文献类型：期刊文献

中文题名：中药联合常规综合疗法治疗小儿弱视疗效的meta分析

英文题名：Meta-analysis of clinical effectiveness on Chinese herbs combined with moderate comprehensive therapy for childhood amblyopia

作者：张奥[1];严兴科[1];刘安国[1]

第一作者：张奥

机构：[1]甘肃中医药大学针灸推拿学院,兰州730000

第一机构：甘肃中医药大学针灸推拿学院

年份：2017

卷号：35

期号：6

起止页码：537

中文期刊名：中华实验眼科杂志

外文期刊名：Chinese Journal Of Experimental Ophthalmology

收录：CSTPCD;;Scopus;北大核心:【北大核心2014】；CSCD:【CSCD_E2017_2018】；

基金：基金项目：国家自然科学基金项目（81260560、81660816）;甘肃中医药大学中青年科研基金项目（ZQ2015-1）

语种：中文

中文关键词：小儿弱视;中药;常规疗法;Meta分析;循证医学

外文关键词：Amblyopia/Childhood; Chinese herbs; Therapy/Moderate comprehensive; Meta analysis; Evidence-based medicine

摘要：背景目前临床上治疗小儿弱视的常规方法主要包括验光配镜、遮盖疗法、阿托品点眼、精细目力训练、仪器治疗等或上述综合疗法，但各种疗法的效果均有一定的局限性。长期以来中药曾用于小儿弱视的治疗过程，但其疗效评价有一定争议。目的系统评价中药联合常规综合疗法治疗小儿弱视的疗效。方法按照我们制定的检索策略用计算机检索2000--2015年中国期刊网全文数据库（CNKI）、万方全文数据库、美国医学文摘数据库（PubMed）中关于中药联合常规综合疗法与单纯常规综合疗法治疗小儿弱视疗效比较的随机对照试验（RCT）和临床对照试验（CCT），按照循证医学（Cochrane）系统评价的方法评价纳入研究的质量，采用改良Jadad评分量表对纳入文献的研究方法学进行评分，提取有效数据，采用RevMan5．1统计学软件进行meta分析。采用固定效应模型分析治疗效果的合并效应量。结果共有33篇符合检索纳入标准的文献纳入分析，总样本量6666例。33篇文献中共25篇描述了组间研究对象基线资料具有可比性；共29篇文献描述了所参照的诊断标准，30篇文献描述了参照的疗效标准；改良Jadad评分显示纳入研究的方法学评分为6分者1篇，3分者2篇，1—2分者30篇。Meta分析显示中药联合常规综合疗法治疗小儿弱视的总有效率合并效应量[比值比（OR）]为3．92[95％可信区间（CZ）：3．30～4．64]，中药联合常规综合治疗组总疗效明显优于对照组，差异有统计学意义（Z=15．74，P〈0．01）。结论中药联合常规综合疗法治疗小儿弱视的总有效率优于单纯常规综合疗法，可以认为中药联合常规综合疗法治疗小儿弱视有效；本研究中纳入文献的总体方法学质量评价尚不令人满意，需要更多设计良好的RCT进一步证实中药在小儿弱视治疗中的作用和疗效。
Background The conventional therapies for childhood amblyopia mainly include optometry, occluding therapy, atropine application, fine eyesight training, instrument or regular comprehensive therapy, but the elinleal effectiveness of each method had its limitation. Chinese herbs have been used to the treatment of childhood amblyopia,however,their effects are still in controversy. Objective This study was to assess the evidence of efficacy of Chinese herbs combined with moderate methods for childhood amblyopia. Methods The published papers of randomized controlled trials （RCT） and controlled clinical trials （CCT） of Chinese herbs combined with moderate comprehensive therapy for childhood amblyopia from 2000 to 2015 were searched in China National Knowledge Infrastructure （CNKI）,Wanfang database and PublVIed database with computer. The methodology quality of included papers was evaluated according to the criteria of Cochrane and advanced Jadad scale. Data synthesis was facilitated using Reviewer Manager 5. 1 software. The overall effect,or odds ratio （OR） of the treatment was analyzed by fixed effective model. Results Thirty-three RCT or CCT papers meeting inclusion eriteria were included with the total sample size 6 666, and matched demography was showed in 25 papers; referential diagnosis criteria and effective criteria were described in 29 papers and 30 papers,respectively. Advanced Jadad scale showed 6,3 and 1-2 scores in 1,2 and 30 papers, respectively. The evidence showed that the total effectiveness of treatment within the group receiving Chinese herbs combined with conventional methods was higher than that in conventional group,with a statistically significant difference between groups （ polled fixed effects model [ OR ] = 3.92,95% confidence interval I CII ：3.30-4.64 ,Z= 15.74 ,P〈0.01 ）. Conclusions The total effectiveness rate of Chinese herbs combined with conventional methods for childhood amblyopia is superior to only conventional treatment,indicating that Chinese herbs is effective for childhood amblyopia. More well-designed RCTs are needed to confirm the effect.