摘要
目的采用网状Meta分析评价补硒治疗大骨节病的疗效。方法计算机检索Pub Med、EMbase、The Cochrane Library(2016年第7期)、CBM、VIP、Wan Fang Data和CNKI数据库,搜集所有补硒治疗大骨节病的随机对照试验(RCT),检索时限均为从建库至2016年7月。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 13.1软件进行分析。结果共纳入16个RCT,包括2 883例患者。Meta分析直接比较结果显示:亚硒酸钠[OR=5.00,95%CI(3.21,7.78)]、硒盐[OR=7.60,95%CI(2.34,24.67)]、以及亚硒酸钠+VE[OR=11.05,95%CI(2.61,46.80)]与安慰剂/空白对照组比较,干骺端X线好转率高。网状Meta分析结果显示:与安慰剂/空白对照组比较,亚硒酸钠、硒盐、亚硒酸钠+VE、亚硒酸钠+VC以及单独口服VC治疗后干骺端X线改善有效率较高,差异具有统计学意义。另外,亚硒酸钠+VE组的X线好转率高于亚硒酸钠+VC组以及单独口服VC组,其差异具有统计学意义。相对治疗效果排序为:亚硒酸钠+VE>硒盐>亚硒酸钠>亚硒酸钠+VC>VC>安慰剂/空白对照。结论网状Meta分析结果提示:亚硒酸钠、亚硒酸钠+VC、亚硒酸钠+VE,以及硒盐可以明显促进儿童大骨节病患者干骺端病变的修复,其中亚硒酸钠+VE效果最好。
Objective To assess the comparative efficacy of all kinds of selenium supplementation in the treatment of patients with Kashin-Beck disease （KBD） by network meta-analysis. Methods We searched seven electronic databases including PubMed, EMbase, The Cochrane Library （Issue 7, 2016）, CBM, VIP, WanFang Data and CNKI databases up to July 2016. All randomized controlled trials （RCTs） assessing the effect of selenium supplementation on KBD were included. Two reviewers independently screened literatures, extracted data and assessed the risk bias of included studies, and then meta-analysis was performed by using Stata13.1 software. Results A total of 16 RCTs involving 2 883 participants were included. Direct meta-analysis comparison showed that： Compared with placebo or blank group, sodium selenite （OR=5.00, 95%CI 3.21 to 7.78）, selenium supplement salt （OR=7.60, 95%CI 2.34 to 24.67）, and combination of sodium selenite and vitamin E （OR=11.05, 95%CI 2.61 to 46.80） had higher metaphysis X-ray improvement （P〈0.05）. Ranking on efficacy indicated that combination of sodium selenite and vitamin E were highest, followed by selenium supplement salt, sodium selenite, sodium selenite plus vitamin C, vitamin C, and placebo/blank. Conclusion Based on the results of network metaanalysis, selenium supplement （sodium selenite, combination of sodium selenite and vitamin C, combination of sodium selenite and vitamin E, as well as selenium salt） is more effective than placebo or no treatment in promoting the repairement of metaphysis impairment. The effect of combination of sodium selenite and vitamin E are highest.
出处
《中国循证医学杂志》
CSCD
2016年第11期1284-1290,共7页
Chinese Journal of Evidence-based Medicine
关键词
大骨节病
补硒
网状Meta分析
随机对照试验
Kashin-Beck disease
Selenium supplementation
Network meta-analysis
Randomized controlled trial
