High-dose and standard-dose glucocorticoids for the treatment of sudden deafness: a systematic review and meta-analysis
高剂量和标准剂量糖皮质激素治疗突发性聋的系统评价和Meta分析

摘要

目的 利用Meta分析的方法探讨高剂量和标准剂量糖皮质激素治疗突发性聋的疗效与安全性。方法 通过关键词在中国知网、维普等数据库系统检索2000~2024年国内外公开发表的关于不同高剂量全身应用糖皮质激素治疗突发性聋的相关文献。根据预先制定的纳入和排除标准筛选文献，使用RevMan5.4.1软件包对符合质量标准的研究进行Meta分析。结果 纳入了4个随机对照研究，患者总数为462例，Meta分析显示高剂量与标准剂量全身应用糖皮质激素治疗突发性聋的总有效率差异有统计学意义（RR=1.39，95% CI= 1.13-1.69，P＝0.001）；痊愈率无统计学差异（RR=1.50，95%CI=0.89-2.55，P=0.13）。药物不良反应主要包括消化系统反应、血糖升高、失眠、肝肾损伤等，两组之间不良反应差异无统计学意义（RR=1.02，95%CI=0.76-1.37，P=0.88）。结论 1.高剂量相较于标准剂量糖皮质激素治疗突发性聋具有更高的有效率，然而在痊愈率方面并未呈现出显著差异，尚需进行更深入的研究与探讨。2.高剂量与标准剂量糖皮质激素治疗突发性聋在不良反应发生率方面并无明显差异。

Abstract

Objective To explore the efficacy and safety of high-dose and standard-dose glucocorticoids in the treatment of sudden deafness using the method of meta-analysis.
Methods The relevant literature published in China from 2000 to 2024 on different high-dose systemic glucocorticoids for the treatment of sudden deafness was systematically retrieved using keywords in databases such as CNKI and VIP. Literature was screened according to the pre-established inclusion and exclusion criteria, and the RevMan5.4.1 software package was used to perform a meta-analysis on studies that met the quality standards.
Results Four randomized controlled studies with a total of 462 patients were included. Meta-analysis showed that there was a statistically significant difference in the total effective rate between high-dose and standard-dose systemic glucocorticoids for the treatment of sudden deafness (RR=1.39, 95%CI=1.13-1.69, P=0.001); there was no statistical difference in the cure rate (RR=1.50, 95%CI=0.89-2.55, P=0.13). Adverse drug reactions mainly included digestive system reactions, increased blood sugar, insomnia, liver and kidney damage, etc. There was no statistically significant difference in adverse reactions between the two groups (RR=1.02, 95%CI=0.76-1.37, P=0.88).
Conclusion   1. High-dose glucocorticoids have a higher efficacy in the treatment of sudden deafness than standard-dose glucocorticoids, but there is no significant difference in the cure rate, which requires further research and discussion. 2. There is no significant difference in the incidence of adverse reactions between high-dose and standard-dose glucocorticoids in the treatment of sudden deafness.