类固醇激素治疗前庭神经炎有效性的Meta分析

Meta-Analysis on Steroids in Treatment of Vestibular Neuritis

目的:系统评价类固醇激素治疗前庭神经炎的有效性。方法:计算机检索The Cochrane Library、PubMed、EMbase、Web of Science、CBM、中国知网、万方及维普数据库,搜集有关类固醇激素治疗前庭神经炎的随机对照试验(RCT),检索时限均为建库至2020年11月27日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan5.4进行Meta分析。结果:共纳入7个RCT,包括294例患者。Meta分析结果显示:类固醇激素可促进治疗后24 h患者眩晕症状的改善(RR=0.29,95%CI 0.11~0.71,P=0.007);但对治疗后1、6月眩晕残障程度评定量表(DHI)评分、治疗后1、6和12月半规管麻痹(CP)程度改善及治疗后眼震消失的平均天数,2组差异无统计学意义(P>0.05)。结论:现有证据表明,类固醇激素可促进前庭神经炎患者发病初期眩晕的恢复;而对半规管轻瘫改善、长期眩晕恢复和眼震消失无促进作用。

Objective:To systematically evaluate the efficacy of steroids in the treatment of vestibular neuritis.Methods:The Cochrane Library,PubMed,Embase,Web of Science,CBM,CNKI,WanFang Data,and VIP databases were electronically searched to collect randomized controlled trials(RCTs)on the efficacy of steroids in the treatment of vestibular neuritis from inception to November 27,2020.Two reviewers independently screened literature,extracted data,and assessed the risk of bias of included studies.Then,meta-analysis was performed using RevMan5.4 software.Results:A total of 7 RCTs were included,including 294 patients.Results of meta-analysis showed that corticosteroids could promote the improvement of vertigo symptoms 24 hours after treatment(RR=0.29,95%CI 0.11~0.71,P=0.007).However,there was no statistical significance between the two groups in the Dizziness Handicap Inventory(DHI)score at 1 and 6 months after treatment,the improvement of canal paresis(CP)at 1,6,and 12 months after treatment,and the mean days of nystagmus disappearance after treatment(P>0.05).Conclusion:The current evidence shows that corticosteroids can promote the recovery of vertigo symptoms in the short term in patients with vestibular neuritis.However,they did not improve semicircular canal function,the recovery of long-term vertigo,and the disappearance of nystagmus.