神经节苷脂对脑瘫患儿疗效的meta分析

目的研究对神经节苷脂（gangliosides，GM-1）治疗脑瘫（cerebral palsy，CP）患儿的疗效进行评价。方法采用相关的检索词检索Cochrane图书馆、MedLine、中文科技期刊全文数据库（CNKI）和中国科技期刊数据库（VIP）获取发表的系统评价（systematic evaluation）和随机对照试验（randomized trial controlled，RTC）及临床对照试验文献。每篇文献由2位系统评价者进行资料提取和质量评价，对同质资料运用RevMan4．3．2软件进行meta分析。结果4篇文献涉及的4项研究（n=325）符合纳入标准。Meta分析结果显示，神经节苷脂治疗组脑瘫患儿的症状和体征改善效果RR=1.24，95％CI（0．95，1．62）]及发育商数（developmental quotient，DQ）值RR=1．20，95％CI（1．06，1．36）]，优于或高于对照组，两组比较，差异有显著意义（P〈0．05）。结论使用神经节苷脂＋基础康复治疗，如运动康复疗法、针灸、按摩等，可增加脑瘫患儿疗效。但由于本系统评价纳入的研究均不是严格的随机对照试验，且样本量较小，故论证强度不够，尚期待高质量、大样本、多中心的随机对照试验对此提供更有力的证据。

Meta Analysis of the Clinical Efficiency of Gangliosides on Children With Cerebral Palsy

Objective To evaluate the efficiency of gangliosides（GM-1） in the treatment of cerebral palsy （CP）. Methods Eligible studies were identified by searching Cochrane library, MedLine, CNKI and VIP. No language restrictions were applied. Two reviewers assessed the quality of included studies and extracted data and processed recta-analysis. All randomized and quasi-randomized trials comparing treatment with and without gangliosides with clinical endpoints were reviewed. Development quotient （DQ） was measured by Gesell. RevMan 4.3.2 was used to do the statistical analysis. Results Four trials involving 325 patients with cerebral palsy were included. All trials were case-control trials. Meta analysis indicated that using the gangliosides could alter the symptoms and signs for the better RR= 1.24, 95%CI（0. 95, 1.62）] 1, and developmental quotient values increased RR = 1. 20, 95 % CI （1.06,1.36）], and there were statistic significance. Conclusion Gangliosides combined with other treatments can improve the manifestations and developmental quotient of cerebral palsy. However, due to all included trials are not randomized trial controlled （RTC）, and numbers of patients of these trials are relatively small, more welldesigned multi-center randomized controlled trials should be performed.