摘要
目的运用Meta分析对糖皮质激素治疗自身免疫性甲状腺炎(AITD)的效果和安全性进行系统评价,以期得到临床上更理想的用药方案。方法通过Cochrane协作网工作手册制订检索策略并进行文献质量评价。检索中国知网、万方、维普、CBM、PubMed、Embase、Cochrane library、SCI、Clinical trial数据库,搜索建库至2019年3月20日前发表的糖皮质激素治疗AITD的随机对照试验。应用Revman 5.3进行Meta分析。结果共纳入15项研究。Meta分析结果显示:治疗组甲状腺过氧化物酶抗体(TPOAb)明显低于对照组,差异有统计学意义(SMD=-1.41,95%CI:-1.97,-0.85,P <0.05)。治疗组甲状腺球蛋白抗体(TGAb)明显低于对照组,差异有统计学意义(SMD=-1.51,95%CI:-2.11,-0.91,P <0.05)。治疗组甲状腺体积明显小于对照组,差异有统计学意义(SMD=-1.66,95%CI:-1.94,-1.37,P <0.05)。两组不良反应发生率比较,差异无统计学意义(OR=0.38,95%CI:0.06,2.51,P> 0.05)。结论糖皮质激素治疗AITD效果显著,能降低AITD的自身抗体水平,减小甲状腺体积,且短时间或者局部应用,不良反应小,能够在临床上使用。
Objective To systematic review the efficacy and safety of glucocorticoid in the treatment of autoimmune thyroiditis(AITD) through Meta-analysis. Methods Through the Cochrane Collaborative Network Manual, the retrieval strategy is formulated and the literature quality is evaluated. By searching the databases of CNKI, Wanfang, VIP, CBM,PubMed, Embase, Cochrane Library, SCI and Clinical trial were searched for randomized controlled trials of glucocorticoid for autoimmune thyroiditis published before March 20, 2019. Revman 5.3 was used for Meta-analysis. Results A total of 15 studies were included. The Meta-analysis showed that: the thyroid peroxidase antibody(TPOAb) in the treatment group was significantly lower than that in the control group, and the difference was statistically significant(SMD=-1.41, 95%CI:-1.97,-0.85, P < 0.05). The thyroglobulin antibody(TGAb) in the treatment group was significantly lower than that in the control group, and the difference was statistically significant(SMD=-1.51,95%CI:-2.11,-0.91, P < 0.05). The thyroid volume in the treatment group was significantly smaller than that in the control group, and the difference was statistically significant(SMD =-1.66, 95% CI:-1.94,-1.37, P <0.05). There was no significant difference in the incidence of adverse reactions between two groups(OR=0.38, 95%CI:0.06, 2.51, P > 0.05). Conclusion Glucocorticoid treatment of AITD has a significant effect. It can reduce the autoantibody level of AITD and the thyroid volume. Moreover, it has short-term or local application, small adverse reactions,and it can be used clinically.
作者
尹谢添
赵诗超
向楠
周广文
曾明星
YIN Xietian;ZHAO Shichao;XIANG Nan;ZHOU Guangwen;ZENG Mingxing(The First Clinical College,Hubei University of Chinese Medicine,Hubei Province,Wuhan 430061,China;Department of Rheumatism Immunology,Hubei Provincial Hospital of Traditional Chinese Medicine,Hubei Province,Wuhan 430061,China;Xiangnan Famous Medical Studio,Hubei Province,Wuhan 430061,China;Department of Geriatrics,Hubei Provincial Hospital of Traditional Chinese Medicine,Hubei Province,Wuhan 430061,China;College of Acupuncture and Orthopedics,Hubei University of Chinese Medicine,Hubei Province,Wuhan 430061,China;College of Basic Medical Hubei,University of Medicine,Hubei Province,Wuhan 430061,China)
出处
《中国医药导报》
CAS
2019年第31期88-93,共6页
China Medical Herald
基金
湖北省卫健委“向楠名医工作室”项目(鄂卫生计生通报[2018]15)
湖北省高等学校优秀中青年科技创新团队(T201708)