甲泼尼龙与地塞米松治疗突发性耳聋疗效比较的Meta分析

目的 应用Meta分析的方法分析甲泼尼龙与地塞米松治疗突发性耳聋的疗效。方法 检索的数据库包括中国知网、万方、维普、CBM、PubMed、Medline、Embase、Cochrane等中英文数据库。检索关键词包括甲泼尼龙、地塞米松和突发性耳聋，质量评价采用纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale，NOS）。使用RevMan5.3软件进行Meta分析，风险比（risk ratio，RR）值和95% CI作为本次研究的效应指标，异质性检验的指标选用I²和P值。进行灵敏度检验及亚组分析，使用Egger's法定量分析是否存在发表偏倚，如果存在发表偏倚，使用剪补法进行评估。结果 两组治疗突发性耳聋的疗效比较，Z=4.91（P<0.000 1）、RR（95% CI）：1.20（1.12~1.29），差异有统计学意义（P<0.05）。亚组分析显示全身用药组Z=5.23（P<0.000 01）、RR（95% CI）：1.28（1.17~1.41），差异有统计学意义（P<0.05）。局部用药组Z=5.99（P<0.000 01）、RR（95% CI）：1.30（1.19~1.42），差异有统计学意义（P<0.05）。灵敏度分析Z=6.83（P<0.000 01）、RR（95% CI）：1.19（1.13~1.26），差异仍有统计学意义（P<0.05）。结论 甲泼尼龙治疗突发性耳聋的疗效优于地塞米松。

Efficacy comparison of methylprednisolone and dexamethasone treatment of sudden deafness:a system review and Meta-analysis

Objective To analyze methylprednisolone and dexamethasone treatment the curative effect of sudden deafness by Meta analysis. Methods The retrieval of database was performed including CNKI, Wanfang, VIP, CBM, PubMed, Medline, Embase, Cochrane database, which were from Chinese and English database. The retrieval keywords including methylprednisolone, dexamethasone, and sudden deafness and the quality evaluation was used to follow the Newcastle-Ottawa Scale (NOS).Using the RevMan5.3 software for Meta analysis, the risk ratio (RR) value indicators and 95% CI as the study effects, the test of heterogeneity indexed choosing I² and P value. Then sensitivity of the inspection and subgroup analyses were done, Egger's test were used to evaluate the publication bias.If the study indicated publication bias, using trim and filling method would be used to make an evaluation. Result By comparison of the two groups for the treatment of curative effect of sudden deafness, Z=4.91(P<0.000 1), RR(95% CI):1.20(1.12-1.29), the difference was statistically significant (P< 0.05).Subgroup analysis in systemic medication group Z=5.23(P<0.000 01), RR(95% CI):1.28(1.17-1.41), the difference was statistically significant (P<0.05). Local drug group Z=5.99(P<0.000 01), RR(95% CI):1.30(1.19-1.42), the difference was statistically significant (P<0.05).Sensitivity analysis:Z=6.83(P<0.000 01), RR(95% CI):1.19(1.13-1.26), the difference was statistically significant too(P<0.05). Conclusion The efficacy of methylprednisolone for the treatment of sudden deafness is better than the dexamethasone for the treatment of sudden deafness.