| ObjectiveSystematical evaluation about the effect of recombinant human growth hor mone(rhGH)on the changes of blood glucose in severely burned patients.MethodsBased on the guidance in Cochrance System Evaluator's Manual,we chose"burns,growth hormone,blood glucose and randomized controlled" as key for finding subject word and free word,which were used to search all papers pu blished from PubMed,Cochrane Library and Embase since the database buildin g to Sep.2018.Besides,we chose"burns,recombinant human growth hormone(rhGH),blood glucose" as key terms to search all papers published from Vip Database,Wan-fang Database,Chinese Biomedical Literature Database and Chi nese Journals Full-text Database since the database building to Sep.2018.Sum marized indicators:blood glucose effect(at the 7th and 14th respectively after drug administration).The processing of the original literature can be divided in to three steps:literature screening,quality evaluation and data extraction.Under the premise of contacting the original author and supplementing the informatio n as much as possible,it can be carried out independently by two reviewers.We use the stata14.0 software to make network structure maps,forest maps an d calibration comparison funnel plots at the basis of adopted literatures which were also used for consistency analysis,and network meta-analysis based on fr equency methodology.ResultsEight RCTs were included in the meta-analysis of this network.These doc uments involved 310 patients with severe burns,including 134 patients in grou p one with rhGH treatment within 7 days after burn;47 patients in group two with rhGH treatment 7 days later after burn;and 129 patients treated in grou p three with saline.All the included literature were scored on the Jadad scale with a score of 3,indicating that there may be a risk of research bias.The Di as model was used for consistency analysis.The result showed no significant d ifference between direct comparison and indirect comparison of the intervention s on the 7th day after administration and on the 14th day after administration.The corresponding P values were greater than 0.05,suggesting that there was no evidence indicates that there is an inconsistency in the network meta-analy sis.We performed a network meta-analysis based on the frequency method.On the 7th day after medication,the average effect difference of blood glucose le vel between patients receiving treatment within 7 days and after 7 days is WM D-0.330[95%CI(-2.242,1.582),P>0.05].This indicates that there was no significant difference in the amount of blood glucose change between the inte rvention group 2 and the intervention group 1 on the 7th day after administrati on.The average effect different of blood glucose level between patients receivi ng normal saline and receiving treatment within 7 days is WMD-2.707[95%C I(-3.536,-1.878),P<0.001].The difference of blood glucose changes betwe en the intervention group 3 and the intervention group 1 on the 7th day after administration was statistically significant.On the 14th day after medication,th e average effect differernce of blood glucose level between patients receiving tr eatment within 7 days and after 7 days is WMD-0.910[95%CI(-2.518,0.698),P>0.05].This indicates that there was no significant difference in the am ount of blood glucose change between the intervention group 2 and the interve ntion group 1 on the 14th day after administration.The average effect different of blood glucose level between patients receiving normal saline and receiving treatment within 7 days is WMD-1.836[95%CI(-2.616,-1.057),P<0.001].The difference of blood glucose changes between the intervention group 3 and the intervention group 1 on the 14th day after administration was statistically significant.ConclusionOn the 7th day and the 14th day after the administration,there was a stat istically significant difference in the amount of blood glucose changes between the patients who received rhGH in 7 days and others received the saline;The re was no statistically significant difference in the amount of blood glucose ch anges between the patients who received rhGH in 7 days and who received rh GH after 7 days.Therefore,rhGH treatment of severe burns can cause elevated blood sugar,but the degree of elevation didn't have significant relationship wi th the tmning of application.In this paper,due to the small amount of data on the 3rd day after drug administration and the 21st day after drug administrati on,the results were not obtained,which resulted in fewer observation indicator s and reduced the credibility of the strength of the research results.Due to the inclusion of literature bias and publication bias,more large sample sizes and high quality RCT literature are needed to obtain more robust clinical evidence. |
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