鼓室内和耳后应用糖皮质激素治疗难治性突发性聋的Meta分析

Intratympanic and Retroauricular Glucocorticoids for Refractory Sudden Deafness:A Meta-Analysis

目的探讨鼓室内和耳后使用糖皮质激素对于难治性突发性聋的有效性。方法通过关键词在中国知网、万方、维普、PubMed、Cochrane等数据库检索2005~2020年国内外公开发表的鼓室内与耳后使用糖皮质激素进行对比治疗难治性突发性聋的随机对照研究,使用Review Manager 5.4和Stata软件包对符合质量标准的研究进行Meta分析。结果本次研究共检索文献数量517篇,最终纳入5篇,均为中文文献,Meta分析显示在难治性突聋的治疗方面,鼓室内注射组总有效率显著大于耳后注射组(RR=0.87,95%CI为0.78~0.97,P=0.01);两种途径的痊愈率无统计学差异(RR=0.71,95%CI为0.50~1.02,P=0.07)。结论难治性突发性聋的治疗中,鼓室内注射糖皮质激素的总有效率优于耳后注射,是难治性突聋较为理想的治疗方法,但需要更大的样本量、更严格的统计学方法和分型更细致的临床试验来证实。

Objective To investigate the efficacy of intratympanic and retroauricular corticosteroids in the treatment of refractory sudden deafness.Methods A randomized controlled trial of corticosteroids in the treatment of refractory sudden deafness published at home and abroad from 2005 to 2020 was searched with keywords in China knowledge Network,Wanfang,VIP,PubMed,Cochrane and other databases.The studies that met the quality standards were analyzed by Meta using ReviewManager5.4 and Stata software packages.Results A total of 517 articles were searched in this study,and finally 5 articles were included,all of which were in Chinese.Meta-analysis showed that the total effective rate in the retroauricular injection group was significantly higher than that in the tympanic injection group(RR=0.87,95%CI=0.78~0.97,P=0.01).There was no significant difference in the cure rate between the two approaches(RR=0.71,95%CI=0.50~1.02,P=0.07).Conclusions In the treatment of refractory sudden deafness,the total effective rate of intratympanic injection of glucocorticoid is better than that of retroauricular injection,which is an ideal method for the treatment of refractory sudden deafness.However,it needs larger sample size,stricter statistical Methods and more detailed clinical trials to confirm.