Objectives To conduct a meta-analysis to evaluate the efficacy and safety of thymosin-α1 for HBeAg-positive chronic hepatitis B. Methods We searched MEDLINE, Science Citation Index, Current Content Connect, Cochrane Controlled Trial Register and Chinese Biomedical Database (CBMdisc) to September 15, 2005, and screened the references of eligible trials by hand-searching. Randomized controlled trials (RCTs) comparing thymosin-α1 with non-antiviral interventions (placebo, no treatment and standard care) in patients with HBeAg positive chronic hepatitis B were eligible for inclusion. We conducted quality assessment and data extraction by two independent investigators with disagreement resolved by discussion. We used chi-square test and Galbraith plot to detect the heterogeneity, and used fixed (Mantel-Haenzel) and random effect model (DerSimonian-Laird) to pool the trials. When the results in two models differed, the results of random effect were reported. Subgroup analysis was performed to detect whether the duration affected the efficacy of thymosin. Results Four RCTs were included. It was found that the rate of loss of HBeAg was 38.8% in thymosin, significantly higher than that of 12.4% in control groups (RR 2.22, 95%CI 1.55 to 3.21, P=0.000). Loss of HBV-DNA was 36.9% in thymosin-α1, significantly higher than that of 13.8% in control groups (RR 2.18, 95%CI 1.50 to 3.17, P=0.000). Both short-duration (8-13 weeks) and regular duration (26-52 weeks) of thymosin-α1 achieved higher loss of HBeAg and HBV-DNA. The complete response rate was 32.3% in thymosin-α1, significantly higher than the control, 11.3% (RR 2.91, 95%CI 1.71 to 4.94, P=0.000). No statistical significance was found for HBeAg seroconversion and ALT normalization. No significant adverse drug reactions were found. Conclusions Thymosin-α1 might be efficacious in loss of HBeAg and HBV-DNA, and complete response for patients with HBeAg-positive chronic hepatitis B. Little evidence was available on HBeAg seroconversion, normalization of ALT, loss of HBsAg, and histological response. Further high-quality RCTs were needed for confirmation.
【摘要】 目的 探讨肌电生物反馈治疗对脑卒中偏瘫患肢上肢腕背伸功能的影响。方法 将36例脑卒中偏瘫患者随机分为治疗组和对照组,每组18例。两组药物治疗相同,对照组进行常规康复治疗,治疗组在常规康复治疗基础上加肌电生物反馈技术进行治疗。观察两组治疗前后腕背伸时主动关节活动范围(AROM),腕背伸时肌肉最大收缩时肌电(EMG)阈值。 结果 3个疗程后治疗组患者腕关节的AROM、EMG阈值均优于对照组(P＜0.001)。 结论 肌电生物反馈治疗有助于明显改善偏瘫患者腕背伸功能。【Abstract】 Objective To explore the effect of the electromyographic biofeedback therapy on the extension of wrist joint of the hemiplegic patients after stroke. Methods Thirtysix hemiplegic patients were included and were divided into two groups randomly, including a treatment group and a control group. They were treated with the same drugs and the routine rehabilitation therapy while the patients in the treatment group still received the electromyographic biofeedback therapy additionally. Results After three courses of treatment, the patients in the treatment group had better active range of movement (AROM) of extension of wrist joint and also higher electromyographic (EMG) threshold of maximum contraction of muscle than the patients in the control group (Plt;0.001). Conclusion The electromyographic biofeedback therapy has good effect on improving the function of the wrist of hemiplegic patients after stroke.