目的:系统评价中医通腑泄热法治疗脓毒症胃肠功能障碍的临床有效性。方法:将预设的关键词在中国学术期刊全文数据库(CNKI)、万方数据库及Cochrane Library和PubMed数据库进行检索。将检索的文献按纳入和排除标准进行筛选,提取筛选后文...目的:系统评价中医通腑泄热法治疗脓毒症胃肠功能障碍的临床有效性。方法:将预设的关键词在中国学术期刊全文数据库(CNKI)、万方数据库及Cochrane Library和PubMed数据库进行检索。将检索的文献按纳入和排除标准进行筛选,提取筛选后文献的一般资料信息(第一作者、发表年份、病例资料来源、分组例数、治疗方法、结局指标、诊断标准、评价标准等),再应用Cochrane协作网提供的Rev Man 5.3软件对文献关键的结局指标按二分类变量或连续变量进行统计分析。结果:西医对症治疗联合中医通腑泄热法治疗脓毒症胃肠功能障碍(中医腑实证)可降低7天死亡率和28天死亡率;改善患者的胃肠功能障碍评分、急性生理与慢性健康Ⅱ评分(acute physiology and chronic health evaluation,APACHEⅡ);降低患者继发多脏器衰竭病例;提高有效率,降低患者血清降钙素原水平、C反应蛋白水平、白细胞总数水平,且优于单纯西医对症治疗组(P<0.01)。结论:西医对症治疗联合中医通腑泄热法治疗脓毒症胃肠功能障碍(中医腑实证)具有一定的优势。鉴于本研究纳入的原始研究质量偏低,尚待更多高质量研究进行证实。展开更多
Aggregate data meta-analysis is currently the most commonly used method for combining the results from different studies on the same outcome of interest. In this paper, we provide a brief introduction to meta-analysis...Aggregate data meta-analysis is currently the most commonly used method for combining the results from different studies on the same outcome of interest. In this paper, we provide a brief introduction to meta-analysis, including a description of aggregate and individual participant data meta-analysis. We then focus the rest of the tutorial on aggregate data metaanalysis. We start by first describing the difference between fixed and random-effects meta-analysis, with particular attention devoted to the latter. This is followed by an example using the random-effects, method of moments approach and includes an intercept-only model as well as a model with one predictor. We then describe alternative random-effects approaches such as maximum likelihood, restricted maximum likelihood and profile likelihood as well as a non-parametric approach. A brief description of selected statistical programs available to conduct random-effects aggregate data meta-analysis, limited to those that allow both an interceptonly as well as at least one predictor in the model, is given. These descriptions include those found in an existing general statistics software package as well as one developed specifically for an aggregate data metaanalysis. Following this, some of the disadvantages of random-effects meta-analysis are described. We then describe recently proposed alternative models for conducting aggregate data meta-analysis, including the varying coefficient model. We conclude the paper with some recommendations and directions for future research. These recommendations include the continued use of the more commonly used random-effects models until newer models are more thoroughly tested as well as the timely integration of new and well-tested models into traditional as well as meta-analytic-specific software packages.展开更多
