【摘要】：背景介紹：突發(fā)性耳聾是耳鼻喉科的常見(jiàn)疾病。目前該病病因不清，通常采用常規(guī)治療方案，即擴(kuò)血管劑、糖皮質(zhì)激素、抗病毒藥物、能量合劑、高壓氧等聯(lián)合治療。自鼓室內(nèi)用藥治療內(nèi)耳疾病以來(lái)，考慮全身用藥不良反應(yīng)大，越來(lái)越多的學(xué)者開(kāi)始嘗試鼓室用糖皮質(zhì)激素治療突發(fā)性耳聾，并指出局部給藥可使內(nèi)外淋巴液獲得比全身更高的藥物濃度，但局部給予糖皮質(zhì)激素治療突發(fā)性耳聾的療效是否優(yōu)于全身用藥尚未得到循證醫(yī)學(xué)的肯定。 目的：利用薈萃分析方法比較國(guó)內(nèi)外局部（鼓室內(nèi)給藥）治療突發(fā)性耳聾與全身（口服或靜脈給藥）治療突發(fā)性耳聾的療效，并探討兩種途徑的安全性。 方法：電子檢索PubMed、OVID、CBM、CNKI、維普、萬(wàn)方數(shù)據(jù)庫(kù)，系統(tǒng)地收集1971-2011年局部和全身給予糖皮質(zhì)激素治療突發(fā)性耳聾的相關(guān)文獻(xiàn)。根據(jù)預(yù)先制定的納入和排除標(biāo)準(zhǔn)篩選文獻(xiàn)，CochraneHandbook5.0嚴(yán)格評(píng)價(jià)納入文獻(xiàn)質(zhì)量，提取數(shù)據(jù)，RevMan5.0軟件進(jìn)行Meta分析。 結(jié)果：納入合格研究文獻(xiàn)9篇，，均為隨機(jī)對(duì)照試驗(yàn)。Meta分析結(jié)果顯示：鼓室內(nèi)給予糖皮質(zhì)激素治療突發(fā)性耳聾療效并不優(yōu)于全身給藥[OR=1.52，95％可信區(qū)間為（0.84，2.75）]，但局部給藥不良反應(yīng)小，尤其是對(duì)血糖的影響。 結(jié)論：鼓室內(nèi)給予糖皮質(zhì)激素治療突發(fā)性耳聾療效與全身用藥無(wú)明顯差異，但副作用較小，在臨床治療中可優(yōu)先考慮使用。
[Abstract]:Background: sudden deafness is a common disease in the department of otolaryngology. At present, the etiology of the disease is not clear, usually used routine treatment, namely vasodilator, glucocorticoid, antiviral drugs, energy mixture, hyperbaric oxygen and other combined treatment. Since the treatment of inner ear disease with intracympanic medication, more and more scholars began to try to treat sudden deafness with glucocorticoid in tympanic chamber. It is pointed out that local administration of glucocorticoid can obtain higher concentration of drugs than that of the whole body, but whether the efficacy of local administration of glucocorticoid in the treatment of sudden deafness is better than that of systemic medication has not been confirmed by evidence-based medicine. Objective: to compare the efficacy of local (intratympanic) and systemic (oral or intravenous) methods in the treatment of sudden deafness at home and abroad, and to explore the safety of the two approaches. Methods: PubMed,OVID,CBM,CNKI, Wiper, Wanfang database was searched electronically, and the literature on local and systemic glucocorticoid therapy for sudden deafness from 1971 to 2011 was systematically collected. According to the pre-established inclusion and exclusion criteria, the quality of the literature was evaluated strictly by CochraneHandbook5.0, and the data was extracted, and the Meta analysis was carried out by RevMan5.0 software. Results: the results of Meta analysis showed that the efficacy of glucocorticoid in the treatment of sudden deafness was not better than that of systemic administration [OR=1.52,95% confidence interval (OR=1.52,95% = 0.84 鹵2.75)]. However, the adverse effects of local administration were small, especially the effect on blood glucose. Conclusion: the curative effect of glucocorticoid in the treatment of sudden deafness is not significantly different from that of systemic medication, but the side effect is relatively small, so it is preferred to be used in clinical treatment.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類(lèi)號(hào)】：R764

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