固定剂量氨氯地平联合贝那普利对比单药治疗高血压有效性和安全性的Meta分析
对照试验，共964例患者纳入研究。Meta分析结果：在有效性方面，氨氯地平2.5 mg联合贝那普利10 mg治疗高血压的临床效果优于单药治疗组[RR = 1.49，95%CI（1.34～1.65），P = 0.000]，且优于氨氯地平单药治疗或贝那普利单药治疗[RR = 1.47，95%CI（1.17～1.86），P = 0.01;RR = 1.49，95%CI（1.32～1.68），P = 0.000];在安全性方面，氨氯地平2.5 mg联合贝那普利10 mg治疗高血压的不良反应发生率与单药治疗组比较差异无统计学意义[RR = 1.23，95%CI（0.94～1.62），P = 0.164]，与氨氯地平单药或贝那普利单药比较差异无统计学意义[RR = 1.37，95%CI（0.75～2.53），P = 0.377;RR = 1.20，95%CI（0.88～1.63），P = 0.269]。最常见的不良反应分别为头疼、头晕、咳嗽、水肿、病毒感染，且其发生率与联合组与单药组比较差异均无统计学意义。 结论 氨氯地平2.5 mg联合贝那普利10 mg治疗高血压患者的有效性优于氨氯地平单药和贝那普利单药且安全性无显著差异。
[关键词] 高血压;贝那普利;氨氯地平;Meta分析
[中图分类号] R544.1 [文献标识码] A [文章编号] 1673-7210（2018）12（c）-0099-06
[Abstract] Objective To evaluate the efficacy and safety of Amlodipine 2.5 mg combined with Benazepril 10 mg in patients with hypertension in comparison with single Amlodipine and Benazepril monotherapy. Methods A comprehensive search was conducted on the databases of CNKI， VIP， PubMed，Web of Science and Springer from January 1995 to February 2017 for relevant studies on the clinical drug treatment and investigation and analysis of hypertension. Two investigators screened the literature based on inclusion and exclusion criteria and extracted relevant data，using stata 14.0 for statistical analysis. Results A total of 5 randomized controlled trials were included， and a total of 964 patients were included in the study. Meta-analysis showed that Amlodipine 2.5 mg combined with Benazepril 10 mg were more effective in the treatment of hypertension than single-drug treatment group [RR = 1.49， 95%CI （1.34-1.65）， P = 0.000]， and it was superior to Amlodipine alone or Benazepril alone in the treatment of hypertension [RR = 1.47， 95%CI（1.17-1.86）， P = 0.01; RR = 1.49， 95%CI （1.32-1.68）， P = 0.000]. In terms of safety， the incidence of adverse reactions of Amlodipine 2.5 mg combined with Benazepril 10 mg in the treatment of hypertension were not significantly different from that of the single drug treatment group [RR = 1.23， 95%CI （0.94-1.62）， P = 0.164]. There was no significant difference compared with Amlodipine or Benazepril in the treatment of hypertension [RR = 1.37， 95%CI （0.75-2.53）， P = 0.377; RR = 1.20， 95%CI （0.88-1.63）， P = 0.269]. The most common adverse reactions were headache， dizziness， cough， sinusitis， edema， and viral infection， and the incidence rate was not significantly different between the combination group and the single drug group. Conclusion Amlodipine 2.5 mg combined with Benazepril 10 mg is more effective than amlodipine and benazepril alone in the treatment of hypertension， and there is no significant difference in safety.