摘要
目的探讨质子泵抑制剂(proton pump inhibitors,PPIs)对成人咽喉反流性疾病(laryngopharyngeal ref lux disease,LPR D)的治疗作用及安全性。方法以建库至2017年8月18日为检索时限,系统检索Pub Med、Cochrane Library、EMBASE、Web of Science、CNKI、CBM、VIP and WANFANG数据库,查找所有PPIs与安慰剂对照治疗LPRD相关临床随机对照试验。严格按照纳入排除标准进行筛选,数据提取和质量评估。采用Rev Man 5.2软件进行Meta分析,并采用GRADE进行证据质量评价。结果共纳入14个随机对照试验(randomized controlled trial,RCT),815例患者,其中使用PPI 438人,使用安慰剂377人。Meta分析结果显示:采用反流症状指数量表(reflux symptoms index,RSI)作为疗效评定结局指标,PPI组与安慰剂组比较有明显改善,[SDM=2.12,95%CI(0.80,3.45),P<0.05];总体有效率方面,PPI组显示有效,但其疗效与安慰剂组比较无明显统计学差异,[OR=1.62,95%CI(0.89,2.95),P>0.05]。结论 PPIs在改善咽喉反流性疾病患者症状方面效果显著,在LPRD患者的治疗策略中建议使用,可以联合生活方式调节。
OBJECTIVE To explore validity and reliability of proton pump inhibitors（PPI） in adult patients with laryngopharyngeal reflux disease（LPRD）. METHODS Randomized and placebo-controlled clinical trials regarding the effectiveness of PPIs on LPRD patients were systematically extracted from Pub Med, Cochrane Library, and EMBASE, Web of Science, CNKI, CBM, VIP and WANFANG from the beginning of indexing to August 2017. After selection and quality assessment, data were extracted from eligible studies meeting the exclusion and inclusion criteria. The Review Manager software（version 5.2, The Cochrane Collaboration） was performed for all of the statistical analysis in this meta-analysis. The level of evidence was assessed by the GRADE（Grades of Recommendation, Assessment, Development and Evaluation）. RESULTS The sample comprised 14 RCTs including a pooled total of 821 LPRD patients were eligible for this meta-analysis, of which 447 and 374 patients took PPIs and placebo, respectively. Pooled results demonstrated that total RSI significantly improved for patients who received PPI therapy by comparing with those receiving placebo [SDM=2.12, 95%CI（0.80, 3.45）, P 〈0.05]. PPI treatment group showed effective in response rate [OR=1.62, 95%CI（0.89, 2.95）, P〉0.05], but the differences between PPIs and placebo groups was not statistically significant.CONCLUSION PPI treatment could significantly improve reflux symptoms in LPRD patients, therefore, should be taken into consideration for LPRD management with other strategies, such as lifestyle modification.
作者
吕芸
何健
卫旭东
张守凯
方媛
杨小龙
LYU Yun1, HE Jian2, WEI Xudong2, ZHANG Shoukai2, FANG Yuanl, YANG Xiaolong2(1 Department of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, 730000, China; 2 Department of Otolaryngology Head and Neck Surgery, Gansu Provincial Hospital, Lanzhou, Gansu, 730000, Chin)
出处
《中国耳鼻咽喉头颈外科》
CSCD
2018年第3期150-156,共7页
Chinese Archives of Otolaryngology-Head and Neck Surgery
关键词
Meta分析[文献类型]
治疗结果
咽喉反流
质子泵抑制剂
Meta-Analysis[Publication Type]
Treatment Outcome
laryngopharyngeal reflux
proton pump inhibitors
