Kleijnen J, Knipschild P
Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, The Netherlands.
Acta Neurol Scand. 1995 May;91(5):330-4. doi: 10.1111/j.1600-0404.1995.tb07017.x.
This review assesses the evidence of the efficacy of hyperbaric oxygen in multiple sclerosis. Material & methods - We used a list of predefined criteria for good methodology and interpreted the results of 14 identified controlled trials with emphasis on the quality. Results - At least eight trials can be considered to have a reasonable to high quality. In one of these 8 trials the results were in favour of hyperbaric oxygen treatment; the others found no clear positive effects. The patients had chronic progressive or chronic stable multiple sclerosis. In most trials, hyperbaric oxygen was supplied at pressures of 1.75-2 ATA, during 20 sessions of 90 min in 4 weeks. The principle endpoint was the (Expanded) Disability Status Score [(E)DSS] and the Functional Status Score as described by Kurtzke. Also specific outcomes such as evoked potentials were frequently used, but no consistent positive effects were demonstrated. Side effects were generally minor, ear and visual problems predominated. Conclusions - The majority of controlled trials could not show positive effects. Further evidence might consist of trials in patients with disease of recent onset or with other dosing regimens but the case for such further trials is not strong. Considering the state of affairs we cannot recommend the use of hyperbaric oxygen in the treatment of multiple sclerosis.
本综述评估了高压氧治疗多发性硬化症疗效的证据。材料与方法——我们使用了一系列预定义的良好方法标准，并重点从质量方面解读了14项已确定的对照试验的结果。结果——至少八项试验可被认为质量合理至高。在这八项试验中的一项中，结果支持高压氧治疗；其他试验未发现明显的积极效果。患者患有慢性进行性或慢性稳定型多发性硬化症。在大多数试验中，高压氧在1.75 - 2个绝对大气压的压力下提供，在4周内进行20次，每次90分钟。主要终点是（扩展）残疾状态评分[(E)DSS]以及库尔茨克所描述的功能状态评分。诱发电位等特定结果也经常被使用，但未显示出一致的积极效果。副作用一般较小，主要是耳部和视觉问题。结论——大多数对照试验未能显示出积极效果。进一步的证据可能来自针对近期发病患者或采用其他给药方案的试验，但进行此类进一步试验的理由并不充分。鉴于目前的情况，我们不建议在多发性硬化症的治疗中使用高压氧。
