局部和全身糖皮质激素治疗突发性耳聋的Meta分析

发布时间：2018-11-09 18:11

【摘要】：背景介绍：突发性耳聋是耳鼻喉科的常见疾病。目前该病病因不清，通常采用常规治疗方案，即扩血管剂、糖皮质激素、抗病毒药物、能量合剂、高压氧等联合治疗。自鼓室内用药治疗内耳疾病以来，考虑全身用药不良反应大，越来越多的学者开始尝试鼓室用糖皮质激素治疗突发性耳聋，并指出局部给药可使内外淋巴液获得比全身更高的药物浓度，但局部给予糖皮质激素治疗突发性耳聋的疗效是否优于全身用药尚未得到循证医学的肯定。目的：利用荟萃分析方法比较国内外局部（鼓室内给药）治疗突发性耳聋与全身（口服或静脉给药）治疗突发性耳聋的疗效，并探讨两种途径的安全性。方法：电子检索PubMed、OVID、CBM、CNKI、维普、万方数据库，系统地收集1971-2011年局部和全身给予糖皮质激素治疗突发性耳聋的相关文献。根据预先制定的纳入和排除标准筛选文献，CochraneHandbook5.0严格评价纳入文献质量，提取数据，RevMan5.0软件进行Meta分析。结果：纳入合格研究文献9篇，，均为随机对照试验。Meta分析结果显示：鼓室内给予糖皮质激素治疗突发性耳聋疗效并不优于全身给药[OR=1.52，95％可信区间为（0.84，2.75）]，但局部给药不良反应小，尤其是对血糖的影响。结论：鼓室内给予糖皮质激素治疗突发性耳聋疗效与全身用药无明显差异，但副作用较小，在临床治疗中可优先考虑使用。
[Abstract]:Background: sudden deafness is a common disease in the department of otolaryngology. At present, the etiology of the disease is not clear, usually used routine treatment, namely vasodilator, glucocorticoid, antiviral drugs, energy mixture, hyperbaric oxygen and other combined treatment. Since the treatment of inner ear disease with intracympanic medication, more and more scholars began to try to treat sudden deafness with glucocorticoid in tympanic chamber. It is pointed out that local administration of glucocorticoid can obtain higher concentration of drugs than that of the whole body, but whether the efficacy of local administration of glucocorticoid in the treatment of sudden deafness is better than that of systemic medication has not been confirmed by evidence-based medicine. Objective: to compare the efficacy of local (intratympanic) and systemic (oral or intravenous) methods in the treatment of sudden deafness at home and abroad, and to explore the safety of the two approaches. Methods: PubMed,OVID,CBM,CNKI, Wiper, Wanfang database was searched electronically, and the literature on local and systemic glucocorticoid therapy for sudden deafness from 1971 to 2011 was systematically collected. According to the pre-established inclusion and exclusion criteria, the quality of the literature was evaluated strictly by CochraneHandbook5.0, and the data was extracted, and the Meta analysis was carried out by RevMan5.0 software. Results: the results of Meta analysis showed that the efficacy of glucocorticoid in the treatment of sudden deafness was not better than that of systemic administration [OR=1.52,95% confidence interval (OR=1.52,95% = 0.84 卤2.75)]. However, the adverse effects of local administration were small, especially the effect on blood glucose. Conclusion: the curative effect of glucocorticoid in the treatment of sudden deafness is not significantly different from that of systemic medication, but the side effect is relatively small, so it is preferred to be used in clinical treatment.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R764

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