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中华妇幼临床医学杂志(电子版) ›› 2009, Vol. 05 ›› Issue (03) : 217 -220. doi: 10.3877/cma.j.issn.1673-5250.2009.03.104

论著

神经节苷脂对脑瘫患儿疗效的meta分析
罗林荫, 杨凡, 李晋蓉, 雷明雨   
  1. 610041 成都,四川大学华西第二医院儿科
  • 出版日期:2009-06-01

Meta Analysis of the Clinical Efficiency of Gangliosides on Children With Cerebral Palsy.

Lin-yin LUO, Fan YANG, Jin-rong LI, Ming-yu LEI   

  1. Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610041, China
  • Published:2009-06-01
引用本文:

罗林荫, 杨凡, 李晋蓉, 雷明雨. 神经节苷脂对脑瘫患儿疗效的meta分析[J]. 中华妇幼临床医学杂志(电子版), 2009, 05(03): 217-220.

Lin-yin LUO, Fan YANG, Jin-rong LI, Ming-yu LEI. Meta Analysis of the Clinical Efficiency of Gangliosides on Children With Cerebral Palsy.[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2009, 05(03): 217-220.

目的

研究对神经节苷脂(gangliosides,GM–1)治疗脑瘫(cerebral palsy, CP)患儿的疗效进行评价。

方法

采用相关的检索词检索Cochrane图书馆、MedLine、中文科技期刊全文数据库(CNKI)和中国科技期刊数据库(VIP)获取发表的系统评价(systematic evaluation)和随机对照试验(randomized trial controlled,RTC)及临床对照试验文献。每篇文献由2位系统评价者进行资料提取和质量评价,对同质资料运用RevMan 4.3.2软件进行meta分析。

结果

4篇文献涉及的4项研究(n=325)符合纳入标准。Meta分析结果显示,神经节苷脂治疗组脑瘫患儿的症状和体征改善效果[RR=1.24,95%CI(0.95,1.62)]及发育商数(developmental quotient,DQ)值[RR=1.20,95%CI(1.06,1.36)],优于或高于对照组,两组比较,差异有显著意义(P<0.05)。

结论

使用神经节苷脂+基础康复治疗,如运动康复疗法、针灸、按摩等,可增加脑瘫患儿疗效。但由于本系统评价纳入的研究均不是严格的随机对照试验,且样本量较小,故论证强度不够,尚期待高质量、大样本、多中心的随机对照试验对此提供更有力的证据。

Objective

To evaluate the efficiency of gangliosides(GM-1) in the treatment of cerebral palsy (CP).

Methods

Eligible studies were identified by searching Cochrane library, MedLine, CNKI and VIP. No language restrictions were applied. Two reviewers assessed the quality of included studies and extracted data and processed meta-analysis. All randomized and quasi-randomized trials comparing treatment with and without gangliosides with clinical endpoints were reviewed. Development quotient(DQ) was measured by Gesell. RevMan 4.3.2 was used to do the statistical analysis.

Results

Four trials involving 325 patients with cerebral palsy were included. All trials were case-control trials. Meta analysis indicated that using the gangliosides could alter the symptoms and signs for the better [RR=1.24, 95%CI(0.95, 1.62)], and developmental quotient values increased [RR=1.20, 95%CI(1.06, 1.36)], and there were statistic significance.

Conclusion

Gangliosides combined with other treatments can improve the manifestations and developmental quotient of cerebral palsy. However, due to all included trials are not randomized trial controlled (RTC), and numbers of patients of these trials are relatively small, more well-designed multi-center randomized controlled trials should be performed.

图1 神经节苷脂+基础康复治疗与单纯基础康复治疗对脑瘫患儿的症状及体征改善比较
图2 神经节苷脂+基础康复治疗与单纯基础康复治疗对脑瘫患儿发育商影响的比较
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