不同治疗方法对注射性硬结疗效的贝叶斯网状Meta分析

Bayesian network Meta-analysis of different treatment methods for injection induration

目的评价不同治疗方法对注射性硬结的疗效。方法计算机检索中国知网、维普、万方数据库、中国生物医学数据库、Pubmed、Cochrane library、Embase、Medline等数据库,检索从建库至2020年4月相关随机对照试验,以评价不同治疗方法对注射性硬结的疗效。由2名研究人员根据要求独立进行筛选文献、提取资料,参考国内外数据库关于治疗注射性行为硬结,使用Stata14软件进行网状图绘制,Gemtc0.14.3进行一致性检验、模型选择、两两比较表,采用RevMan5.3软件对数据进行Meta分析。结果共纳入RCT研究17项,由于肌肉注射、皮下注射、皮内注射产生硬结患者共计1393例。网状Meta分析结果显示直接比较,与50%硫酸镁相比,30%硫酸镁、陈渭良伤科油、50%硫酸镁溶液+鸡蛋清、陈渭良伤科油、芒硝、赛肤润等差异具有统计学意义(P<0.05),不同治疗方法应用效果前3位为地塞米松+土豆法、舒康博透明贴法和活血散疗法。结论地塞米松+土豆法、舒康博透明贴法和活血散疗法作为临床治疗注射性硬结最佳治疗的可能性最大,但仍需更多高质量、大样本研究进一步证实。

Objective To evaluate the effect of different treatment methods on injection induration,so as to provide scientific basis for the treatment of injection induration.Methods CNKI,VIP,Wanfang database,China biomedical database,PubMed,Cochrane Library,EMBASE and MEDLINE were searched by computer.Objective to search the randomized controlled trials(RCTs)from the establishment of the database to April 2020 to evaluate the efficacy of different treatment methods for injection induration.According to the requirements,two researchers independently screened the literature and extracted the data.Referring to the domestic and foreign databases about the treatment of injection induced behavioral induration,stata14 software was used to draw the mesh diagram,and gemtc 0.14.3 was used for consistency test,model selection,pairwise comparison table,and revman5.3 software was used for meta analysis of the data.Results A total of 17 RCT studies were included.A total of 1393 patients had induration due to intramuscular injection,subcutaneous injection and intradermal injection.The results of mesh meta-analysis showed that,compared with 50%magnesium sulfate,30%magnesium sulfate,Chen Weiliang Shangke oil,50%magnesium sulfate solution+egg white,Chen Weiliang Shangke oil,mirabilite,Saifurun,MEBO,Comfeel Transparent paste,cactus wet compress,the clinical differences were statistically significant.The top three therapeutic effects of different treatment methods may be dexamethasone+potato method and Shukang Bo transparent paste method and Huoxue powder therapy.Conclusion Dexamethasone+potato method,shukangbo transparent paste method and Huoxue powder therapy as the best treatment for injection induration are most likely,but more high-quality and large sample studies are needed to further confirm.