鼓室注射曲安奈德联合盐酸氨溴索治疗分泌性中耳炎的Meta分析

发布时间：2019-04-24 14:29

【摘要】：目的：客观评价鼓室注射曲安奈德联合盐酸氨溴索与鼓室注射地塞米松联合盐酸氨溴索或鼓膜置管治疗分泌性中耳炎（secretory otitismedia,SOM）的有效性和安全性。方法：通过检索PubMed、Embase、Medline、相关期刊论文（CNKI）、万方数据库、维普数据库，收集关于鼓室注射曲安奈德联合盐酸氨溴索与鼓室注射地塞米松联合盐酸氨溴索或鼓膜置管对照治疗分泌性中耳炎的相关文献。严格制定纳入和排除标准后对相关文献进行筛选，对纳入的文献进行严格的质量评价，2名研究员分别进行数据提取，，对所提取的数据用RevMan5.2软件进行Meta分析。结果：5个随机对照研究（RCT）共615耳纳入研究。在5个对照研究中，治疗组（鼓室注射曲安奈德联合盐酸氨溴索）的疗效和对照组（鼓室注射地塞米松联合盐酸氨溴索）比较：比值比（odds ratio,OR）为4.25,95%confidence interval（95%CI）为（2.71，6.66），P0.01；其中2个对照研究，治疗组（鼓室注射曲安奈德联合盐酸氨溴索）与对照组（鼓膜置管）的疗效及并发症比较：OR（95%CI）1.67（0.61，4.60），P=0.32及OR（95%CI）0.16（0.03，0.94），P=0.04。结论：在分泌性中耳炎的治疗中，鼓室注射曲安奈德联合盐酸氨溴索的疗效优于地塞米松联合盐酸氨溴索；鼓室注射曲安奈德联合盐酸氨溴索能有效降低患者气导平均听阈及骨导听阈25dB的发生率。鼓室注射曲安奈德联合盐酸氨溴索的疗效与鼓膜置管的相当，但并发症发生率低于鼓膜置管。因此鼓室注射曲安奈德联合盐酸氨溴索治疗分泌性中耳炎值得临床推广。
[Abstract]:Objective: to evaluate the efficacy and safety of tympanic injection of triamcinolone acetonide combined with ambroxol hydrochloride and dexamethasone combined with ambroxol hydrochloride or tympanic membrane catheterization in the treatment of secretory otitis media (secretory otitismedia,SOM). Methods: through searching PubMed,Embase,Medline, Chinese journal full-text database (CNKI), Wanfang database and Vip database. Literature on the treatment of secretory otitis media by tympanic injection of triamcinolone acetonide combined with ambroxol hydrochloride and tympanic injection of dexamethasone combined with ambroxol hydrochloride or tympanic membrane catheterization was collected. After strictly formulating the standards of inclusion and exclusion, the relevant documents were screened, the quality of the included documents was evaluated strictly, the data were extracted by two researchers, and the extracted data were analyzed by Meta with RevMan5.2 software. Results: a total of 615 ears of (RCT) were included in 5 randomized controlled studies. In five control studies, the efficacy of treatment group (tympanic injection of triamcinolone acetonide combined with ambroxol hydrochloride) was compared with that of control group (tympanic injection of dexamethasone combined with ambroxol hydrochloride): ratio of (odds ratio, OR was 4.25, 95% confidence interval (95%CI) was (2.71, 6.66), P0.01; The efficacy and complications of the treatment group (tympanic injection of triamcinolone acetonide combined with ambroxol hydrochloride) and the control group (tympanic membrane catheterization) were compared with those of the control group (: OR (95%CI) 1.67 (0.61, 4.60). P < 0. 32 and OR (95%CI) 0. 16 (0. 03, 0. 94), P < 0. 04. Conclusion: in the treatment of secretory otitis media, tympanic injection of triamcinolone acetonide combined with ambroxol hydrochloride is superior to dexamethasone combined with Ambroxol hydrochloride. Tympanic injection of triamcinolone acetonide combined with ambroxol hydrochloride could effectively reduce the incidence of mean auditory threshold and bone conduction threshold 25dB in patients. Tympanic injection of triamcinolone acetonide combined with ambroxol hydrochloride was similar to that of tympanic membrane catheterization, but the incidence of complications was lower than that of tympanic membrane catheterization. Therefore, tympanic injection of triamcinolone acetonide combined with ambroxol hydrochloride in the treatment of secretory otitis media is worthy of clinical promotion.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R764.21

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