高压氧治疗突发性耳聋效果评价的Meta分析

摘要

目的:探讨高压氧治疗对突发性耳聋的疗效,为其治疗提供指导.方法:检索Cochrane图书馆、PubMed、MEDLINE、万方数据库和中国知网数据库自建库到2016年7月有关高压氧联合药物治疗突发性耳聋的文献.应用Cochrane协作网提供的RevMan 5.3软件对纳入文献的数据进行处理.结果:共纳入39篇随机对照试验(RCTs)文献,共计4 599例患者,其中高压氧联合药物治疗2 418例(治疗组),单纯药物治疗2 181例(对照组).纳入36篇文献对治疗组和对照组之间临床疗效进行Meta分析,治疗组疗效优于对照组(RR:1.26,95%CI:1.22~1.30,P<0.000 1).纳入6篇文献比较治疗组与对照组言语频率平均听阈(PTA)改善程度,治疗组PTA改善更明显(WMD:11.8,95%CI:4.77~18.83,P<0.000 1).纳入11篇文献分析引入高压氧治疗的早晚对临床疗效的影响,早期联合高压氧治疗优于晚期(RR:1.42,95%CI:1.31~1.53,P<0.000 01). 结论:高压氧联合药物治疗对于突发性耳聋疗效优于单纯药物治疗,并可明确改善PTA,且早期联合高压氧治疗疗效优于晚期治疗.%Objective:To evaluate the clinical efficacy of treatment of sudden deafness using hyperbaric oxygenation, and to provide guidance for its treatment. Methods:The studies about sudden deafness treated with hyperbaric oxygenation combined with drug were retrieved in Cochrane Library, PubMed , MEDLINE, Wanfang Database and CNKI up to July 2016.RavMan 5.3 provided by Cochrane was used for Meta-analysis.Results:Thirty-nine studies which were randomized controlled trials (RCTs)were included, a total of 4 599 cases,of which 2 418 cases received hyperbaric oxygenation therapy combined with drug treatment as treatment group and 2 181 cases received drug treatment alone as control group.A total of 36 studies about the comparison of clinical efficacy between treatment group and control group were included in the Meta-analysis, the result showed that treatment group had a significant clinical efficacy than control group(RR:1.26,95%CI:1.22-1.30,P<0.0001).A total of 6 studies about the improvement of the pure tone average(PTA)in the two groups were included in the Meta-analysis, the PTA gain was significant better in hyperbaric oxygenation group(WMD:11.8,95%CI:4.77-18.83,P<0.000 1).A total of 11 studies about the stage of using hyperbaric oxygenation therapy were included in the Meta-analysis, the result suggested that the early use of hyperbaric oxygenation therapy had better effect than the late use of hyperbaric oxygenation (RR:1.42,95%CI:1.31-1.53,P<0.000 01).Conclusion:The clinical efficacy of hyperbaric oxygenation combined with drug therapy is better than drug therapy alone, the PTA gain is significantly improved and the introduction of hyperbaric oxygenation therapy at the earlier stage shows better results.