本文選題：潰瘍性結(jié)腸炎 + 丙酸倍氯米松��； 參考：《重慶醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的:系統(tǒng)性評價丙酸倍氯米松灌腸和傳統(tǒng)糖皮質(zhì)激素灌腸治療遠端潰瘍性結(jié)腸炎的有效性及安全性。 方法:計算機檢索PubMed、EBSCO、The Cochrane Library、CBM、CNKI數(shù)據(jù)庫，篩選關(guān)于丙酸倍氯米松灌腸和傳統(tǒng)糖皮質(zhì)激素灌腸治療遠端潰瘍性結(jié)腸炎患者的隨機對照試驗。2名評價者獨立對納入文獻進行質(zhì)量評價和數(shù)據(jù)提取,采用RevMan5.0進行數(shù)據(jù)分析。 結(jié)果:共納入6篇研究共計351例患者，其中丙酸倍氯米松組181例、傳統(tǒng)糖皮質(zhì)激素組170例。Meta分析結(jié)果顯示:灌腸治療后兩組在內(nèi)鏡（OR=0.60,95%CI:0.17～2.17，， P=0.44）以及臨床癥狀（OR=1.00,95%CI:0.32～3.11，P=0.99）改善方面的差異無統(tǒng)計學(xué)意義；BDP對病理組織學(xué)改善優(yōu)于TGC（OR=0.33,95%CI:0.12～0.95，P=0.04）；灌腸治療后兩組的空腹皮質(zhì)醇濃度（MD=0.28,95%CI:0.09～0.48，P=0.004）及ACTH刺激試驗（MD=0.57,95%CI:0.29～0.84，P＜0.0001）有統(tǒng)計學(xué)差異。 結(jié)論:本文嚴格評價隨機對照試驗后表明：對于急性輕中度遠端潰瘍性結(jié)腸炎患者的治療，BDP與TGC灌腸在改善內(nèi)鏡與臨床癥狀方面有相似療效，在病理組織學(xué)方面BDP優(yōu)于TGC。BDP對下丘腦-垂體-腎上腺軸無明顯抑制作用，安全性高于TGC。
[Abstract]:Objective: to evaluate the efficacy and safety of beclomethasone propionate enema and traditional glucocorticoid enema for distal ulcerative colitis. Methods: a computer-based search was conducted for the Cochrane Library CBM Cochrane CNKI database. Two randomized controlled trials of beclomethasone propionate enema and traditional glucocorticoid enema for distal ulcerative colitis were carried out. The quality evaluation and data extraction of the literature were conducted independently. The data were analyzed by RevMan5.0. Results: a total of 351 patients were included in 6 studies, including 181 patients in beclomethasone propionate group. Meta-analysis of 170 cases in the traditional glucocorticoid group showed that there was no significant difference between the two groups in the improvement of the clinical symptoms and the improvement of the clinical symptoms: 0.6095CI0.170.172.17 and 0.3295CIW 0.323.11P0.99) after enema treatment, BDP was better than TGCORO 0.33995 CIW 0.120.95P0.04 in the improvement of histopathology. The fasting cortisol concentration was 0.2895% (CI: 0.09 0. 48% P0. 004) and the ACTH stimulation test was 0. 57% 0. 29% 0. 29% 0. 84% (P < 0. 0001). Conclusion: the results of a randomized controlled trial showed that BDP and TGC enema had similar efficacy in improving endoscopy and clinical symptoms in patients with acute mild to moderate distal ulcerative colitis. In histopathology, BDP was superior to TGC.BDP in inhibiting hypothalamus-pituitary-adrenal axis, and its safety was higher than that of TGC.BDP.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R574.62

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