扩血管剂治疗突发性聋随机对照试验的系统评价(初步结果)  

Vasodilators for sudden sensorinenral hearing loss: a systematic review of randomized controlled trials

作　　者：龚允[1,3] 梁传余[1] 李静[2] 田爱民[1] 陈娜[1,3] 

机构地区：[1]四川大学华西医院耳鼻咽喉科,成都610041 [2]四川大学临床流行病学教研室,中国循证医学/Cochrane中心 [3]四川省人民医院耳鼻咽喉科

出　　处：《中华耳鼻咽喉科杂志》2002年第1期64-68,共5页Chinese Journal of Otorhinolaryngology

基　　金：Cochrane协作网注册课题 /CMB循证医学资助项目( 98 6 80 )

摘　　要：目的　评价扩血管剂治疗突发性聋的疗效及安全性。方法　通过对Medline、Embase、Cochrane临床对照试验资料库和中国生物医学文摘数据库的机检 ,5种中文耳鼻咽喉科杂志手检 ,和参考文献的查阅 ,选出以扩血管剂为干预措施来治疗突发性聋的随机对照试验 ,并且至少有 2位研究者独立评估试验质量和提取数据。结果　共 13篇文章 ,115 5例病耳符合纳入标准进入研究。扩血管剂与安慰剂比较的 4个试验中 ,没有一个发现扩血管剂疗效优于安慰剂。扩血管剂相互比较的 7个试验中 ,没有发现哪一种扩血管剂疗效更好。扩血管剂与其他疗法进行比较的 2个试验 ,提示其他治疗 (泛影葡胺或腹蛇抗栓酶 )可能优于某些扩血管剂 (低分子右旋糖苷、烟酸、山莨菪碱、丹参 )。 8个试验描述了皮肤瘙痒、过敏反应等副作用。结论　目前尚缺乏证据表明扩血管剂治疗突发性聋的疗效优于安慰剂或其他治疗 ,也缺乏证据表明哪一种扩血管剂疗效最佳。扩血管剂对突发性聋的疗效尚不能作最后结论 。Objective To assess the effects and safety of vasodilators on sudden sensorineurial hearing loss(SSHL). Search strategy Electronic databases: MEDLINE from 1966, EMBASE from 1974, the Cochrane Controlled Trails Register, Chinese Bio-medicine Database from 1989. Hand search: Five kinds of Chinese otolaryngology journals were selected. Literature references were checked intensively. Selection criteria Randomized controlled trials comparing vasodilators with placebo or other drugs in patients with SSHL. Data collection and analysis Three reviewers independently accessed the quality of trials and extracted the data. Results Thirteen trials with 1 155 patients were eligible and covered in the systematic review. Ten of the trials were conducted in developed countries, and three in China. None of the four trials showed the effects of vasodilators on SSHL were better than that of placebo. None of the seven trials comparing different drugs showed the effects of one kind of vasodilators were better than that of the other vasodilators. Two trials showed that some other drugs, such as batroxobin and hypaque were probably better than the vasodilators (dextran, papaverine, 654-2, danshen). Eight trials showed side effects of vasodilators, such as pruritus, allergy, etc. Conclusions Based on the systematic review of current eligible randomized controlled clinical trials, there is no evidence to prove that vasodilator therapy is more effective than placebo or other therapies for SSHL, or the effects of one kind of vasodilators to be better than that of the other vasodilators. So far we can′t draw a reliable conclusion about the effects of vasodilators for SSHL. In addition, we must pay attention to their potential adverse reactions.

关 键 词：突发性耳聋 血管舒张药 综合分析 系统评价 随机对照试验 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]