【作者】 刘伟；

【导师】 孙明莉；

【作者基本信息】 吉林大学 ， 临床医学硕士（专业学位）， 2018， 硕士

【摘要】 目的:带状疱疹(Herpes zoster,HZ)是皮肤科常见的病毒感染性疾病,带状疱疹后遗神经痛(Postherpetic neuralgia,PHN)是带状疱疹最常见的并发症,近年来,高压氧治疗逐渐成为临床上治疗PHN的常用方法。本研究通过meta分析的方法,全面综合的相关文献,来评价高压氧治疗PHN的临床治疗效果,为高压氧治疗PHN提供依据。方法:本研究检索了Pubmed、Cochrane Library、Web of science、EMBASE、万方数据、中国知网、中文科技期刊数据库等中英文数据库,并辅以文献追溯和手工检索等方法,收集了2000年1月至2018年1月间在上述数据库中公开发表的有关高压氧治疗带状疱疹后遗神经痛的相关文献。根据纳入与排除标准,共纳入了高压氧治疗带状疱疹后遗神经痛文献(PHN)13篇,数据定量分析应用RevMan5.3软件及Stata12.0软件计算合并效应量。二分类计数资料选用相对危险度(Risk Ratio,RR)为合并效应量,连续性计量资料选用标准化均数差(Standardized Mean Difference,SMD)为合并相应量,并计算此二者相应的95%可信区间(Confidence Interval,CI),根据所得到的漏斗图进行发表偏倚分析,运用Stata12.0软件对其进行敏感性分析,以评价结果的稳定性及可靠性。对纳入的所有文献的不良反应情况进行统计分析,明确高压氧治疗的不良反应发生率、安全性以及患者依从情况。结果:对符合纳入与排除标准的13篇高压氧治疗PHN疗效的文献进行meta分析,结果如下:治愈率、有效率的合并效应量RR值及其95%CI分别为:1.78[1.51,2.10]、1.26[1.19,1.33]。视觉模拟评分法(Visual analogue scale,VAS)的合并效应量SMD值及其95%CI为-1.36[-2.00,-0.72]。患者不良反应发生率在2.78%~20%之间,反应轻微,可自行缓解,基本不影响继续治疗。结论:1、高压氧治疗可以提高PHN患者的治疗有效率、治愈率;2、高压氧治疗可以缓解PHN患者主观疼痛感觉程度;3、高压氧治疗PHN不良反应少而轻微,安全性高,患者依从性强,值得推广。更多还原

【Abstract】 Objective:Herpes zoster(HZ)is a common viral infectious disease in dermatology.Post-herpetic neuralgia(PHN)is the most common complication of herpes zoster.In recent years,hyperbaric oxygen therapy has gradually become a common treatment for PHN.This study used meta-analysis methods to evaluate the clinical therapeutic effect of hyperbaric oxygen therapy for PHN and provide basis for hyperbaric oxygen therapy for PHN.Methods:The study searched Pubmed,Cochrane Library,Web of Science,EMBASE,Wanfang Data,China Knowledge Network,Chinese Sci-tech Periodical Database,and other Chinese and English databases for collecting papers.And we also used auxiliary means such as literature review and manual search.All related literatures of hyperbaric oxygen therapy for treating postherpetic neuralgia were published from January 2000 to January 2018 in the above databases.According to the inclusion and exclusion criteria,13 articles were included.Quantitative analysis of data was performed by RevMan5.3 software and Stata12.0 software to calculate the combined effect.For dichotomous count data,the risk ratio(RR)was used as the combined effect,and for the continuousmeasurement data,the standardized mean difference(SMD)was used to combine the corresponding amounts.Then we calculated the corresponding 95% confidence interval(CI)of the two results.The publication bias analysis were performed according to the obtained funnel diagram.And the Sensitivity Analysis was carried out by the Stata12.0 software to evaluate the stability and reliability of the results.Statistical analysis of the adverse reactions was performed on all included literatures to determine the adverse reactions incidence,the safety and patient compliance of hyperbaric oxygen therapy.Results:Meta-analysis results of 13 literatures about the efficacy of hyperbaric oxygen therapy for PHN,witch met the inclusion and exclusion criteria were as follows: The RR of combined cure rate,effective rate and their 95% CI were 1.78 [1.51,2.10],1.26 [ 1.19,1.33].The combined effect of visual analogue scale(VAS)scores and its 95% CI were-1.36 [-2.00,-0.72].The incidence of adverse reactions in patients was between 2.78% and 20%.The response was mild and could be relieved on their own,basically not affecting continued treatment.Conclusion:1.Hyperbaric oxygen therapy can improve the treatmentefficiency and cure rate of PHN patients;2.Hyperbaric oxygen therapy can relieve the degree of subjective pain in PHN patients;3.hyperbaric oxygen treatment PHN adverse reactions less and mild,high safety,patient compliance,it is worth promoting.更多还原