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目的:吸入糖皮质激素为支气管哮喘缓解期治疗的一线药物,探讨哮喘患者长期大量吸入糖皮质激素是否有引起骨质疏松的危险。资料来源:应用计算机检索Medline1980-01/2003-12和Embase1980-01/2003-12期间的有关糖皮质激素和骨质疏松关系的文献,检索词“asthma,bonedensity,bonemetabolism,Inhaledglucocorticoids”,并限定文章语言种类为English。同时计算机检索CBM、CBMdisc系统,手工检索《中国临床康复》等杂志1990-01/2004-04期间的相关文献,限定文章语言种类为中文,检索词“哮喘、骨密度、骨代谢、吸入糖皮质激素”。研究对象为服用糖皮质激素的成年男性和绝经前女性哮喘患者。资料选择:选取试验包括吸入糖皮质激素治疗组和对照组的骨密度、骨代谢变化比较的相关文献,进行初审,删除明显不随机临床试验(RCT)的研究,然后查找余下的文献全文,进一步判断是否为RCT。纳入标准:①RCT,无论是否为单盲、双盲或非盲法;②平行对照组,即未使用激素的哮喘患者或健康对照;治疗组为吸入激素的哮喘患者。排除标准:明显不随机的临床试验。质量评价主要考察资料的真实性,调查设计是否严密,实施过程是否严格,统计学处理是否合理。资料提炼:共检索30篇关于研究吸入糖皮质激素对哮喘患者骨密度和骨代谢的影响的随机和未随机
OBJECTIVE: Inhaling glucocorticoids as the first-line drug for the treatment of bronchial asthma during remission, and to explore whether long-term inhaled glucocorticosteroid may cause osteoporosis in asthma patients. DATA SOURCES: A computer-based online search of literature on the relationship between glucocorticoid and osteoporosis between Medline1980-01 / 2003-12 and Embase1980-01 / 2003-12 was conducted using the term “asthma, bonedensity, bonemetabolism, Inhaledglucocorticoids” The language is English. At the same time, the CBM and CBMdisc systems were searched by computer, and the related articles of “China Clinical Rehabilitation” and other magazines from January 1990 to April 2004 were searched by hand. The language of article was defined as Chinese. The search term was “asthma, bone mineral density, bone metabolism, hormone”. The subjects were adult male corticosteroids and pre-menopausal women with asthma. DATA SELECTION: Select trials that include inhaled glucocorticosteroid-treated and control groups for a comparison of changes in bone mineral density and bone metabolism, initial reviews, and studies that clearly exclude randomized clinical trials (RCTs), and then search the remaining articles for full text further Judge whether it is RCT. Inclusion criteria: â ’RCT, whether single-blind, double-blind or non-blind; â’¡ parallel control group, that is, without the use of hormones in asthma patients or healthy controls; treatment group inhaled hormones in patients with asthma. Exclusion criteria: Apparently not randomized clinical trials. Quality evaluation mainly examine the authenticity of the data, investigate the design is tight, the implementation process is rigorous, statistical processing is reasonable. DATA EXTRACTION: A total of 30 random and nonrandomized studies were conducted on the effects of inhaled corticosteroids on bone mineral density and bone metabolism in asthmatic patients