复方樟柳碱参与治疗外伤性视神经病变的循证医学评价

Compound anisodine use as a role in traumatic optic neuropathies treatment： a meta-analysis

目的评价复方樟柳碱参与治疗外伤性视神经病变（TON）的疗效。方法以“樟柳碱”、“视神经病变”、“外伤”或“挫伤”为关键词，检索2007年4月以前国内生物医学期刊公开发表的有关复方樟柳碱参与治疗TON的临床研究，并对其疗效进行循证医学评价。结果符合纳入标准的对照试验文献6篇，合计415只眼，复方樟柳碱参与治疗后，优势比OR=6．54，95％可信区间为[4．14，10．35]，P〈0．00001，差异具有统计学意义；亚组分析P值均〈0．0001。结论复方樟柳碱参与治疗能提高TON的疗效；糖皮质激素治疗联合复方樟柳碱能进一步提高疗效；单纯使用复方樟柳碱治疗TON是可行的。但由于纳入的研究证据强度较低，未来需要更多高质量的多中心、随机、双盲临床试验，以提高该药治疗TON疗效的证据强度。

Objective To estimate the quality and efficacy of the academic thesis of compound anisodine in traumatic optic neuropathies（TON） treatment. Method We searched Chinese database last updated in April 2007 for published magazine papers using ＂anisodine＂ ＆ ＂optic neuropathy＂ ＆ ＂trauma＂ or ＂blunt trauma＂ as key words ,and analyzed them using the standard of evidence-based medicine （EBM）. Result 6 RCTs with a total of 415 eyes included are retrieved , and the OR value is 6.54 with a 95%CI of[4.14,10. 35],P〈0. 00001, the difference is significant ; sub-category analyses are made and both show significant difference（P〈0. 0001）. Conclusion The existing evidence supports that prognosis of TON is better when compound anisodine are adopt in treatment, and this effect is significant in steroid treatment. Compound anisodine can be used alone for TON treatment. However, because there are only 6 thesis are retrieved and all of them have methodological short-comings,the evidence is not convincing. There is an urgent need of well-planed, large-scale and multiple-center studies to assess the role of compound anisodine in traumatic optic neuropathies treatment.