Ntu 2: Qhov tshwm sim ntawm Mob ntawm cov neeg mob uas muaj kab mob raum ntev siv kev tshuaj xyuas thiab ntsuas ntsuas
Mar 10, 2022
NyemNtawm norau Part 1
Hu rau:joanna.jia@wecistanche.com/ WhatsApp: 008618081934791
cistanchekho tauraumkab mobtxhim kholub raum ua haujlwm
Neuropathic mob
Kaum ob txoj kev tshawb fawb suav nrog tag nrho ntawm 3384 cov tib neeg tau muab faib ua pawg kom tau txais kev nthuav dav thoob ntiaj teb ntawm neuropathicmobntawm 0 feem pua (95 feem pua CI: 6 feem pua – 15 feem pua ) (Daim duab 6) uas tsis muaj qhov sib txawv tseem ceeb ntawm cov pab pawg uas tau teev tseg los ntawmmob raum mobtswj cov tswv yim (P ¼ {{0}}.51). Heterogeneity yog thoob ntiaj teb siab (I2 ¼ 95 feem pua) tshwj tsis yog hauv KTRs pawg uas muaj 2 cov kev tshawb fawb nrog kev kwv yees zoo sib xws (I2 ¼ 0 feem pua).
Meta-regression qhia tias feem pua ntawm cov neeg koom nrog cuam tshuam los ntawm kev kub siab hauv cov qauv thiab qhov siab dua BMI yog ob qho tib si cuam tshuam nrog ntau dua ntawm neuropathic.mob(Cov duab ntxiv S2A thiab B; P 0. Univariate qauv nrog kub siab thiab BMI raws li kev kwv yees tsuas yog tshuav 14 feem pua thiab 0 feem pua ntawm unaccounted heterogeneity, ntsig txog, qhia txog kev sib raug zoo (Cov Lus Ntxiv S11). Cov koom haum tseem nyob hauv cov qauv sib txawv uas tswj hwm hnub nyoog, poj niam txiv neej, thiab thaj chaw. Tus qauv multivariate kuj tau nthuav tawm lwm qhov tseem ceeb covariate: feem pua ntawm cov neeg mob ntshav qab zib mellitus hauv cov qauv ua tau zoo sib cuam tshuam nrog kev sib kis ntawm neuropathic.mobtom qab tswj xyuas hnub nyoog, poj niam txiv neej, thiab thaj chaw thaj chaw (Sab Ntxiv Table S11; P ¼ 0.03; I2 ¼ 61 feem pua ).
Thaum kawg, univariate meta-regression qhia tau hais tias qhov kev faib ua feem ntawm cov poj niam cov kev kawm hauv cov qauv kev tshawb fawb tau cuam tshuam tsis zoo nrog rau qhov tshwm sim ntawm neuropathic.mob(Table Ntxiv S11 thiab Daim Duab Ntxiv S2C).
Mob cuam tshuam rau qhov chaw ntawm lub cev
Supplementary Table S12 qhia txog qhov sib koom ua ke uas tau txais rau ntau qhov chaw hauv lub cev thiab fibromyalgia, tag nrho thiab stratified los ntawmmob raum mob tswj lub tswv yim. Musculoskeletalmobtshwm sim yog feem ntaumobCov tsos mob hauv cov neeg mob uas tsis yog mob ntshav qab zibmob raum mob (42 feem pua ; 95 feem pua CI: 28 feem pua -56 feem pua ) nrog rau cov uas tab tom kawmlim ntshav(45 feem pua ; 95 feem pua CI: 36 feem pua – 55 feem pua ), tab sis nws yog qhov tseem ceeb tsawg ntawm KTRs (18 feem pua ; 95 feem pua CI: 6 feem pua – 44 feem pua ). Nws yog ib qho tsim nyog sau cia tias qhov muaj ntau heev ntawm fibromyalgia pom hauv cov neeg mobmob raum mob (11 feem pua ; 95 feem pua CI: 8 feem pua – 14 feem pua ), ntau dua li 1.78 feem pua (95 feem pua CI: 1.65 feem pua – 1.92 feem pua ) kwv yees muaj feem ntau ntawm cov pejxeem qhia nyob rau hauv ib tug yav dhau los meta-kev tshuaj ntsuam, tab sis ntau nyob rau hauv kab nrog rau 6.30 feem pua (95 feem pua CI: 4.60 feem pua – 7.90 feem pua ) prevalence lawv pom ntawm cov neeg mob kho nroghemodialysis.28 Ntawm KTRs, cov tsos mob tshwm sim tshaj plaws yog mob plabmob(41 feem pua ; 95 feem pua CI: 7 feem pua –{3}} feem pua ) nrog rau qhov muaj feem ntau siab dua nyob rau hauvmob raum mob tsis-lim ntshav(15 feem pua ; 95 feem pua CI: 2 feem pua -63 feem pua ) thiablim ntshav(16 feem pua; 95 feem pua CI: 10 feem pua – 24 feem pua) sub- pawg. Hais txog qhov cuam tshuam ntawmlim ntshavmodalities, 3 kev tshawb fawb soj ntsuam plabmobntawm cov neeg mob kho nroghemodialysislos yog peritoneallim ntshavraug txheeb xyuas. Ob ntawm lawv 29,30 pom muaj ntau dua ntawm cov neeg mob kho nroghemodialysisthaum peb 31 pom tsis muaj qhov txawv txav. Tom qab muab cov 3 cov kev tshawb fawb no ua ke, peb qhov kev ntsuam xyuas qhov tshwm sim tsis zoo tsis tau qhia qhov txawv ntawm 2 cov qauv (c2 xeem rau pawg sib txawv: P ¼ 0.7) (Daim duab 7).
