-2,especially in the newly infected patients.Therefore,randomized controlled trials and real world clinical studies should be carried out as soon as possible to further explore the clinical effect of interferon-αon SARS-CoV-2.
作者
陈岷
童荣生
边原
舒永全
杨勇
杜姗
李文渊
刘心霞
闫峻峰
龙恩武
何林
CHEN Min;TONG Rongsheng;BIAN Yuan;SHU Yongquan;YANG Yong;DU Shan;LI Wenyuan;LIU Xinxia;YAN Junfeng;LONG Enwu;HE Lin(Personalized Drug Therapy Key Laboratory of Sichuan Province,Department of Pharmacy,Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610072,China)
出处
《医药导报》
CAS
北大核心
2020年第4期483-488,共6页
Herald of Medicine
基金
四川省科技厅重点研发计划资助项目(2019YFS0514)
四川省人民医院科研基金资助项目(2016LY04)
成都市药学会赞邦药学科研基金资助项目(201918)
国家临床重点专科建设资助项目(30305030698)
四川省省级公益性科研院所基本科研业务专项课题资助项目(2018YSKY0017)
四川省人民医院院级科研基金临床研究及转化资助项目(2018LY09)。