益生菌治疗轻微肝性脑病的系统评价

发布时间：2018-06-21 19:59

本文选题：益生菌 + 轻微肝性脑病　；参考：《新疆医科大学》2014年硕士论文

【摘要】：目的：本研究的目的是对已发表的有关于益生菌与常规保肝治疗或安慰剂治疗进行对照研究的随机对照试验进行系统评价,以明确现在是否有充分的证据可以证明益生菌对轻微肝性脑病治疗的效果。方法：首先,制定明确的纳入标准和排除标准,应用计算机检索技术全面检索Cochrane临床对照试验数据库、Medline、Embase、万方医学网、同方医学网等相关数据库,并手工检索相关的会议论文以及所有检索到的试验的参考文献,由两位研究评价员分别对筛选出的文献进行相关资料的提取以及对文献质量和内容进行评价,并且由两位评价员相互核对。然后对符合纳入条件的文献进行整理以及资料整合。采用血氨监测、心理系统检测、临床型肝性脑病发病率等标准评价益生菌对轻微肝性脑病患者的疗效。结果：总共检索到的可能符合纳入标准的文献有12篇,其中6个试验共包括340例患者符合纳入标准。但是,经Jadad评分后,各试验质量相差很大。所有纳入试验的患者均为肝硬化以及门脉高压且排除临床型肝性脑病患者。益生菌治疗后相关检测指标均提示益生菌对轻微肝性脑病有良好疗效,且和对照组相比较有明显差异(P0.05)。轻微肝性脑病逆转率明显较对照组高,差别有显著差异(P0.05)。结论：本系统评价显示益生菌对轻微肝性脑病的治疗、逆转、相关检测指标的改善明显优于常规治疗以及安慰剂。但是,因为现在轻微肝性脑病治疗的研究较少,高质量以及大样本的研究更加缺乏,所得结论有一定局限性。因此,需进行更加严谨以及大样本、多中心的相关试验以进一步提高试验结论的可靠性。同时,相关研究应尽可能长时间随访,并严格遵守随机、双盲以及对失访患者进行原因探查。
[Abstract]:Objective: the purpose of this study was to systematically evaluate the published randomized controlled trials of probiotics and conventional liver preservation or placebo treatment to determine whether there is sufficient evidence to prove the effect of probiotics on treatment of mild hepatic encephalopathy. The standard and exclusion criteria are used to retrieve Cochrane clinical trial database, Medline, Embase, Wanfang medical network, Tongfang medical network and other related databases, and manual retrieval of related conference papers and all the referenced references of the retrieved tests by two research evaluators. The related data were extracted and the quality and content of the literature were evaluated, and the two evaluators checked each other. Then the documents were collated and the data were integrated. The therapeutic effect of probiotics on mild hepatic encephalopathy was evaluated by blood ammonia monitoring, psychological system detection, and the incidence of clinical hepatic encephalopathy. Results: a total of 12 articles were found to be eligible for inclusion criteria. 6 of them included 340 patients who met the inclusion criteria. However, after Jadad scores, the quality of each test was very different. All the patients included were cirrhosis and portal hypertension and patients with clinical hepatic encephalopathy were excluded. Probiotics were associated with the treatment. The results showed that probiotics had a good effect on mild hepatic encephalopathy and compared with the control group (P0.05). The reversal rate of mild hepatic encephalopathy was significantly higher than that of the control group (P0.05). Conclusion: the system evaluation showed that the treatment of probiotics to mild hepatic encephalopathy was reversed and the related indexes were improved. It is better than conventional therapy and placebo. However, because of the few studies on the treatment of mild hepatic encephalopathy and the lack of high quality and large sample studies, the conclusions are limited. Therefore, more rigorous and large sample, multi center related experiments are needed to further improve the reliability of the test conclusions. The study should be followed up for as long as possible and strictly observe the causes of blindness, double blindness and missed visit.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R575.3

【参考文献】