健康教育对我国儿童龋病患病率影响的Meta分析及试验序贯分析
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摘要
目的通过Meta分析和试验序贯分析(TSA)评价健康教育对我国儿童龋病患病率的影响。方法计算机检索中国生物医学文献数据库(CBM)、中文期刊全文数据库(CNKI)和维普中文科技期刊数据库(VIP)、万方数据库,搜索关于健康教育对我国儿童龋病发病率影响的随机对照试验(RCT),检索时间均为建库至2017年5月。由2名评价员独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用Rev Man 5. 3软件进行Meta分析,采用试验序贯分析软件进行TSA。结果最终纳入6项研究,共2 138例患者,其中试验组1 069例,对照组1 069例。Meta分析结果显示:健康教育能降低儿童龋病患病率,RR=0. 68,95%CI为0. 57～0. 77,差异有统计学意义(P<0. 001);且TSA结果显示累计Z值跨过了传统界限和TSA界限,进一步肯定了Meta分析的结果。结论健康教育能降低我国儿童龋病患病率,但纳入文献质量不高,还需大样本、多中心的随机对照试验加以证实。
Objective To evaluate the effect of health education on the prevalence of dental caries among Chinese children by means of Meta analysis and trial sequential analysis. Methods Reviewing of the randomized controlled trials of the effect of health education on theprevalence of dental caries among Chinese children from the databases of Chinese Biomedical Literature Database( CBM),Chinese Journal Full-text Database( CNKI),VIP Chinese Science and Technology Periodical Database( VIP),Wanfang Database( RCT),retrieval time from database foundation to May 2017. After two reviewers screened the literature,extracted data,and assessed the risk of being included in the study,Meta-analysis was performed using Rev Man 5. 3 software and TSA was performed using trial sequential analysis software.Results Six studies were finally enrolled,with a total of 2138 patients,of which 1069 were in the experimental group and 1069 were in the control group. Meta analysis results show that health education can reduce the prevalence of dental caries,RR = 0 68,95% CI( 0 57,077),P<0. 001,the difference is statistically significant; TSA results show that the cumulative Z value across the traditional boundaries and TSA boundaries,the results of Meta analysis are further affirmed. Conclusion The available evidences show that health education can reduce the prevalence of dental caries among child in our country. However,the quality of the included literature was generally low. We need more sample and multicenter randomized controlled trials in order to stdudy and validate it.
Objective To evaluate the effect of health education on the prevalence of dental caries among Chinese children by means of Meta analysis and trial sequential analysis. Methods Reviewing of the randomized controlled trials of the effect of health education on theprevalence of dental caries among Chinese children from the databases of Chinese Biomedical Literature Database( CBM),Chinese Journal Full-text Database( CNKI),VIP Chinese Science and Technology Periodical Database( VIP),Wanfang Database( RCT),retrieval time from database foundation to May 2017. After two reviewers screened the literature,extracted data,and assessed the risk of being included in the study,Meta-analysis was performed using Rev Man 5. 3 software and TSA was performed using trial sequential analysis software.Results Six studies were finally enrolled,with a total of 2138 patients,of which 1069 were in the experimental group and 1069 were in the control group. Meta analysis results show that health education can reduce the prevalence of dental caries,RR = 0 68,95% CI( 0 57,077),P<0. 001,the difference is statistically significant; TSA results show that the cumulative Z value across the traditional boundaries and TSA boundaries,the results of Meta analysis are further affirmed. Conclusion The available evidences show that health education can reduce the prevalence of dental caries among child in our country. However,the quality of the included literature was generally low. We need more sample and multicenter randomized controlled trials in order to stdudy and validate it.
引文
[1]刘玲,梁志刚,臧运泰.儿童口腔健康教育干预措施的效果观察与研究[J].中外医疗,2012,31(9):128.
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[7]蔡楠,王桂茹,侯丹丹,等.小学生口腔健康知、信、行现状及口腔健康教育研究进展[J].中国妇幼保健,2016,31(9):2002-2004.
