اثر شیر خشت بر زردی نوزادان یک مرور نظامند همراه با متا آنالیز
Subject Areas : Journal of Medicinal Herbs, "J. Med Herb" (Formerly known as Journal of Herbal Drugs or J. Herb Drug)علیرضا صالحی 1 , محدثه استوار 2 , مریم مرزبان 3
1 - مرکز تحقیقات طب سنتی، دانشگاه علوم پزشکی شیراز، شیراز، ایران
2 - گروه طب سنتی، دانشگاه علوم پزشکی شیراز، شیراز، ایران
3 - مرکز توسعه پژوهش های بالینی، بیمارستان شهدای خلیج فارس، دانشگاه علوم پزشکی بوشهر، بوشهر، ایران
Keywords: شیر خشت, زردی نوزادان, پرژک, بیلیناستر, طب سنتی ایرانی,
Abstract :
زمینه و هدف: در طب سنتی از شیر خشت به عنوان یک روش درمانی به صورت سنتی در طب ایرانی برای درمان زردی نوزادان استفاده میشود. با استفاده از متا آنالیز و مرور متون، اثر شیر خشت بر زردی نوزادان بررسی شد. روش تحقیق: هدف از این مطالعه بررسی اثر کارآزمایی های بالینی انجام شده در مورد شیرخشت بر زردی نوزادان است. شیوه اصلی که در این مطالعه استفاده شده شامل جستجو مقالات انگلیسی و فارسی تا مارچ 2016 بوده است. کیفبت کارآزمایی های بالینی با استفاده از چک لیست کانسورت برای مداخلات دارویی بررسی شد. هفت مطالعه که دارای تورش پایین یا متوسط بوده اند با 804 شرکت کننده برابر با 410 مورد در برابر 394 شاهد برای ورود به مطالعه مروری و یا متا آنالیز با نرم افزار CMA نسخه 2.2 انتخاب شدند. نتایج: مقدار کلی بیلی روبین پلاسما در 0، 12، 24 ، 36، 48 ساعت و طول دوره اقامت در بیمارستان کنترل شده و هیچگونه عارضه جانبی گزارش نشده است. متاآنالیز نشان دهنده هتروژنیتی برجسته ای از نتایج بوده است(Q-value = 132.446, P< 0.0001, I2 = 87.165, τ = 0.998). با این حال، اثرات موثر شیرخشت بر زردی نوزادان نشان داده شده است(n= 804, OR = 0.242, 95% CI: 0.147 to 0.399, P < 0.0001). همچنین میتوان اذعان نمود که شیر خشت میتواند مدت اقامت در بیمارستان را نیز کاهش دهد(n= 804, SMD= -1.154, 95% CI: -1.854 to -0.455, P< 0.001). با این حال نتایج به دست آمده هتروژن و ناهمگن بوده است(Q-value= 119.642, P< 0.0001, I2= 94.985, τ= 0.913). توصیه های کاربردی/ صنعتی: گرچه که متاآنالیز شیر خشت بر زردی نوزدان نشان دهنده اثر مثبت شیرخشت بر زردی نوزادان در این مطالعات بوده، با این حال انجام مطالعات چند مرکزی کارآزمایی بالینی با حجم نمونه بالاتر که برای عوامل خطر کنترل شده و مقایسه آن با روش درمان رایج که فتوتراپی می باشد توصیه میشود.
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