纳米银与磺胺嘧啶银治疗烧伤创面疗效比较的Meta分析

背景:国内外应用纳米银治疗烧伤创面较为广泛,但临床研究报道多为小样本随机对照研究,缺乏循证医学方面的依据和说服力。目的:对纳米银与磺胺嘧啶银治疗烧伤创面疗效进行系统评价。方法:计算机检索PubMed、Sciencedirect(SD)数据库、重庆维普中文科技期刊全文数据库(VIP,1989/2010)和清华同方数据库(CNKI,1979/2010),收集有纳米银制剂治疗烧伤与磺胺嘧啶银治疗相比较的随机对照实验。评价纳入研究的方法学质量并进行资料提取后,采用RevMan5.1软件进行Meta分析。结果与结论:共纳入8个随机对照实验,包括513例Ⅱ度烧伤患者。Meta分析结果显示:创面愈合时间纳米银治疗组少于磺胺嘧啶银组(P<0.001);第15天创面愈合率纳米治疗组与对照组差异无显著性意义,结果为(MD=7.10,95%CI=-2.29~16.50,P=0.14);纳米银治疗组和磺胺嘧啶银组相比,在减少烧伤创面疼痛方面两者差异有显著性意义(P<0.00001)。提示应用纳米银与应用磺胺嘧啶银相比能明显促进烧伤创面的愈合,对缓解创面疼痛程度优势明显,但尚需大样本高质量随机对照研究去进一步证实。

Meta-analysis of nanocrystalline silver versus silver sulfadiazine in the treatment of burn wounds

BACKGROUND: Nanocrystalline silver (NS) is widely used in the treatment of burn wounds, and many articles have confirmed the effectiveness of NS treatment. However the deficient number of cases impacts the credibility of the articles and relevant evidence-based medicine studies are rare. OBJECTIVE: To systematic review the effects of NS and nanocrystalline silver (SD-Ag) for the treatment of second-degree burns. METHODS: Pubmed, science direct (SD), VIP (from 1989 to 2010) and CNKI (from 1979 to 2010) were searched. Randomized controlled trials (RCTs) of NS and SD-Ag for second-degree burns were collected. The methodological quality of the included studies was evaluated, and data analysis was performed using the Cochrane Collaboration’s software RevMan 5.1. RESULTS AND CONCLUSION: A total of 8 RCTs involving 513 second-degree burns patients were included. Meta analysis of the results was presented: the wound healing time in the NS treatment group was less than that in the control group (SD-Ag group) (P<0.001). The wound healing rate between NS treatment and control groups were not significantly different at 15 days (MD=7.10, 95%CI=-2.29 to 16.50, P=0.14). But in reliefing the pain there was statistical difference between the two groups (P<0.000 01). According to the evidence, treatment for second-degree burns with NS can improve the wound healing rate and relief the pain of wounds. But it still needs a large sample of high-quality randomized controlled studies to be further confirmed.