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目的应用循证方法分析减少糖尿病合并消化性溃疡患者的临床风险。方法对糖尿病合并消化性溃疡患者的病情进行评估,并提出相关问题。使用计算机检索中国知网、维普网、万方数据库、中国生物医学文献数据库、Medline数据库及Cochrane,检索时间为1992年1月~2013年10月,严格按照纳入标准筛选文献并进行提取和质量评估,根据牛津循证医学所提出的证据分级标准评价文献质量,并进行描述性分析。结果共检测出相关文献17篇,其中1篇为系统评价/Meta分析,其余16篇文献均为对照研究。1篇系统评价/Meta系统评价文献中,糖尿病合并消化性溃疡患者出现消化道出血和死亡。16篇对照研究文献中,有5篇文献中患者溃疡发作,6篇文献中溃疡愈合,3篇文献中患者溃疡复发、5篇文献中患者消化道出血、1篇文献中患者死亡。结论通过应用循证方法发现糖尿病合并消化性溃疡患者的临床风险在不断增加,临床治疗应重视对糖尿病患者消化道的保护,综合控制多种危险因素的发生。
Objective To evaluate the clinical risk reduction of patients with peptic ulcer due to diabetes by evidence-based method. Methods Patients with diabetes mellitus and peptic ulcer disease were evaluated and related issues were raised. Using computer to search CNKI, VW network, Wanfang database, Chinese Biomedical Literature Database, Medline database and Cochrane, the searching time was from January 1992 to October 2013, and the documents were screened strictly according to inclusion criteria and extracted and quality assessed The quality of the literature was evaluated according to the evidence grading standards proposed by Oxford Evidence-Based Medicine and the descriptive analysis was conducted. Results A total of 17 articles were detected, one of which was a systematic review / meta-analysis. The remaining 16 articles were control studies. A systematic review / meta-review of systematic reviews found that patients with diabetes mellitus and peptic ulcer developed gastrointestinal bleeding and died. Of the 16 control studies, 5 were reported with ulcer episodes, 6 with ulcer healing, 3 with recurrent ulcers, 5 with gastrointestinal bleeding in one of the articles, and 1 with death in the literature. Conclusion The clinical risk of patients with diabetes mellitus and peptic ulcer is increasing by using evidence-based method. The clinical treatment should pay attention to the protection of digestive tract in patients with diabetes mellitus, and comprehensively control the occurrence of various risk factors.