目的:采用Meta分析评价以情景模拟为基础的多元化教学法在康复护理中的教学效果。方法:计算机检索PubMed、CENTRAL、EMBase、Web of Science、CNKI、WANFANG DATA、VIP、CBM,检索时间为建库至2022年5月。按照纳入和排除标准筛选文献,运...目的:采用Meta分析评价以情景模拟为基础的多元化教学法在康复护理中的教学效果。方法:计算机检索PubMed、CENTRAL、EMBase、Web of Science、CNKI、WANFANG DATA、VIP、CBM,检索时间为建库至2022年5月。按照纳入和排除标准筛选文献,运用RevMan 5.3软件进行分析。结果:纳入9篇文献,共805名学生。Meta分析结果显示,在提高学生理论成绩[MD=11.33,95%CI=(9.40,13.26),P<0.001]、操作成绩[MD=8.60,95%CI=(5.67,11.52),P<0.001]、操作能力[RR=1.40,95%CI=(1.23,1.59),P<0.001]和团队合作能力[RR=1.32,95%CI=(1.18,1.47),P<0.001]方面,试验组优于对照组。结论:目前证据支持以情景模拟为基础的多元化教学法可提高康复护理课程的教学效果,但由于纳入研究质量偏低,以上结论仍需更多大样本、多中心、高质量的随机对照试验予以进一步验证。展开更多
目的:评价不同清洗消毒方法对中医拔罐器具的清洗效果。方法:通过检索PubMed、EMbase、Web of Science、the Cochrane Library、中国知网(CNKI)、维普(VIP)、万方(WanFang)、中国生物医学文献数据库(CBM)中不同清洗消毒方法处理中医拔...目的:评价不同清洗消毒方法对中医拔罐器具的清洗效果。方法:通过检索PubMed、EMbase、Web of Science、the Cochrane Library、中国知网(CNKI)、维普(VIP)、万方(WanFang)、中国生物医学文献数据库(CBM)中不同清洗消毒方法处理中医拔罐器具的随机对照试验研究,采用RevMan 5.4软件进行Meta分析。结果:共纳入6篇文献。Meta分析结果显示,全自动清洗消毒机清洗消毒中医拔罐器具在目测清洗合格率[RR=1.17,95%CI(1.02,1.35),P=0.02]方面优于人工清洗+含氯消毒剂浸泡消毒中医拔罐器具;全自动清洗消毒机清洗消毒中医拔罐器具在ATP生物荧光快速检测结果[WMD=-7.84,95%CI(-11.98,-3.70),P=0.0002]方面合格结果明显优于碱性多酶溶液浸泡清洗+含氯制剂浸泡消毒中医拔罐器具;多酶低泡强度清洗剂浸泡+全自动清洗消毒机清洗消毒中医拔罐器具在劳动效率[SMD=-18.96,95%CI(-34.91,-3.00),P=0.02]方面明显比人工清洗+含氯消毒剂浸泡消毒中医拔罐器具所用时间更短。结论:采用全自动清洗消毒机清洗消毒中医拔罐器具,可提高中医拔罐器具的目测清洗消毒合格率及ATP生物荧光检测结果,同时明显缩短清洗消毒所用时间,但仍应结合各层级医院的资源配备情况选择合适的清洗消毒方法。展开更多
目的:评价豁痰祛瘀法治疗急性脑梗死的临床疗效。方法:在万方数据库、中国生物医学文献数据库、中国知网、维普网、PubMed、Embase中检索建库至2023年5月发表的关于豁痰祛瘀法治疗急性脑梗死的随机对照试验。将文献按照纳排标准进行筛选...目的:评价豁痰祛瘀法治疗急性脑梗死的临床疗效。方法:在万方数据库、中国生物医学文献数据库、中国知网、维普网、PubMed、Embase中检索建库至2023年5月发表的关于豁痰祛瘀法治疗急性脑梗死的随机对照试验。将文献按照纳排标准进行筛选,再使用Cochrane风险偏倚评估工具对其进行质量评价,将提取到的结局指标运用Revman 5.4.1软件进行Meta分析及敏感性分析。结果:按照纳排标准共筛选出临床试验31项,纳入患者2998例,采用豁痰祛瘀法治疗急性脑梗死的治疗组Barthel指数[标准均数差(SMD)=0.65,95%置信区间(CI)[0.53,0.76],P<0.00001)]、临床疗效[比值比(OR)=4.05,95%CI[3.17,5.17],P<0.00001)]方面高于对照组,差异均具有统计学意义(P<0.05),治疗组在美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分(SMD=–1.07,95%CI[–1.32,–0.82],P<0.00001)、改良的Rankin量表(Modified Rankin Scale,MRS)评分(SMD=–0.67,95%CI[–0.83,–0.52],P<0.00001)、全血高切黏度(SMD=–1.80,95%CI[–3.25,–0.34],P=0.02)、全血低切黏度(SMD=–0.50,95%CI[–0.71,–0.29],P<0.00001)、血浆黏度(SMD=–0.87,95%CI[–1.05,–0.69],P<0.00001)方面低于对照组,差异均具有统计学意义(P<0.05)。结论:豁痰祛瘀法治疗急性脑梗死在改善神经功能、血液学指标方面具有较好的疗效,值得临床推广。展开更多
文摘目的:系统评价中医通腑泄热法治疗脓毒症胃肠功能障碍的临床有效性。方法:将预设的关键词在中国学术期刊全文数据库(CNKI)、万方数据库及Cochrane Library和PubMed数据库进行检索。将检索的文献按纳入和排除标准进行筛选,提取筛选后文献的一般资料信息(第一作者、发表年份、病例资料来源、分组例数、治疗方法、结局指标、诊断标准、评价标准等),再应用Cochrane协作网提供的Rev Man 5.3软件对文献关键的结局指标按二分类变量或连续变量进行统计分析。结果:西医对症治疗联合中医通腑泄热法治疗脓毒症胃肠功能障碍(中医腑实证)可降低7天死亡率和28天死亡率;改善患者的胃肠功能障碍评分、急性生理与慢性健康Ⅱ评分(acute physiology and chronic health evaluation,APACHEⅡ);降低患者继发多脏器衰竭病例;提高有效率,降低患者血清降钙素原水平、C反应蛋白水平、白细胞总数水平,且优于单纯西医对症治疗组(P<0.01)。结论:西医对症治疗联合中医通腑泄热法治疗脓毒症胃肠功能障碍(中医腑实证)具有一定的优势。鉴于本研究纳入的原始研究质量偏低,尚待更多高质量研究进行证实。
基金Supported by Grant R01 HL069802 from the National Institutes of Health,National Heart,Lung and Blood Institute(to Kelley GA)
