局部和全身应用糖皮质激素治疗突发性耳聋的Meta分析

Local and systemic glucocorticoid treatment for sudden hearing loss: a Meta-analysis

目的:利用Meta分析方法比较国内外局部和全身应用糖皮质激素治疗突发性耳聋(Sudden hearing loss,SHL)的疗效,并探讨其安全性。方法:电子检索PubMed、OVID、CBM、CNKI、维普、万方数据库,系统地收集1971-2011年局部和全身给药治疗SHL的相关文献。根据预先制定的纳入和排除标准筛选文献,Cochrane Handbook 5.0严格评价纳入文献质量,提取数据,RevMan 5.0软件进行Meta分析。结果:纳入文献7篇,均为随机对照试验。Meta分析结果显示:局部给药组与全身给药组总有效率的比值比(Odds ratio,OR)为2.01,95%可信区间(Confident interval,CI)为1.31-3.08。关于2种途径给药对血糖的影响,统计结果χ2=3.592,P>0.05。结论:虽然局部给予糖皮质激素治疗SHL与全身用药的不良反应无明显差异,但局部用药疗效优于全身用药,在临床中可优先考虑使用。

Objective： To assess the efficacy and safety of glucocorticoid in treating sudden hearing loss with local and systemic ways.Methods ：The data base of PubMed, OVID, CBM, CNKI,VIP,Wanfang were systematically retrieved and the literatures associated with local and systemic glucocorticoid in the treatment of sudden hearing loss between 1971 and 2011 were collected. Literatures were screened according to the pre-established inclusion and exclusion standards and the quality was evaluated strictly by using the Cochrane Handbook 5.0. The data were extracted and analyzed by using RevMan 5.0 Meta-analysis software. Results：Among all the qualified literatures,7 articles were randomized controlled trials. Meta analysis results showed that the odds ratio（OR） of the total effective rate within two groups was 2.01 and 95% confident interval（CI） was between 1.31 and 3.08. Regarding the influence of blood sugar,the statistical results showed that the value of x2 was 3.592 and the value of P was greater than 0.05. Conlusions：Ahhough there is no significant difference of the adverse effects between local and systemic glucocorticoid treatment, the local glucocorticoid for sudden deafness is more effective than the systemic administration. It can be preferred in clinical treatment.