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目的比较抗病毒药物联合类固醇与单独使用类固醇治疗不同程度贝尔麻痹的疗效。方法计算机检索Cochrane Central Register of Controlled Trials、Pubmed、CNKI、万方数据库、MEDLINE、EMbase、中国生物医学文献数据库、中文科技期刊全文数据库,科学网中关于抗病毒药物联合类固醇治疗贝尔麻痹的临床随机对照试验(RCTs)。采用Cochrane协作网提供的Rev Man 5.1软件对纳入资料进行统计分析。结果按照统一的纳入和排除标准筛选,最终纳入9篇随机对照试验(RCTs),共计1732例贝尔麻痹患者,其中777例重度贝尔麻痹患者。与单独使用类固醇治疗组相比,抗病毒药物联合类固醇治疗组对整体贝尔麻痹患者的疗效无差异,[OR=1.66,95%CI=(0.92,2.98),P=0.09>0.05]。但可以增加重度贝尔麻痹患者面肌功能恢复率(HB》Ⅱ)。[OR=2.06,95%CI=(1.15,3.67),P=0.02<0.05]。亚组分析显示3种不同抗病毒药物组间差异无统计学意义[(P=0.25>0.05)]。结论联合用药方案不能使总体贝尔麻痹患者获益,但可使新发的重度贝尔麻痹患者获益。
Objective To compare the efficacy of antipsychotics plus steroids and steroids alone in treating Bell’s palsy to varying degrees. Methods We searched the Cochrane Central Register of Controlled Trials, Pubmed, CNKI, Wanfang Database, MEDLINE, EMbase, Chinese Biomedical Literature Database, Chinese Science and Technology Journals Full-Text Database, and the scientific randomized controlled clinical trials of antivirals and steroids in treating Bell’s palsy Test (RCTs). Rev Man 5.1 software provided by the Cochrane Collaboration was used for statistical analysis of inclusion data. The results were screened according to uniform inclusion and exclusion criteria, and finally 9 randomized controlled trials (RCTs) were enrolled, totaling 1732 patients with Bell’s palsy, including 777 with severe Bell’s palsy. There was no difference in the efficacy of antivirals versus steroids in patients with overall Bell’s palsy compared with steroid alone (OR = 1.66, 95% CI = (0.92, 2.98), P = 0.09> 0.05]. But can increase facial muscle function recovery rate in patients with severe Bell’s palsy (HB "II). [OR = 2.06, 95% CI = (1.15, 3.67), P = 0.02 <0.05]. Subgroup analysis showed no significant difference among the three different antiviral groups [(P = 0.25> 0.05)]. Conclusions Combination regimens do not benefit patients with overall Bell’s palsy but benefit newer patients with severe Bell’s palsy.