中国循证医学杂志
中國循證醫學雜誌
중국순증의학잡지
CHINESE JOURNAL OF EVIDENCE-BASED MEDICINE
2006年
7期
500-506
,共7页
声嘶%抗反酸治疗%随机对照试验%系统评价
聲嘶%抗反痠治療%隨機對照試驗%繫統評價
성시%항반산치료%수궤대조시험%계통평개
Hoarsenness%Acid reflux treatment%RCT%Systematic review
目的 通过全面检索前瞻性随机对照研究,系统评价在无其它明显病因时,抗返流疗法(药物或手术均可)治疗声嘶患者的疗效(无论是否确诊咽喉返流或胃食管返流).方法 用事先确定的关键词检索Cochrane ENT组临床试验注册库、Cochrane临床对照试验中心注册库(CENTRAL)(Cochrane图书馆2005年第3期)、MEDLINE(1966～2005)、EMBASE(1974～2005)及会议论文集.检索时间更新至2005年9月.研究对象为无其它明显病因(如恶性肿瘤、声带麻痹或结节),无论是否确诊咽喉返流或胃食管返流的声嘶患者的随机对照试验.由三名评价者浏览检索结果,筛选试验,以决定是否纳入本系统评价.结果 共检索到302项试验,但均不符合本评价纳入标准.其中有6项随机对照试验,报告其部分研究对象有声嘶症状,采用了质子泵抑制剂治疗.但我们无法确定其他研究对象的喉部症状是否包括声嘶,因此排除这些试验.但这些试验显示安慰剂也有明显效果,在某些试验中与抗返流疗法疗效相当.由于没有符合纳入标准的试验,对抗返流疗法治疗声嘶的疗效我们无法得出明确结论.结论 尚需高质量随机对照试验评价抗返流疗法对可能因咽喉返流或胃食管返流所致的声嘶的疗效.
目的 通過全麵檢索前瞻性隨機對照研究,繫統評價在無其它明顯病因時,抗返流療法(藥物或手術均可)治療聲嘶患者的療效(無論是否確診嚥喉返流或胃食管返流).方法 用事先確定的關鍵詞檢索Cochrane ENT組臨床試驗註冊庫、Cochrane臨床對照試驗中心註冊庫(CENTRAL)(Cochrane圖書館2005年第3期)、MEDLINE(1966～2005)、EMBASE(1974～2005)及會議論文集.檢索時間更新至2005年9月.研究對象為無其它明顯病因(如噁性腫瘤、聲帶痳痺或結節),無論是否確診嚥喉返流或胃食管返流的聲嘶患者的隨機對照試驗.由三名評價者瀏覽檢索結果,篩選試驗,以決定是否納入本繫統評價.結果 共檢索到302項試驗,但均不符閤本評價納入標準.其中有6項隨機對照試驗,報告其部分研究對象有聲嘶癥狀,採用瞭質子泵抑製劑治療.但我們無法確定其他研究對象的喉部癥狀是否包括聲嘶,因此排除這些試驗.但這些試驗顯示安慰劑也有明顯效果,在某些試驗中與抗返流療法療效相噹.由于沒有符閤納入標準的試驗,對抗返流療法治療聲嘶的療效我們無法得齣明確結論.結論 尚需高質量隨機對照試驗評價抗返流療法對可能因嚥喉返流或胃食管返流所緻的聲嘶的療效.
목적 통과전면검색전첨성수궤대조연구,계통평개재무기타명현병인시,항반류요법(약물혹수술균가)치료성시환자적료효(무론시부학진인후반류혹위식관반류).방법 용사선학정적관건사검색Cochrane ENT조림상시험주책고、Cochrane림상대조시험중심주책고(CENTRAL)(Cochrane도서관2005년제3기)、MEDLINE(1966～2005)、EMBASE(1974～2005)급회의논문집.검색시간경신지2005년9월.연구대상위무기타명현병인(여악성종류、성대마비혹결절),무론시부학진인후반류혹위식관반류적성시환자적수궤대조시험.유삼명평개자류람검색결과,사선시험,이결정시부납입본계통평개.결과 공검색도302항시험,단균불부합본평개납입표준.기중유6항수궤대조시험,보고기부분연구대상유성시증상,채용료질자빙억제제치료.단아문무법학정기타연구대상적후부증상시부포괄성시,인차배제저사시험.단저사시험현시안위제야유명현효과,재모사시험중여항반류요법료효상당.유우몰유부합납입표준적시험,대항반류요법치료성시적료효아문무법득출명학결론.결론 상수고질량수궤대조시험평개항반류요법대가능인인후반류혹위식관반류소치적성시적료효.
Objectives The aim of the review was to assess the effectiveness of anti-reflux therapy for patients with hoarseness, in the absence of other identifiable causes,whether or not a definitive diagnosis of laryngopharyngeal and gastro-oesophageal reflux has been made. This was assessed by evaluation of prospective randomised controlled studies that were identified by a systematic review of the literature. Both medical and surgical treatments were evaluated.Method The Cochrane ENT Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library Issue 3, 2005),MEDLINE (1966 to 2005), EMBASE (1974 to 2005) and conference proceedings were searched with prespecified terms. The date of the last search was September 2005.Randomised controlled trials recruiting patients with hoarseness in the absence of other identifiable causes, such as malignancy, cord palsy or nodules, whether or not a definitive diagnosis of laryngopharyngeal and gastro-oesophageal reflux has been made. Data collection and analysis Three reviewers examined the search results and identified studies before deciding which would be included in the review.Results 302 potential studies were identified by the search strategy. No trials were identified which met our inclusion criteria. Six randomised controlled trials were identified in which some, but not all patients presented with hoarseness, and were treated with proton pump inhibition. As we could not determine with certainty whether all these patients had hoarseness among the other laryngeal symptoms, these were excluded. However, these studies suggest a significant placebo response, which is comparable to the benefit derived from anti-reflux therapy in some studies. As no trials met our criteria, we are unable to reach any firm conclusions regarding the effectiveness of anti-reflux treatment for hoarseness.Conclusions There is a need for high quality randomised controlled trials to evaluate the effectiveness of anti-reflux therapy for patients with hoarseness which may be due to laryngopharyngeal and gastro-oesophageal reflux.