文摘Aggregate data meta-analysis is currently the most commonly used method for combining the results from different studies on the same outcome of interest. In this paper, we provide a brief introduction to meta-analysis, including a description of aggregate and individual participant data meta-analysis. We then focus the rest of the tutorial on aggregate data metaanalysis. We start by first describing the difference between fixed and random-effects meta-analysis, with particular attention devoted to the latter. This is followed by an example using the random-effects, method of moments approach and includes an intercept-only model as well as a model with one predictor. We then describe alternative random-effects approaches such as maximum likelihood, restricted maximum likelihood and profile likelihood as well as a non-parametric approach. A brief description of selected statistical programs available to conduct random-effects aggregate data meta-analysis, limited to those that allow both an interceptonly as well as at least one predictor in the model, is given. These descriptions include those found in an existing general statistics software package as well as one developed specifically for an aggregate data metaanalysis. Following this, some of the disadvantages of random-effects meta-analysis are described. We then describe recently proposed alternative models for conducting aggregate data meta-analysis, including the varying coefficient model. We conclude the paper with some recommendations and directions for future research. These recommendations include the continued use of the more commonly used random-effects models until newer models are more thoroughly tested as well as the timely integration of new and well-tested models into traditional as well as meta-analytic-specific software packages.
文摘目的:采用Meta分析评价以情景模拟为基础的多元化教学法在康复护理中的教学效果。方法:计算机检索PubMed、CENTRAL、EMBase、Web of Science、CNKI、WANFANG DATA、VIP、CBM,检索时间为建库至2022年5月。按照纳入和排除标准筛选文献,运用RevMan 5.3软件进行分析。结果:纳入9篇文献,共805名学生。Meta分析结果显示,在提高学生理论成绩[MD=11.33,95%CI=(9.40,13.26),P<0.001]、操作成绩[MD=8.60,95%CI=(5.67,11.52),P<0.001]、操作能力[RR=1.40,95%CI=(1.23,1.59),P<0.001]和团队合作能力[RR=1.32,95%CI=(1.18,1.47),P<0.001]方面,试验组优于对照组。结论:目前证据支持以情景模拟为基础的多元化教学法可提高康复护理课程的教学效果,但由于纳入研究质量偏低,以上结论仍需更多大样本、多中心、高质量的随机对照试验予以进一步验证。
文摘目的:评价豁痰祛瘀法治疗急性脑梗死的临床疗效。方法:在万方数据库、中国生物医学文献数据库、中国知网、维普网、PubMed、Embase中检索建库至2023年5月发表的关于豁痰祛瘀法治疗急性脑梗死的随机对照试验。将文献按照纳排标准进行筛选,再使用Cochrane风险偏倚评估工具对其进行质量评价,将提取到的结局指标运用Revman 5.4.1软件进行Meta分析及敏感性分析。结果:按照纳排标准共筛选出临床试验31项,纳入患者2998例,采用豁痰祛瘀法治疗急性脑梗死的治疗组Barthel指数[标准均数差(SMD)=0.65,95%置信区间(CI)[0.53,0.76],P<0.00001)]、临床疗效[比值比(OR)=4.05,95%CI[3.17,5.17],P<0.00001)]方面高于对照组,差异均具有统计学意义(P<0.05),治疗组在美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分(SMD=–1.07,95%CI[–1.32,–0.82],P<0.00001)、改良的Rankin量表(Modified Rankin Scale,MRS)评分(SMD=–0.67,95%CI[–0.83,–0.52],P<0.00001)、全血高切黏度(SMD=–1.80,95%CI[–3.25,–0.34],P=0.02)、全血低切黏度(SMD=–0.50,95%CI[–0.71,–0.29],P<0.00001)、血浆黏度(SMD=–0.87,95%CI[–1.05,–0.69],P<0.00001)方面低于对照组,差异均具有统计学意义(P<0.05)。结论:豁痰祛瘀法治疗急性脑梗死在改善神经功能、血液学指标方面具有较好的疗效,值得临床推广。
