综合疗法对比传统遮盖疗法治疗儿童弱视的系统评价研究

Meta-analysis of Clinical Effectiveness on Combined Therapy for Childhood Amblyopia

目的利用Meta分析方案系统评价综合疗法与传统遮盖疗法治疗儿童弱视的疗效差异,以期为今后儿童弱视治疗提供一种更为有效、安全的治疗方案。方法制定检索策略并在中国期刊全文数据库(CNKI)、万方全文数据库、维普、美国医学文献数据库(PubMed)中检索2000-2020年有关传统遮盖疗法与在传统遮盖基础上的综合疗法治疗儿童弱视的疗效比较的随机对照试验(randomized controlled trial,RCT)和临床对照实验(clinical control experiment,CCT),按照循证医学(Cochrane)Meta分析的方法将符合规则的文章纳入研究并统计有效数据,采用RevMan 5.3软件进行Meta分析。结果共纳入符合纳入标准的12篇文献,总样本量为2428例。Meta分析结果显示综合疗法治疗儿童弱视的总有效率合并效应量[比值比(OR)]为2.87[95%可信区间(CI):2.14~3.85],综合疗法的疗效明显优于传统遮盖疗法,且差异具有统计学意义(Z=7.04,P<0.001)。结论综合疗法治疗儿童弱视的总有效率明显优于传统单一遮盖疗法,认为综合疗法治疗儿童弱视具有更高的临床治愈率;本研究存在纳入的文献方法学质量评价偏低的问题,今后鼓励更多地遵循循证医学研究方法和更高质量的RCT研究发表,以期为儿童弱视的治疗提供更为有效、安全的治疗方法。利用Meta分析方案系统评价综合疗法与传统遮盖疗法治疗儿童弱视的疗效差异,以期为今后儿童弱视治疗提供一种更为有效、安全的治疗方案。

Objective Using Meta analysis program system to evaluate the curative effect of comprehensive treatment and traditional therapy for children amblyopia are covered,in order to provide a more efficient and safe treatment for the children amblyopia treatment in the future.Methods According to the retrieval strategy by computer retrieval,2000-2019 China journal full-text database(CNKI)ten thousand VIP party full text database American medical literature databases(PubMed)about comprehensive therapy or traditional mask therapy in the treatment of amblyopia children curative effect comparison of randomized controlled trials(randomized controlled trials,RCT)and clinical control experiment(CCT),according to the evidence-based medicine(Cochrane)Meta analysis method into the research of quality,improved the Jadad score scale to score into the literature research methodology,the extraction of available data,using RevMan5.3 meta-analysis by statistical software and analysis of combined effect size of treatment effect by fixed effect model.Results There were 12 literatures that met the inclusion criteria,and the total sample size of 2075 cases and 12 literatures were all described and comparable.Conclusion The total effective rate of comprehensive therapy in the treatment of amblyopia in children is better than that of traditional single masking therapy.It can be considered that comprehensive therapy in the treatment of amblyopia in children has a higher clinical cure rate.The overall methodological evaluation quality of the included literature in this study is low,and more evidence-based medical research methods and higher quality RCTS are encouraged to be published in the future,so as to provide a more effective and safe treatment for children with amblyopia.