那他霉素联合氟康唑治疗真菌性角膜炎的临床疗效研究

The Clinical Effectiveness of a Combination of Natamycin and Fluconazole in Treating Fungal Keratitis

摘要: 目的：本研究旨在系统性地评估那他霉素和氟康唑联合治疗真菌性角膜炎的临床疗效，以期为真菌性角膜炎的临床治疗提供有力的参考依据。方法：通过计算机检索，从知网(CNKI)、维普网(VIP)、万方数据库、Pubmed、Web of Science (WOS)和Cochrane Library数据库中，检索出从2000年1月到2022年1月期间联合应用那他霉素和氟康唑治疗真菌性角膜炎的随机对照实验，并根据排除或纳入标准，筛选出有效数据，最终进行Meta-分析。将联合应用那他霉素和氟康唑组视为实验组，将单独应用那他霉素或氟康唑组视为对照组。结果：共纳入8个RCT，样本总数714例，其中实验组361例，对照组353例。Meta-分析结果：在治疗真菌性角膜炎方面，实验组的有效率(OR = 3.66, 95% CI: 2.27~5.91, Z = 5.31, P < 0.00001)和显效率(OR = 2.29, 95% CI: 1.68~3.13, Z = 5.24, P < 0.00001)均高于对照组。结论：那他霉素和氟康唑联合应用治疗真菌性角膜炎疗效好于单独使用氟康唑或那他霉素。

Abstract: Objective: To evaluate the clinical effectiveness of combination therapy of natamycin and flucona-zole in treatment of fungal keratitis, providing reference for the combined use of natamycin and fluconazole incurring fungal keratitis. Methods: Obliged with the standard of inclusion and exclu-sion criteria, randomized controlled trials (RCTs) about combined treatment of natamycin and flu-conazole for fungal keratitis from January 1st, 2000 to January 1st, 2022 were selected from CNKI, VIP, Wanfang, Pubmed, Web of Science and Cochrane Library through computer retrieval. Accord-ing to the exclusion or inclusion criteria, the valid data were screened out, and finally meta-analysis was performed. The groups of combined use of natamycin and fluconazole were defined as experi-mental group and the groups of single use of natamycin or fluconazole were defined as control groups. Results: 8 RCTs including 361 experimental cases and 353 control cases (totally 714 cases) were selected. The efficacy (OR = 3.66, 95% CI: 2.27~5.91, Z = 5.31, P < 0.00001) and marked effi-cacy (OR = 2.29, 95% CI: 1.68~3.13, Z = 5.24, P < 0.00001) of the combination of natamycin and flu-conazole in treating fungal keratitis was superior to that of the single application of either drug. Conclusion: The combined use of natamycin and fluconazole was more effective than the single use of natamycin or fluconazole in treatment of fungal keratitis.