| ObjectiveSecretory otitis media (secretory otitis media, otitis media with effusion, referred to as SOM, or OME) is the middle ear of non-suppurative inflammatory diseases. Its main characteristic are middle ear effusion (including serous, mucus, pulp-mucus, rather than blood or cerebrospinal fluid), and hearing loss. In the past many years, Traditional Chinese Medicine do a lot research and practice on etiology and pathogenesis of the disease. It comprehensive use treatment based on differentiation of syndromes, external treatment, acupuncture moxibustion and other method to treat the diseases and achieved better clinical efficacy. This research mainly uses the system appraisal and the Meta analysis method to comprehensively understanding the Randomized controlled clinical scientific research methodology application condition of Chinese medicine and the cooperation of Chinese and Western medicine treat secretory otitis media Literatur, the existence question, appraised objectively the research quality of the aggregate level, the science appraisal of Chinese medicine and the cooperation of Chinese and Western medicine treatment validity and the security, will provide the clue and the mentality for the next research.MethodThe matched-control literatures are those published in the civil. TO investigate the clinical effect of TCM and TCM-WM that it helps the Secretory otitis media. Data base on (the CBM,1978-2009 year), (the VIP,1989-2009 year) and (the CNKI,1979-2009 year). Followed the the method of Cochrane Meta-Analysis, followed the basis clinical epidemiology/DME methodology principle and the method, according to《Chinese medicine Medical Literature System Appraisal Work Handbook》the standard, formulates《Chinese medicine and the cooperation of Chinese and Western medicine treat secretory otitis media Literature System Appraisal And Information Gathering Table)).The appraisal content include:Literature ordinary circumstances, The main principles of clinical research design, medication situation and the characteristic of secrectory otitis media.The Meta analysis literature was 1978-2009 publishes in domestic medicine periodical Chinese medicine and the cooperation of Chinese and Western medicine treat Secretory otitis media the stochastic comparison clinical research literature. The statistical software uses Revman4.3 offered by Cochrane Collaboration. Measurement data uses OR, while continuous variables adopts weighted mean difference, both are presented by 95%confidence intervals CI. Then carry out the heterogeneous inspection toward each result of trail. If there is no any heterogeneity existed, adopt the fixed effects model, and on the contrary, use random effects model. By Meta analysis result in sign stderr (score compared to the OR logarithm)took by mistake the Y axis, by OR(treatment group effective population/control group effective population)took X axis, draws the funnel chart, analyzes clinical research material distributed shape which collects, judges whether has the publication dominance, integrates the literature number is bigger than 5 pieces to conduct the publication dominance research(inspection levelα=0.05). According to the method of treatment difference, carries on the analysis according to under several aspects:The Chinese medicine takes orally vs western medicine, Chinese medicine and western medicine takes orally vs western medicine, Chinese patent drug takes orally vs western medicine, Chinese patent drug for external use vs western medicine for external use.ResultAltogether picks out Secretory otitis media Chinese medicine and the cooperation of Chinese and Western medicine RCT literature 59, did not retrieve the most reliable evidence-systematic review (SR).The quality assessment indicate that the literature's methodological quality of clinical research were not seriously. It may be relatived with the Chinese medicine clinical scientific research level limit and the Chinese medicine theory in the objectification, and standardized aspect study insufficiency in former.Mteta analysis showed that the Chinese medicine takes orally vs western medicine, Chinese medicine takes orally and western medicine vs western medicine, Chinese patent drug takes orally vs western medicine, Chinese patent drug for external use vs western medicine for external use. Explained above Chinese medicine remedial measure the influence has statistics significance to the curative effect, provides the basis for the Chinese medicine treat Secretory otitis media. At the same time, the block the result is consistent, explained this findings credible also the authenticity is high, moreover as a result of the literature reason, Chinese medicine takes orally vs eustachian tube insufflation+auripuncture and irrigation, internal and external use of Chinese medicine vs auripuncture and injection, internal and external use of Chinese medicine vs Internal and external use of western medicine, Chinese medicine takes orally vs auripuncture and irrigation, Chinese medicine takes orally vs surgery, Chinese patent drug takes orally and western medicine vs western medicine and Chinese patent drug takes orally vs surgerycurative effect still cannot appraise.ConclusionMeta analysis showed that it is certain curative effect after the Meta analysis demonstration Chinese medicine and cooperation of Chinese and Western medicine treat Secretory otitis media, in the application which provides medicine evidence for the Chinese medicine pharmacotherapy but pay attention to the above conclusion and the experimental methodology quality. Clinical test methodology quality should be enhancement. As time progressed, the rise of evidence-based medicine and subject to our reconstruction, it is a hope that the literature in this area will be more and more. Expect that there will be a high quality literature which including a completely randomized double-blind controlled clinical trial and further confirmed this result. |
