Meta-analysis Of Efficacy And Safty Of Ultrasound-guided Injection Versus Oral Corticosteroids In The Treatment Of Subacute Thyroiditis

Objective : To systematically evaluate the clinical effect of local injection /intrathyroidal injection glucocorticoids(GCs)on subacute thyroiditis(SAT).Methods and materials: A comprehensive search of 7 electronic databases was conducted based on PubMed?Embase?Web Of Science?CBM?CNKI?VIP database and Wanfang Data.According to inclusive and exclusive criteria,the published clinical trials local with the sufficient data were included for this analysis.A Meta-analysis on acquired data was performed with RevMan5.3 software and Stata 15.1 software.Results: A total of 17 trials with 1253 SAT patients were included.Our Meta-analysis showed that the overall efficiency of intrathyroid injection of hormone group was higher than that of oral hormone group with a statistical significance(RR=1.08,95% CI 1.03~1.13,p<0.01);The upper thyroid injection group have the better clinical remission than the oral group,and the difference between the two groups was statistically significant(Fever: SMD=-2.46,95% CI-2.84~-2.09,p<0.01;Pain: SMD=-2.486,95%CI-2.64~-2.33,p<0.01;Goiter: SMD=-1.73,95% CI-2.02~-1.45,p<0.01);recovery of erythrocyte sedimentation rate was significantly faster in the experimental group than in the control group(SMD=-2.36,95% CI-2.64~-2.07,p<0.01);the recurrence rate was significantly lower in the thyroid injection group than in the oral group(RR=0.36,95%CI: 0.138~0.935,p<0.01);intrathyroid injection was safe and reliable without adverse reactions.Conclusion: The overall efficacy of intrathyroid injection of hormone in the treatment of subacute thyroiditis is better than oral hormone therapy.It is also superior to the oral group in alleviating the decline of clinical symptoms and blood cell sedimentation rate.In the incidence of adverse reactions,there is no intrathyroid injection group.Adverse reactions,while the control group showed about 20% of weight gain,upper abdominal discomfort and other adverse reactions;in terms of safety,only a small number of intrathyroid injection group due to poor operation of local hematoma,pain.Since the current literatures are all derived from domestic research,most of the studies only mention randomization,no specific implementation methods,and the quality of research evaluation is general.According to the existing research,the above conclusions need to be further verified by large samples and high quality RCTs.