内镜下套扎术与硬化剂注射术治疗内痔的疗效及安全性比较的Meta分析

Meta-Analysis of the Efficacy and Safety of Endoscopic Lancing Compared with Sclerotherapy in the Treatment of Internal Hemorrhoids

摘要: 目的：系统性比较内镜下套扎术(EBL)与硬化剂注射疗法(EIS)治疗内痔的有效率和安全性，为临床疾病的治疗提供循证医学参考。方法：本研究通过计算机检索PubMed、Web Of Science、Embase、The Cochrane Library、CBM、CNKI、万方、维普数据库中关于EBL与EIS治疗内痔的临床随机对照研究，检索时间为自建库至2024年11月，由2名研究人员根据纳排标准筛选文献后提取相关数据，应用RevMan5.4软件进行Meta分析，比较2种术式的临床疗效、术后并发症、疼痛VAS评分及复发情况。结果：本研究共纳入13篇文献，均为随机对照研究。Meta分析结果显示：EBL组和EIS组在疗效及复发率方面差异没有统计学意义(P > 0.05)，但是与EBL组比较，EIS组在术后并发症发生率及疼痛评分方面明显低于EBL组。结论：EBL和EIS两种方法在内痔治疗方面疗效相当，其中，EIS治疗术后疼痛和并发症发生率更低。但本研究尚有一定局限性，需今后更多高质量的临床研究提供更加可靠的循证医学证据。

Abstract: Objective: To systematically compare the efficacy and safety of endoscopic lancing (EBL) and sclerotherapy injection (EIS) for the treatment of internal hemorrhoids, and to provide evidence-based medical references for the treatment of clinical diseases. Methods: In this study, we searched the PubMed, Web of Science, Embase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases by computer for clinically randomized controlled studies on EBL versus EIS for the treatment of internal hemorrhoids from the time of library construction to November 2024. Two researchers screened the literature according to the inclusion and exclusion criteria, and Meta-analysis was performed by applying RevMan5.4 software to compare the clinical efficacy, postoperative complications, VAS scores, and recurrence of the 2 procedures. Results: A total of 13 papers were included in this study, all of which were randomized controlled studies. Meta-analysis showed that the difference between the EBL group and the EIS group was not statistically significant in terms of efficacy and recurrence rate (P > 0.05), but the EIS group was significantly lower than the EBL group in terms of the incidence of postoperative complications and VAS scores when compared with the EBL group. Conclusion: The efficacy of both EBL and EIS methods in the treatment of internal hemorrhoids is comparable, in which the postoperative pain and complication rates are lower in EIS treatment. However, there are some limitations in this study, and more high-quality clinical trials are needed to provide more reliable evidence-based medical evidence in the future.