慢性萎缩性胃炎伴不典型增生患者的循证治疗

Evidence-Based Treatment of Chronic Atrophic Gastritis with Dysplasia

目的借助循证医学的方法为一例慢性萎缩性胃炎伴不典型增生患者确定治疗目标及治疗方案。方法在充分评估患者情况后,提出临床问题,从Cochrane图书馆(1970—2010年)、Medline(PubMed 1970—2010年)、EMBASE(1970—2010年)和万方数据库(1970—2010年)进行检索,收集相关证据,对所获证据进行评价,并结合医生的经验及患者的愿望制定治疗方案。结果共检出与问题相关的系统评价或Meta分析4篇,随机对照试验20篇,临床诊断指南2篇。通过对检索结果进行分析,并结合患者意愿,为患者制定了合理的治疗方案,通过3个月的随访,证实该例患者的治疗方案疗效满意。结论采用循证治疗的方法,为慢性萎缩性胃炎伴不典型增生患者确定合理的治疗方案,可以有效改善患者症状,提高患者生活质量。

Objective To formulate an evidence-based treatment plan for chronic atrophic gastritis with dysplasia.Methods After clinical problems were put forward,evidence was collected from the Cochrane Library（1970—2010）,Medline（PubMed 1970—2010）,EMBASE（1970—2010）,WanFang Data（1970—2010） and critically assessed.Patient preferences and physician clinical experience were also taken into consideration in the decision-making for treatment.Results A total of 4 Meta-analysis or systemtic reviews,20 randomized controlled trials（RCTs）,and 2 clinical diagnosis guides were identified.A rational treatment plan was made upon a serious evaluation of the data and the opinion of the patient.After a 3 months follow-up,the plan was proved to be optimal.Conclusion Clinical symptoms and the quality of life for the patient diagnosed as Chronic atrophic gastritis with dysplasia has been improved by the individualized treatment plan formulated by evidence-based methods.