舌下特异性免疫治疗治疗柳杉花粉症疗效的系统评价和meta分析

发布时间：2018-04-21 07:15

本文选题：柳杉花粉症 + 舌下特异性免疫治疗　；参考：《重庆医科大学》2017年硕士论文

【摘要】：背景:用单一的柳杉花粉抗原提取物做舌下特异性免疫治疗对患柳杉花粉症患者疗效仍不确定。目的:通过做系统评价和meta分析来评估舌下特异性免疫治疗对柳杉花粉症患者的有效性。方法:在MEDLINE、EMBASE和Cochrane数据库中检索比较舌下特异性免疫治疗与安慰剂对照治疗柳杉花粉症患者的随机对照试验,主要的结局指标是症状药物评分,次要的结局指标是不良反应、生活质量和血清特异性Ig E和Ig G4的水平。结果:我们最终纳入共计受试者762个的4个随机对照实验。Meta分析显示舌下特异性免疫治疗组相对于对照组明显降低了受试者的症状药物评分(standardized mean difference[SMD],-0.94;95%confidence interval[CI],-1.75 to-0.14;P=0.02;I 2=93%),亚组分析显示在花粉浓度小于(SMD,-2.29;95%CI,-3.64 to-2.16;P.001)或者大于(SMD,-0.36;95%CI,-0.51 to-0.21;P.001;I2=0%)1200/cm 2及治疗时间大于1年(SMD,-0.43;95%CI,-0.59to-0.26;P.001;I 2=0%)的情况下,舌下特异性免疫治疗组相对于对照组更能改善患者的病情。在共计405人的实验组中有237人(58.5%)以及在共计357人的对照组有192人(53.8%)报道出现过不良反应。结论:这个研究显示舌下特异性免疫治疗对治疗柳杉花粉症患者有统计学上的有效性。然而这些发现仅基于很少量的随机对照试验分析,后期仍需大样本和高质量的随机对照试验做进一步的研究。
[Abstract]:Background: the effect of sublingual specific immunotherapy with a single extract of Cryptomeria chinensis pollen antigen is still uncertain. Objective: to evaluate the efficacy of sublingual specific immunotherapy in patients with Cryptomeria pollinosis by systematic evaluation and meta analysis. Methods: in the database of MEDLINE EMBASE and Cochrane, a randomized controlled trial was conducted to compare sublingual specific immunotherapy with placebo-controlled therapy in patients with Cryptomeria pollen syndrome. The main outcome index was symptomatic drug score, and the secondary outcome index was adverse reaction. Quality of life and serum specific levels of IgE and IgG4. Results: we finally included 762 subjects in 4 randomized controlled trials. Meta-analysis showed that the sublingual specific immunotherapy group significantly decreased the drug score of standardized mean difference [SMD] -0.94c95 confidence interval [CI] -1.75 to 0.14% Pt0.02I2935.The subcomponent of the sublingual specific immunotherapy group was significantly lower than that of the control group. When the pollen concentration is less than SMD-2.29CI-3.64 to-2.16 P.001) or larger than SMD-0.36 ~ 95CI-0.51 to-0.21, P.001and the treatment time is longer than 1 year SMD-0.4395CI-0.59to-0.26 (P.001C), the treatment time is longer than that of SMD-0.4395CI-0.59to-0.26. The sublingual specific immunotherapy group can improve the patient's condition more than the control group. Adverse reactions were reported in 237 of 405 experimental groups and 192 of 357 control groups. Conclusion: this study shows that sublingual specific immunotherapy is statistically effective in the treatment of Cryptomeria pollen syndrome. However, these findings are based on only a small number of randomized controlled trial analyses, and further research is needed at a later stage with large samples and high quality randomized controlled trials.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R765.21

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