中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2013年
8期
634-639
,共6页
王晓燕%吉彬%雍军%刘立中
王曉燕%吉彬%雍軍%劉立中
왕효연%길빈%옹군%류립중
眩晕%半规管%物理治疗技术%治疗结果%Meta分析
眩暈%半規管%物理治療技術%治療結果%Meta分析
현훈%반규관%물리치료기술%치료결과%Meta분석
Vertigo%Semicircular canals%Physical therapy modalities%Treatment outcome%Meta-analysis
目的 系统评价改良Epley法与改良Semont法治疗后半规管良性阵发性位置性眩晕(BPPV)的临床疗效,以期为临床耳石复位法的选择提供循证依据.方法 计算机检索中国学术期刊全文数据库(CNKI)、万方数据库、中国生物医学文献光盘数据库(CBM)、OVID、PubMed、EMBASE和Cochrane Library(2013年第1期)以及康健循证医学知识仓库,检索时间截至2013年2月,纳入有关改良Epley法与改良Semont法治疗后半规管BPPV的随机对照实验,经两位研究者独立进行文献筛选、资料提取和方法学质量评价后,采用RevMan 5.1软件进行Meta分析.结果 共纳入6个随机对照实验,合计453例患者,其中改良Epley法治疗组232例,改良Semont法治疗组221例.Meta分析结果显示:改良Epley法治疗一周时的疗效(包括一周治愈率和一周有效率)优于改良Semont法,其差异均具有统计学义[OR=3.25,95％ CI(2.08,5.10),P＜0.01；OR =4.72,95％ CI(1.16,19.15),P=0.03]；而在三个月治愈率、不良反应发生率以及复发率上,两组结果相近,差异均无统计学意义[OR =2.10,95％ CI(0.57,7.75),P =0.27;OR =0.82,95％ CI(0.44,1.52),P =0.53;OR =0.56,95％CI(0.20,1.57),P=0.27].结论 改良Epley法在快速缓解后半规管BPPV症状方面优于改良Semont法,但长期疗效、复发率和不良反应发生率二者相当,由于受纳入文献质量的限制和可能存在的发表性偏倚的影响,上述结论尚需更多高质量随机双盲对照试验加以验证.
目的 繫統評價改良Epley法與改良Semont法治療後半規管良性陣髮性位置性眩暈(BPPV)的臨床療效,以期為臨床耳石複位法的選擇提供循證依據.方法 計算機檢索中國學術期刊全文數據庫(CNKI)、萬方數據庫、中國生物醫學文獻光盤數據庫(CBM)、OVID、PubMed、EMBASE和Cochrane Library(2013年第1期)以及康健循證醫學知識倉庫,檢索時間截至2013年2月,納入有關改良Epley法與改良Semont法治療後半規管BPPV的隨機對照實驗,經兩位研究者獨立進行文獻篩選、資料提取和方法學質量評價後,採用RevMan 5.1軟件進行Meta分析.結果 共納入6箇隨機對照實驗,閤計453例患者,其中改良Epley法治療組232例,改良Semont法治療組221例.Meta分析結果顯示:改良Epley法治療一週時的療效(包括一週治愈率和一週有效率)優于改良Semont法,其差異均具有統計學義[OR=3.25,95％ CI(2.08,5.10),P＜0.01；OR =4.72,95％ CI(1.16,19.15),P=0.03]；而在三箇月治愈率、不良反應髮生率以及複髮率上,兩組結果相近,差異均無統計學意義[OR =2.10,95％ CI(0.57,7.75),P =0.27;OR =0.82,95％ CI(0.44,1.52),P =0.53;OR =0.56,95％CI(0.20,1.57),P=0.27].結論 改良Epley法在快速緩解後半規管BPPV癥狀方麵優于改良Semont法,但長期療效、複髮率和不良反應髮生率二者相噹,由于受納入文獻質量的限製和可能存在的髮錶性偏倚的影響,上述結論尚需更多高質量隨機雙盲對照試驗加以驗證.
목적 계통평개개량Epley법여개량Semont법치료후반규관량성진발성위치성현훈(BPPV)적림상료효,이기위림상이석복위법적선택제공순증의거.방법 계산궤검색중국학술기간전문수거고(CNKI)、만방수거고、중국생물의학문헌광반수거고(CBM)、OVID、PubMed、EMBASE화Cochrane Library(2013년제1기)이급강건순증의학지식창고,검색시간절지2013년2월,납입유관개량Epley법여개량Semont법치료후반규관BPPV적수궤대조실험,경량위연구자독립진행문헌사선、자료제취화방법학질량평개후,채용RevMan 5.1연건진행Meta분석.결과 공납입6개수궤대조실험,합계453례환자,기중개량Epley법치료조232례,개량Semont법치료조221례.Meta분석결과현시:개량Epley법치료일주시적료효(포괄일주치유솔화일주유효솔)우우개량Semont법,기차이균구유통계학의[OR=3.25,95％ CI(2.08,5.10),P＜0.01；OR =4.72,95％ CI(1.16,19.15),P=0.03]；이재삼개월치유솔、불량반응발생솔이급복발솔상,량조결과상근,차이균무통계학의의[OR =2.10,95％ CI(0.57,7.75),P =0.27;OR =0.82,95％ CI(0.44,1.52),P =0.53;OR =0.56,95％CI(0.20,1.57),P=0.27].결론 개량Epley법재쾌속완해후반규관BPPV증상방면우우개량Semont법,단장기료효、복발솔화불량반응발생솔이자상당,유우수납입문헌질량적한제화가능존재적발표성편의적영향,상술결론상수경다고질량수궤쌍맹대조시험가이험증.
Objective To evaluate the efficacy of the modified Epley maneuver Versus modified Semont maneuver for posterior canal benign paroxysmal positional vertigo.Methods The randomized controlled trials (RCT) about modified Epley maneuver Versus modified Semont maneuver for posterior canal benign paroxysmal positional vertigo from January 1985 to July 2013 were searched in CNKI,OVID,PubMed,CBM,EMBASE,WanFang Data,and Cochrane Library.Two reviewers independently screened the literatures,extracted the data,and evaluated the methodological quality.Then meta-analyses were conducted by using RevMan 5.1 software.Results A total of six RCTs were included.Among the 453 patients involved,232 patients were in the modified Epley maneuver group,while the other 221 patients were in the modified Semont maneuver group.The results of meta-analyses showed that the efficacy of the modified Epley maneuve group was superior to that of the modified Semont maneuver group in one-week cure rate [OR =3.25,95％ CI (2.08,5.10),P ＜ 0.01],one-week efficient [OR =4.72,95 ％ CI (1.16,19.15),P =0.03],with significant differences.There was no significant difference between the two groups in threemonths cure rate [OR =2.10,95％ CI(0.57,7.75),P =0.27],incidence of adverse reactions [OR =0.82,95％ CI(0.44,1.52),P =0.53] and relapse rate [OR =0.56,95 ％ CI (0.20,1.57),P =0.27].Conclusions Based on the current studies,modified Epley maneuver is superior to modified Semont maneuver in quicking relief posterior canal benign paroxysmal positional vertigo symptoms,but the long-term efficacy,recurrence rate and incidence of adverse reactions had no significant difference.For the quality restrictions and possible publication bias of the included studies,more double blind RCTs with high quality are required to further assess the effects.