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[13]覃建春.社区健康教育结合氟化泡沫对幼儿防龋的效果分析[J].保健医学研究与实践,2014,11(6):28-29.
[14]杨梅,吕健,辛秉昌,等.口腔健康教育对改善小学生口腔卫生状况、口腔健康知识和行为的作用分析[J].全科口腔医学杂志(电子版),2016,3(4):4-5.
[15]Nakre PD,Harikiran AG.Effectiveness of oral health education programs:a systematic review[J].J Int Soc Prev Community Dent,2013,3(2):103-105.
[16]Liu J,Zhang SS,Zheng SG,et al.Oral health status and oral health care model in China[J].Int J Dent Hyg,2016,19(4):207-215.
[17]邵斌.青少年口腔健康状况调查[J].中国社区医师(医学专业),2010,12(18):131.
[18]Ghaffari M,Rakhshanderou S,Ramezankhani A,et al.Oral health education and promotion programmes:meta-analysis of 17-year intervention[J].Int J Dent Hyg,2018,16(1):59-67.
[19]Albrecht M,Kupfer R,Reissmann DR,et al.Oral health educational interventions for nursing home staff and residents[M].The Cochrane Library,2013:CD010535.
[2]Dye BA,Hsu KL,Afful J.Prevalence and measurement of dental caries in young children[J].Pediatr Dent,2015,37(3):200.
[3]Anil S,Anand PS.Early childhood caries:prevalence,risk factors,and prevention[J].Front Pediatr,2017,5:157.
[5]Liu J,Zhang SS,Zheng SG,et al.Oral health status and oral Health Care Model in China[J].Chin J Dent Res,19(4):207-215.
[6]孙佩,宋靓雯,方琳.健康教育在儿童龋齿防治中的应用研究[J].基层医学论坛,2010,14(30):903-904.
[7]蔡楠,王桂茹,侯丹丹,等.小学生口腔健康知、信、行现状及口腔健康教育研究进展[J].中国妇幼保健,2016,31(9):2002-2004.
[8]Habbu SG,Krishnappa P.Effectiveness of oral health education in children-a systematic review of current evidence(2005-2011)[J].Int Dent J,2012,65(2):57-64.
[9]储月琴.进行口腔健康教育对改善小学生口腔健康状况的效果探析[J].当代医药论丛,2014,12(20):180-182.
[10]傅乐,童锦发.不同健康教育模式对提高儿童口腔保健的干预效果观察[J].中国妇幼健康研究,2016,27(12):1520-1522.
[11]高薇,刘洪,严俊,等.口腔健康教育对改善小学生口腔卫生状况、口腔健康知识和行为的效果研究[J].护理研究,2015,29(2):220-222.
[12]景国华,蒋娟雯.健康教育对预防儿童龋齿患病率的效果观察[J].中国妇幼健康研究,2016,27(9):1117-1118.
[13]覃建春.社区健康教育结合氟化泡沫对幼儿防龋的效果分析[J].保健医学研究与实践,2014,11(6):28-29.
[14]杨梅,吕健,辛秉昌,等.口腔健康教育对改善小学生口腔卫生状况、口腔健康知识和行为的作用分析[J].全科口腔医学杂志(电子版),2016,3(4):4-5.
[15]Nakre PD,Harikiran AG.Effectiveness of oral health education programs:a systematic review[J].J Int Soc Prev Community Dent,2013,3(2):103-105.
[16]Liu J,Zhang SS,Zheng SG,et al.Oral health status and oral health care model in China[J].Int J Dent Hyg,2016,19(4):207-215.
[17]邵斌.青少年口腔健康状况调查[J].中国社区医师(医学专业),2010,12(18):131.
[18]Ghaffari M,Rakhshanderou S,Ramezankhani A,et al.Oral health education and promotion programmes:meta-analysis of 17-year intervention[J].Int J Dent Hyg,2018,16(1):59-67.
[19]Albrecht M,Kupfer R,Reissmann DR,et al.Oral health educational interventions for nursing home staff and residents[M].The Cochrane Library,2013:CD010535.