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中华眼科医学杂志(电子版) ›› 2017, Vol. 07 ›› Issue (03) : 114 -120. doi: 10.3877/cma.j.issn.2095-2007.2017.03.004

所属专题： 总编推荐； 文献；

论著

中西药联合治疗流行性角结膜炎临床治疗效果的Meta分析
贺莉1, 喻京生1,†()   
  1. 1. 410007　长沙，湖南中医药大学第一附属医院眼科
  • 收稿日期:2017-06-24 出版日期:2017-06-28
  • 通信作者: 喻京生

Meta analysis of clinical research on the treatment of epidemic keratoconjunctivitis with combination of Chinese and western medicine

Li He1, Jingsheng Yu1,†()   

  1. 1. Department of Ophthalmology, Hunan University of Chinese Medicine & the First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha 410007, China
  • Received:2017-06-24 Published:2017-06-28
  • Corresponding author: Jingsheng Yu
  • About author:
    Corresponding author: Yu Jingsheng, Email:
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引用本文：

贺莉, 喻京生. 中西药联合治疗流行性角结膜炎临床治疗效果的Meta分析[J]. 中华眼科医学杂志(电子版), 2017, 07(03): 114-120.

Li He, Jingsheng Yu. Meta analysis of clinical research on the treatment of epidemic keratoconjunctivitis with combination of Chinese and western medicine[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2017, 07(03): 114-120.

目的

采用Meta分析的方法对国内外已公开发表的关于中西药联合治疗流行性角膜结膜炎(EKC)的临床疗效进行系统评价，为临床治疗EKC提供参考。

方法

检索PubMed、MEDLINE、中国知网、万方数据库、维普数据库及中国生物医学文献数据库中收录的中西药联合治疗EKC的中、英文文献。依据纳入与排除标准筛选文献，对纳入研究的数据进行提取，将采用中西药联合治疗的患者作为治疗组，采用西药治疗的患者作为对照组。按照Meta分析的要求对检索到的文献进行质量评估，并采用Review Manager 5.3软件对纳入的研究进行Meta分析，评价中西药联合治疗EKC的临床疗效。采用修改后的Jadad质量记分法对纳入文献进行质量评价。各研究间采用卡方检验进行异质性检验，若P>0.05，表示同质性较好，采用固定效应模型；否则采用随机效应模型计算合并效应量。总有效率采用相对危险度(OR)及95%可信区间表示。

结果

共纳入符合标准的文献7篇，共包含520例(1022只眼)患者，其中，治疗组553只眼，对照组469只眼。7篇文献均比较了治疗组与对照组EKC患者的治疗总有效率，经异质性检验，I2＝15%，P>0.05，提示同质性良好，故采用固定效应模型进行Meta分析。结果显示两组差异有显著统计学意义(OR＝9.00，95%可信区间：4.53～17.89，Z＝6.27；P<0.05)，说明中西药联合组与西药组总体相比，中西药联合治疗的方式疗效更好。

结论

中西药联合治疗EKC相对于单纯的西药治疗有较显著的优势。

关键词: 流行性角结膜炎, 中西药联合疗法, Meta分析
Objective

System evaluation about the clinical efficacyof combining traditional Chinese and western medicine for epidemic keratoconjunctivitispublished at home and abroad by the method of Meta analysis, and provide reference for clinicaltreatment of EKC.

Methods

Through the collection of PubMed, MEDLINE, China retrieval CNKI, Wanfang database, VIP database and China biomedical literature database of Chinese medicine combined with western medicine in the treatment of EKC related Chinese and English literature. According to the inclusion and exclusion criteria, the literature was extracted, and the data of the study were extracted. The combination of Chinese medicine and Western medicine was used as the treatment group, and Western medicine treatment as the control group. According to the requirement of the Meta analysis to evaluate the quality of the literature retrieved, and use the RevMan5.3 for researching according to the Meta analysis, evaluation of the clinical curative effect of EKC. The revised Jadad quality scoring method was used to evaluate the included literature. The chi square test was used to test the heterogeneity of the study. If the P>0.05 indicated the homogeneity was better, the fixed effect model was used; otherwise, the random effect model was used to calculate the combined effect. The total effective rate was expressed by relative risk (OR) and 95% confidence interval.

Results

7 trials including 520 patients were included. There were 553 eyes in the treatment group and 469 eyes in the control group. 7 articles are the combination of traditional Chinese and Western medicine treatment group and the control group, the total effective rate of treating EKC, after heterogeneity test, the difference was statistically significant (I2=15%, P>0.05), suggesting good homogeneity, so we use the fixed effect model of Meta analysis. The results showed that the difference between the two groups was statistically significant(OR=9.00, 95% confidence interval: 4.53~17.89, Z=6.27, P<0.05). It shows that the combination of traditional Chinese medicine and Western medicine is better than western medicine in the treatment of traditional Chinese medicine and Western medicine.

Conclusion

The overall effective rate of combining traditional Chinese and western medicine for EKC is significantly superior to control group.

Key words: Epidemic keratoconjunctivitis, Combination of Chinese traditional and Western medicine, Meta-analysis
表1 纳入研究文献的基本特征
项目 眼数(治疗组/对照组) 失访 疗程(d) 治疗组的治疗方法 对照组的治疗方法 Jadad评分
赵凤英[8] 94/87 未提及 9～14 双黄连粉针剂联合西药治疗 西药治疗 1
张琴[9] 145/130 无 4～9 中药汤剂联合西药治疗 西药治疗 1
刘元真[10] 82/53 无 10 平肝明目汤联合西药治疗 西药治疗 1
邬文彬[11] 60/40 无 7～14 祛风散热饮子联合西药治疗 西药治疗 1
徐东[12] 38/30 无 7 中药汤剂联合西药治疗 西药治疗 2
鄢小维[13] 70/69 无 7 石决明散联合西药治疗 西药治疗 1
李越[14] 64/60 无 7 菊花决明散联合西药治疗 西药治疗 1
图1 中西药联合治疗与单纯西药治疗EKC的Meta分析图
图2 中西药联合治疗EKC的漏斗图　各研究点分布于轴线两侧，图形不对称
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