复方樟柳碱注射液治疗前部缺血性视神经病变有效性和安全性的Meta分析
Efficacy and safety of compound anisodine injection for anterior ischemic optic neuropathy: a meta-analysis
摘要目的:系统评价复方樟柳碱注射液(CA)对前部缺血性视神经病变(AION)的有效性和安全性。方法:检索1978年1月至2021年6月PubMed、Cochrane图书馆、Web of Science、中国知网、万方数据库、中文科技期刊全文数据库和中国生物医学文献光盘数据库中CA参与治疗AION的随机对照试验(RCT),由2名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RevMan 5.3进行Meta分析。结果:符合纳入标准的RCT文献13篇,共1 636眼,治疗组829眼,未经CA治疗的对照组807眼。治疗组治疗总有效率较对照组高[比值比( OR)=3.25,95%置信区间( CI):2.47~4.28, P<0.01],治疗组最佳矫正视力优于对照组[均数差(MD)=0.14,95% CI:0.11~0.17, P<0.01],剔除异质性大的文献后治疗组最佳矫正视力仍优于对照组(MD=0.14,95% CI:0.12~0.16, P<0.01)。治疗组视野平均缺损小于对照组(MD=-2.58,95% CI:-3.98~-1.19, P<0.01),视野平均光敏感度高于对照组(MD=3.49,95% CI:3.07~3.91, P<0.01)。 结论:CA治疗AION的疗效优于未使用CA的对照组,其疗效主要是提高视力和视野平均敏感度、降低视野平均缺损。
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abstractsObjective:To evaluate the efficacy and safety of compound anisodine (CA) injection for anterior ischemic optic neuropathy (AION).Methods:Studies, which were randomized controlled trials (RCT) of CA with routine treatment for AION from PubMed, The Cochrane Library, Web of Science, CNKI, Wanfang database, Chinese science and technology journals full-text database and CD-ROM database of Chinese Biology Medical disc published from January 1978 to June 2021 were searched.Included studies were screened by two researchers independently based on inclusion and exclusion criteria.After data collection and quality assessment, a meta-analysis of included studies was performed with Revman 5.3 software.Results:Thirteen RCT were included, involving 1 636 eyes, with 829 eyes in treatment group and 807 eyes in control group without CA treatment.It was found that the total effective rate of treatment group was higher than that of control group ( OR=3.25, 95% CI: 2.47-4.28, P<0.01), and the best corrected visual acuity of AION patients after CA treatment was significantly better than that of control group when articles with high heterogeneity were excluded (MD=0.14, 95% CI: 0.11-0.17, P<0.01) or not (MD=0.14, 95% CI: 0.12-0.16, P<0.01).The mean defect of visual field was significantly smaller and the mean sensitivity of visual field was higher in treatment group than control group (MD=-2.58, 95% CI: -3.98--1.19, P<0.01; MD=3.49, 95% CI: 3.07-3.91, P<0.01). Conclusions:CA shows good efficacy in the treatment of AION.It can improve visual acuity and mean sensitivity of visual field, decrease mean defect of visual field.
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