Li Ping, Ning Xiao-Hui, Lin Hua, Zhang Ning, Gao Yan-Feng, Ping Fen
Department of Gerontology, Hebei General Hospital, Shijiazhuang City, Hebei Province, 050051, China.
Department of Gerontology, Hebei General Hospital, Shijiazhuang City, Hebei Province, 050051, China.
Sleep Med. 2020 Aug;72:5-11. doi: 10.1016/j.sleep.2020.03.015. Epub 2020 Mar 21.
The goal of this study was to review relevant randomized controlled trials in order to determine the efficacy of continuous positive airway pressure (CPAP) versus mandibular advancement device (MAD) in the treatment of obstructive sleep apnea (OSA).
Using appropriate keywords, we identified relevant studies using PubMed, the Cochrane Library, and Embase. Key pertinent sources in the literature were also reviewed, and all articles published through October 2019 were considered for inclusion. For each study, we used odds ratios (ORs), mean difference (MD), and 95% confidence interval (95% CI) to assess and synthesize outcomes.
We included 14 RCTs, for a total of 249 patients in the CPAP group and 247 in the MAD group. Compared with MAD, CPAP significantly decreased apnea hypopnea index (AHI) (WMD: -7.08, 95%CI: -9.06∼-5.10) and the percentage of stage 1 and 2 after therapy (WMD: -3.728, 95%CI: -6.912∼-0.543). However, compared with MAD, CPAP significantly decreased the SF-36-social function score (WMD: -3.381, 95%CI: -6.607∼-0.154).There was no significant difference in Epworth sleepiness scale score after therapy between the two groups.
CPAP has better therapeutic efficacy in OSA patients than MAD.
本研究的目的是回顾相关随机对照试验，以确定持续气道正压通气（CPAP）与下颌前移装置（MAD）在治疗阻塞性睡眠呼吸暂停（OSA）方面的疗效。
使用适当的关键词，我们通过PubMed、Cochrane图书馆和Embase检索相关研究。还查阅了文献中的关键相关资料，并纳入了截至2019年10月发表的所有文章。对于每项研究，我们使用比值比（OR）、平均差（MD）和95%置信区间（95%CI）来评估和综合结果。
我们纳入了14项随机对照试验，CPAP组共有249例患者，MAD组有247例。与MAD相比（CPAP）显著降低了呼吸暂停低通气指数（AHI）（加权平均差：-7.08，95%CI：-9.06至-5.10）以及治疗后1期和2期的百分比（加权平均差：-3.728，95%CI：-6.912至-0.543）。然而，与MAD相比，CPAP显著降低了SF-36社会功能评分（加权平均差：-3.381，95%CI：-6.607至-0.154）。两组治疗后Epworth嗜睡量表评分无显著差异。
在OSA患者中，CPAP比MAD具有更好的治疗效果。
