本文選題：甲狀腺功能亢進(jìn)癥　切入點(diǎn)：Graves病　出處：《廣西醫(yī)科大學(xué)》2015年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：背景抗甲狀腺藥物廣泛用于甲狀腺功能亢進(jìn)癥的臨床治療,但藥物的選擇、藥物劑量及用藥持續(xù)時(shí)間在臨床上目前沒(méi)有統(tǒng)一標(biāo)準(zhǔn)。目的系統(tǒng)評(píng)價(jià)抗甲狀腺藥物治療Graves病持續(xù)時(shí)間對(duì)疾病復(fù)發(fā)的影響資料與方法應(yīng)用計(jì)算機(jī)檢索中英文數(shù)據(jù)庫(kù)共7個(gè),包括中國(guó)生物醫(yī)學(xué)、萬(wàn)方、中國(guó)知網(wǎng)、重慶維普、Cochrane Library databases、PubMed、EMBASE數(shù)據(jù)庫(kù)。納入的文獻(xiàn)包括抗甲狀腺藥物治療Graves病不同持續(xù)時(shí)間的隨機(jī)對(duì)照試驗(yàn)研究、前瞻性研究及回顧性病例對(duì)照研究。對(duì)納入的文獻(xiàn),兩位研究員分別提取數(shù)據(jù),數(shù)據(jù)包括接受抗甲狀腺藥物治療的患者人數(shù)、藥物類(lèi)型、治療持續(xù)時(shí)間、治療結(jié)束隨訪時(shí)間及隨訪結(jié)束復(fù)發(fā)人數(shù)及緩解人數(shù),并對(duì)納入的文獻(xiàn)進(jìn)行質(zhì)量評(píng)分,將分別提取的數(shù)據(jù)整合,最后使用RevMan5.3軟件進(jìn)行分析。結(jié)果共納入10個(gè)文獻(xiàn),1269例Graves病患者。10個(gè)研究均報(bào)道了抗甲狀腺藥物治療Graves病持續(xù)時(shí)間與短期隨訪復(fù)發(fā)的關(guān)系,結(jié)果顯示延長(zhǎng)藥物治療的持續(xù)時(shí)間可改善短期內(nèi)疾病的復(fù)發(fā)率,6至12月療程與18至24月療程對(duì)復(fù)發(fā)影響比較結(jié)果提示長(zhǎng)療程方案疾病短期復(fù)發(fā)較少,且二者差異有統(tǒng)計(jì)學(xué)意義(RR0.00001,95%CI[1.33,1.90]),18月至24月療程與36月至42月療程對(duì)復(fù)發(fā)影響提示長(zhǎng)療程方案疾病短期復(fù)發(fā)較少且差異有統(tǒng)計(jì)學(xué)意義(RR=0.008,95%CI [1.09, 1.81]),對(duì)于常規(guī)治療計(jì)劃及長(zhǎng)期小劑量ATD維持治療對(duì)疾病復(fù)發(fā)影響比較,結(jié)果顯示對(duì)年齡小于35歲的二者無(wú)明顯差異(OR=0.54,95%CI [0.48,1.46]),但對(duì)于年齡大于35歲的結(jié)果顯示長(zhǎng)期小劑量維持疾病緩解率較高,差異有統(tǒng)計(jì)學(xué)意義(OR=0.006,95%CI[1.17,2.55])。對(duì)于長(zhǎng)期隨訪緩解率比較顯示,小于等于24月治療及大于24月治療二者差異無(wú)統(tǒng)計(jì)學(xué)意義(RR=0.71, 95%CI[0.46,3.17])。結(jié)論適當(dāng)延長(zhǎng)抗甲狀腺藥物治療Graves病持續(xù)時(shí)間可改善短期內(nèi)疾病的復(fù)發(fā)率。
[Abstract]:Background antithyroid drugs are widely used in the clinical treatment of hyperthyroidism, but the choice of drugs, There is no uniform standard for drug dosage and duration in clinical practice. Objective to evaluate the effect of antithyroid drug therapy on the recurrence of Graves disease and to search 7 databases in Chinese and English by computer. Including China Biomedicine, Wanfang, ChinaNet, Chongqing Weipurn Cochrane Library database PubMMBASE database. The literature included randomized controlled trial studies of different durations of antithyroid drugs for Graves's disease. Prospective studies and retrospective case-control studies. The two researchers extracted data on the included literature, including the number of patients treated with antithyroid drugs, the type of drugs, and the duration of the treatment. At the end of follow-up, the number of relapses and remissions at the end of the follow-up period, and the quality score of the literature included, the collected data were integrated. Finally, RevMan5.3 software was used to analyze the results. Results A total of 1269 patients with Graves's disease were included in 10 literatures. All the 10 studies reported the relationship between the duration of antithyroid drug therapy for Graves's disease and the short-term recurrence of Graves's disease. The results showed that prolonging the duration of drug therapy could improve the recurrence rate of the disease in a short period of time from 6 to December and from 18 to 24 months. The results showed that the short term recurrence rate of long term treatment regimen was less than that of 18 to 24 months treatment. The difference was statistically significant (RR0.00001 ~ 95CI [1.33 / 1.90]). The effects of 18-24 and 36-42 courses of treatment on recurrence were less and the difference was statistically significant. RR0.008 / 95CI [1.09, 1.81] was small for routine treatment plan and long-term treatment. Comparison of the effects of dose ATD maintenance therapy on the recurrence of disease, The results showed that there was no significant difference between the two groups aged less than 35 years old (CI = 0.481.46), but for those older than 35 years old, the remission rate of long-term low-dose maintenance disease was higher, and the difference was statistically significant (P < 0.05). There was no significant difference between the treatment of less than 24 months and that of more than 24 months. Conclusion prolonging the duration of antithyroid drug therapy for Graves disease can improve the recurrence rate of Graves disease in a short period of time.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R581.1

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本文編號(hào)：1633904