气囊扩张和肉毒毒素注射治疗贲门失弛缓症中远期疗效比较的荟萃分析

背景：一些随机对照试验比较了气囊扩张和肉毒毒素注射治疗贲门失弛缓症的中远期疗效。但结论不尽一致。目的：评价气囊扩张和肉毒毒素注射治疗贲门失弛缓症的中远期疗效。方法：通过GUT、中国生物医学文献数据库（CBMdisc）、PubMed和维普中文科技期刊全文数据库（VIP）检索有关比较气囊扩张和肉毒毒素注射治疗贲门失弛缓症中远期（6～12个月）疗效的研究，行荟萃分析。应用RevMan4．2软件，采用固定效应模型分析各研究中两组中远期症状缓解率的OR值，荟萃分析总OR值。结果：气囊扩张组贲门失弛缓症的中远期症状缓解率显著高于肉毒毒素注射组（OR：3．06，95％CI：1．82～5．14，P〈0．0001）。结论：气囊扩张治疗贲门失弛缓症的中远期疗效显著优于肉毒毒素注射疗法，临床医师可根据患者的耐受程度、治疗需达到的目的等因素选择治疗方案。

Mid- and Long-term Eflicacies of Pneumatic Dilatation and Endoscopic Injection of Botulinus Toxin in the Treatment of Achalasia:A Meta-analysis

Background： There have been several randomized controlled trials comparing the mid- and long-term efficacies of pneumatic dilatation and endoscopic injection of botulinus toxin in treating achalasia, but with varying conclusions. Aims： To appraise the mid- and long-term efficacies of pneumatic dilatation and endoscopic injection of botulinus toxin in treating achalasia. Methods： GUT, China Biological Medicine Disc （CBMdisc）, PubMed, and VIP Chinese Scientific and Technologic Periodical Database were searched for studies comparing mid- and long-term （6-12 months） efficacies of pneumatic dilatation and endoscopic injection of botulinus toxin in treating achalasia, which were included in the meta- analysis. With the RevMan 4.2 software, meta-analysis was performed by combining the odds ratio （OR） of mid- and long- term symptomatic relief rates in the individual studies with fixed effect model. Results： Mid- and long-term symptomatic relief rate of achalasia in pneumatic dilatation group was significantly higher than that in endoscopic injection of botulinus toxin group （OR： 3.06, 95% CI： 1.82-5.14, P〈0.0001）. Conclusions： Mid- and long-term efficacy of pneumatic dilatation is superior to endoscopic injection of botulinus toxin in treating achalasia. Clinicians can select the better therapy according to the tolerance of patients and the goals of treatment.