CAJ | 학술논문

目的：综合评价有机硒对地方性砷中毒患者的治疗效果，为今后进行地方性砷中毒的药物预防与干预提供科学依据。方法计算机检索万方数据库、维普数据库（ VIP）、中国知网数据库（ CNKI）、PubMed、EBSCO、OVID， Springer、Sciencedirect，并结合文献追溯的方法，收集1994~2012年在国内外发表的关于我国地方性砷中毒药物干预的随机对照研究，包括自身对照、空白对照、及相互对照试验，以人体平均尿砷及血砷浓度为结局指标，干预手段为补充人体有机硒。选择符合纳入标准的临床试验，评价其方法学质量，并从中获取患者基本情况、干预措施、终点指标和结果等相关资料进行 Meta 分析。结果本研究共纳入9篇文献，合计664例患者纳入研究，采用 Jadad 量表对文献进行质量评价，纳入试验2项为低质量，7项为高质量。Meta 分析结果显示：平均尿砷浓度 WMD 为-18.90（95% CI 为-27.96~-9.85）；平均血砷浓度 WMD 为-10.75（95% CI 为-23.05~1.56）；补硒干预可有效降低尿液及血清中砷离子的浓度。结论补充有机硒干预可降低尿液和血清中砷离子浓度，对砷中毒患者具有一定的排砷作用。但纳入研究的9项试验总样本量小，降低了这一结论的可靠性。开展高质量、内在真实性好的相关随机对照试验非常必要。
목적：종합평개유궤서대지방성신중독환자적치료효과，위금후진행지방성신중독적약물예방여간예제공과학의거。방법계산궤검색만방수거고、유보수거고（ VIP）、중국지망수거고（ CNKI）、PubMed、EBSCO、OVID， Springer、Sciencedirect，병결합문헌추소적방법，수집1994~2012년재국내외발표적관우아국지방성신중독약물간예적수궤대조연구，포괄자신대조、공백대조、급상호대조시험，이인체평균뇨신급혈신농도위결국지표，간예수단위보충인체유궤서。선택부합납입표준적림상시험，평개기방법학질량，병종중획취환자기본정황、간예조시、종점지표화결과등상관자료진행 Meta 분석。결과본연구공납입9편문헌，합계664례환자납입연구，채용 Jadad 량표대문헌진행질량평개，납입시험2항위저질량，7항위고질량。Meta 분석결과현시：평균뇨신농도 WMD 위-18.90（95% CI 위-27.96~-9.85）；평균혈신농도 WMD 위-10.75（95% CI 위-23.05~1.56）；보서간예가유효강저뇨액급혈청중신리자적농도。결론보충유궤서간예가강저뇨액화혈청중신리자농도，대신중독환자구유일정적배신작용。단납입연구적9항시험총양본량소，강저료저일결론적가고성。개전고질량、내재진실성호적상관수궤대조시험비상필요。
Objective In order to systematically evaluate the efficacy of organic selenium in treatment of patients with endemic arsenic poisoning,and to provide the reference for taKing drug for prevention and intervention in the field of endemic arsenic poisoning. Methods The database including WANFANG,VIP,CNIK,PubMed,EBSCO,OIVD,Springer,Sciencedirect,combined with the method of literature survey, and randomly collected controlled studies on drug intervention for endemic arsenic poisoning by taKing selenium,and these studies were published in domestic and foreign references during 1994 to 2012. Its control experiments,blanK control experiment met the need for control experiments. The clinical trials conformed to the joining standard,taKing 〞As in urine〞 and 〞As in serum〞 as the indicators and their methodological quality had been evaluated,the basic situation of patients,intervention and relevant data about the ending indicators and results for maKing systematically evaluation had been taKen. Results This study included 9 studies containing 664 patients. The quality of study had been evaluated by 〞Jadad〞scale,which found that the quality of 2 was low and 7 of them were high. The result of Meta analysis showed that:WMD of the average of 〞As in urine〞 was - 18. 90(95% CI - 27. 96 ~ - 9. 85),and WMD of the average of 〞As in serum〞 was - 10. 75(95% CI - 23. 05 ~ 1. 56). Conclu-sion The supplementation of organic selenium can reduce the concentration of As in urine and serum. So organic selenium has the effect of dis-charging arsenic,but these 9 studies have insufficient sample size,thus it may reduce the reliability of conclusion. So it is necessary to carry out more good and reliable experiments.