质子泵抑制剂与促胃肠动力药治疗咽喉反流的Meta分析  

Proton Pump Inhibitor and Prokinetic Drug on the Treatment of Laryngopharyngeal Reflex Diseases:A Meta-analysis

作　　者：邓智锋[1] 许昱[1] 周涛[1] 屈季宁[1] 刘昀[1] 欧劲 石文丹[1] 

机构地区：[1]武汉大学人民医院耳鼻咽喉头颈外科,武汉430060

出　　处：《听力学及言语疾病杂志》2014年第1期39-44,共6页Journal of Audiology and Speech Pathology

摘　　要：目的评价质子泵抑制剂联合促胃肠动力药治疗咽喉反流的疗效和安全性。方法根据预定的纳入、排除标准,在cochrane图书馆、Embase、Elsevier、Pubmed、维普数据库(VIP)、万方数据库、中国知网(CNKI)和中国生物医学文献数据库(CBM)等中英文数据库中对应用质子泵抑制剂与促胃肠动力药治疗咽喉反流的文献进行检索,检索时限均为从建库至2012年11月。由三名评价员独立提取资料,应用Meta分析软件包Revman 5.1和GRAEDprofiler3.6对纳入的文献进行统计分析。结果共检索相关文献346篇,最终共纳入7篇符合纳入标准的文献,共614例患者,试验组及对照组各307例,试验组治疗方案为质子泵抑制剂和促胃肠动力药联合治疗,对照组为单用其中一种药。Meta分析结果显示:质子泵抑制剂和促胃肠动力药联合治疗咽喉反流患者的总体有效率高于对照组[RR=1.18,95%CI(1.10,1.28),P<0.0001];纤维喉镜检查咽喉部体征好转率高于对照组[RR=1.38,95%CI(1.16,1.65),P<0.001];发声障碍症状平均消失时间短于对照组[MD=-1.70,95%CI(-2.95,-0.45),P<0.001]。结论质子泵抑制剂联合促胃肠动力药较分别单用这两类药治疗咽喉反流的疗效更显著,但就安全性而言,尚需更多的大样本、多中心、方法科学的高质量随机对照实验来进一步论证。Objective To evaluate the efficacy and safety of proton pump inhibitor （PPI）plus prokinetic drug on the treatment of laryngopharyngeal reflex. Methods According to predetermined criteria of inclusion and exclu-sion, Cochrane Central Register of Controlled Trails （CENTRAL）, Embase, Elsevier, Pubmed, VIP, Wanfang Data, CNKI and CBM were searched for the randomized controlled trails of proton pump inhibitor and prokinetic drug on the treatment of laryngopharyngeal reflex diseases from the date of establishment of the datebases to November 2012. Revman 5.1 software and GRAED profiler 3.6 software were applied to analysis the data, which was extrac- ted by three independent evaluators. Results A total of 346 related articles were obtained, 7 trails were included, 614 patients in total. The results of Meta-analysis showed that： the overall effictive rate of combination therapy with proton pump inhibitors plus prokinetic drug in patients with laryngopharyngeal reflex was higher than those in the control group [RR= 1.18,95 %CI（1.10,1. 28）, P〈0. 0001]. The rate of improvement of laryngeal signs exam-ined by fiberoptic laryngoscope was higher than those in the control group[-RR= 1.38,95 % CI（1.16,1. 65）, P〈0. 001]. The average relief time of dysphonia symptoms was shorter than those in the control group [MD = -1.70, 95 CI （-2.95, -0.45）, P〈0. 001]. Conclusion The effect of proton pump inhibitor plus prokinetic drug on the treatment of laryngopharyngeal reflex is superior to those of proton pump inhibitors or prokinetic drug only, but in terms of safety, more large-sample, high-quality randomized controlled trails are required.

关 键 词：质子泵抑制剂 促胃肠动力药 咽喉反流 META分析 

分 类 号：R766[医药卫生—耳鼻咽喉科] R767[医药卫生—临床医学]