资源描述：
《联合用药的降压治疗优于单一用药双倍剂量治疗》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。
1、联合用药的降压治疗优于单一用药双倍剂量治疗(2009-04-0112:09:28)转载MedWireNews:Bloodpressure(BP)reductionfromcombiningdrugsfromdifferentclassescanbepredictedonthebasisofadditiveeffects,andisapproximatelyfivetimesgreaterthandoublingthedoseofasingledrug,astudyindicates・MedWire新闻：一项研究显示，不同种药物的联合用药的降压作用是叠加的效应，大概是单种药物双倍剂量
2、的五倍药效。Effectivenessoflow-dosedrugcombinationsasinitialtreatmentforBPreductionreliesontheeffectsofthecombineddmgsbeingadditive・低剂量药物的初始降压效果依赖于联合用药的叠加作用。Toexaminetheevidenceforthis,ateamfromtheLondonQueenMary'sSchoolofMedicineandDentistry,UK,ledbyDavidWald,conductedameta-analysisof42factorialtri
3、alsinvolving10,968participantsinwhichcombinationsofanytwoofthiazides,beta-blockers,ACEinhibitors(ACEIs),andcalciumchannelblockers(CCBs)weretestedagainsteachdruggivenaloneandplacebo.为找到研究的证据，來自英国伦敦女王玛丽口腔医学与临床医学院的DavidWald领导的实验小组对10968名参加者进行了42个析因试验并进行荟萃分析。试验者从曝嗪类利尿药、卩■受体阻断剂、血管紧张素转化酶抑制剂、钙通道阻滞剂中选
4、取2种联合用药，或是单用一种药物和安慰剂。Withthiazideusedalone,themeanplacebo-subtractedreductioninsystolicbloodpressurewas7.3mmHg,and14.6mmHgcombinedwithadrugfromanotherclass.Thecorrespondingreductionswere9.3mmHgand18.9mmHgwithbeta-blocker,6.8mmHgand13.9mmHgwithACEI,and8.4mmHgand14.3mmHgwithCCB.卩塞嗪类利尿药单用的平均收缩压减少
5、7.3mmHg而联合用约是减少14.6mmHg。相应的B■受体阻断剂单用和联用分别减少9.3mmHg和1&9mmHg,ACEI单用和联用分别减少6.8mmHg和13.9mmHg,CCB单用和联用分别减少8.4mmHg和14.3mmHgoTheexpectedbloodpressurereductionfromtwodrugstogether,assuminganadditiveeffect,closelypredictedtheobservedbloodpressurereductions・Theratiosoftheobservedtoexpectedincrementalblo
6、odpressurereductionsfromcombiningeachclassofdrugwithanyotheroverthatfromonedrugwere,respectively,forthiazides,beta-blockers,ACEIs,andCCBs:1.04,1.00,1.16,and0.89.Theoverallaveragewas1.01.原先假设的期望屮的两种药物的联合作用的效果接近于实测得到的降压值。联合用药的血压降低的值比单用血压降低的值增加的比率分别是：靡嗪类利冰药、P-受体阻断剂、血管紧张索转化酶抑制剂、钙通道阻滞剂——1.04,1.00,1
7、.16,0.89。总的平均值是1.0kComparisonofresultswiththoseofapublishedmeta-analysisofdifferentdosesofthesamedrugshowedthatdoublingthedoseofonedrughadapproximatelyonefifthoftheequivalentincrementaleffect(0.22).对药物的不同剂量的药效结果的荟萃分析显示双倍剂量的单-用药物的药效只有联合用
