丙酸倍氯米松和传统糖皮质激素灌肠治疗远端溃疡性结肠炎：Meta分析

发布时间：2018-04-29 17:27

本文选题：溃疡性结肠炎 + 丙酸倍氯米松　；参考：《重庆医科大学》2014年硕士论文

【摘要】：目的:系统性评价丙酸倍氯米松灌肠和传统糖皮质激素灌肠治疗远端溃疡性结肠炎的有效性及安全性。方法:计算机检索PubMed、EBSCO、The Cochrane Library、CBM、CNKI数据库，筛选关于丙酸倍氯米松灌肠和传统糖皮质激素灌肠治疗远端溃疡性结肠炎患者的随机对照试验。2名评价者独立对纳入文献进行质量评价和数据提取,采用RevMan5.0进行数据分析。结果:共纳入6篇研究共计351例患者，其中丙酸倍氯米松组181例、传统糖皮质激素组170例。Meta分析结果显示:灌肠治疗后两组在内镜（OR=0.60,95%CI:0.17～2.17，， P=0.44）以及临床症状（OR=1.00,95%CI:0.32～3.11，P=0.99）改善方面的差异无统计学意义；BDP对病理组织学改善优于TGC（OR=0.33,95%CI:0.12～0.95，P=0.04）；灌肠治疗后两组的空腹皮质醇浓度（MD=0.28,95%CI:0.09～0.48，P=0.004）及ACTH刺激试验（MD=0.57,95%CI:0.29～0.84，P＜0.0001）有统计学差异。结论:本文严格评价随机对照试验后表明：对于急性轻中度远端溃疡性结肠炎患者的治疗，BDP与TGC灌肠在改善内镜与临床症状方面有相似疗效，在病理组织学方面BDP优于TGC。BDP对下丘脑-垂体-肾上腺轴无明显抑制作用，安全性高于TGC。
[Abstract]:Objective: to evaluate the efficacy and safety of beclomethasone propionate enema and traditional glucocorticoid enema for distal ulcerative colitis. Methods: a computer-based search was conducted for the Cochrane Library CBM Cochrane CNKI database. Two randomized controlled trials of beclomethasone propionate enema and traditional glucocorticoid enema for distal ulcerative colitis were carried out. The quality evaluation and data extraction of the literature were conducted independently. The data were analyzed by RevMan5.0. Results: a total of 351 patients were included in 6 studies, including 181 patients in beclomethasone propionate group. Meta-analysis of 170 cases in the traditional glucocorticoid group showed that there was no significant difference between the two groups in the improvement of the clinical symptoms and the improvement of the clinical symptoms: 0.6095CI0.170.172.17 and 0.3295CIW 0.323.11P0.99) after enema treatment, BDP was better than TGCORO 0.33995 CIW 0.120.95P0.04 in the improvement of histopathology. The fasting cortisol concentration was 0.2895% (CI: 0.09 0. 48% P0. 004) and the ACTH stimulation test was 0. 57% 0. 29% 0. 29% 0. 84% (P < 0. 0001). Conclusion: the results of a randomized controlled trial showed that BDP and TGC enema had similar efficacy in improving endoscopy and clinical symptoms in patients with acute mild to moderate distal ulcerative colitis. In histopathology, BDP was superior to TGC.BDP in inhibiting hypothalamus-pituitary-adrenal axis, and its safety was higher than that of TGC.BDP.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R574.62

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