Hais txog lwm qhov chaw tshwj xeeb mob, 2 kev tshawb fawb7,31qhia txog qhov sib xws ntawm mob taub hau ntawm cov neeg mob kho nroghemodialysisthiab peritoneallim ntshav. Hauv kev tshawb nrhiav kev tshawb nrhiav fibromyalgia, Berber et al.32 pom tsis muaj qhov sib txawv tseem ceeb ntawmlim ntshavmodalities thaum Sargin et al.33qhia txog qhov muaj ntau dua ntawm cov neeg mob tau txaishemodialysis. Meta-regression analyses pom tias cov laus lub hnub nyoog nruab nrab yog txuam nrog ntau dua ntawm fibromyalgia (Cov duab ntxiv S3, P ¼ 0.05; I2 ¼ 58 feem pua).
Ib qho zoo sib xws ntawm kev mob taub hau ntawm cov neeg mob kho nroghemodialysisthiab peritoneallim ntshavpom, thiab cistanche tej zaum yuav pab tau tso tawmmobthiab pab rau lub raum.
Kawm zoo
Cov Lus Qhia Ntxiv S13 thiab S14 qhia cov kev ntsuam xyuas zoo ntawm qib kawm rau txhua yam ntawm 3 qhov chaw (xaiv kev tsis ncaj ncees, tsis meej pem, thiab cov txiaj ntsig ntsuas kev tsis ncaj ncees) ntsuas los ntawm Newcastle-Ottawa nplai (saib Cov Khoom Siv Ntxiv S2). Feem ntau ntawm cov kev tshawb fawb (51 feem pua) yog qhov zoo nruab nrab, thaum 24 feem pua thiab 25 feem pua yog qhov qis thiab zoo, feem. Qhov feem ntau ntawm cov kev tshawb fawb zoo me ntsis tuaj yeem piav qhia los ntawm qhov kev pheej hmoo tsawg ntawm kev ntsuas qhov ntsuas tsis zoo tab sis muaj kev pheej hmoo siab dua ntawm kev xaiv tsis ncaj ncees. Qhov tseeb tiag, feem ntau cov kev tshawb fawb (54 feem pua) tau kuaj cov neeg tuaj koom los ntawm ib lub chaw, yog li tsuas yog sawv cev rau cov neeg mob uas tuaj koom lub chaw tshwj xeeb no thiab cov kev coj ua hauv chav tsev tshwj xeeb. Hauv ib nrab ntawm cov kev tshawb fawb, tus nqi teb tsis tau txheeb xyuas, thiab ntawm 22 cov kev tshawb fawb qhia txog tus nqi teb.<80%, only="" 5="" demonstrated="" the="" representativeness="" of="" their="" responders="" either="" by="" showing="" they="" were="" no="" different="" from="" nonresponders="" or="" by="" comparing="" them="" to="" the="" larger="" population="" they="" were="" sampled="" from.="" finally,="" random="" sampling="" was="" only="" used="" in="" a="" minority="" of="" articles="" (12%).="" consecutive="" sampling="" was="" pre-dominant,="" probably="" to="" obtain="" a="" larger="" sample="" size,="" especially="" for="" studies="" recruiting="" patients="" from="" a="" single="" center.="" in="" nearly="" one-half="" of="" the="" studies="" included="" (n="" 48)="" the="" impact="" of="" confounding="" related="" to="" variables="" such="" as="" age,="" sex,="">mob raum mob stage, lublim ntshavmodality tsis tau txiav txim siab. Hais txog cov txiaj ntsig ntsuas kev tsis ncaj ncees, qhov zoo tau txaus siab raws li tus kheej tshaj tawmmobKev ntsuam xyuas, uas yog suav tias yog tus qauv kub, tau xaiv los ntawm cov neeg tshawb xyuas feem ntau (89 feem pua). Tsuas yog 4 tau siv qhov kev ntsuam xyuas npe los ntawm tus kws kho mob34,35los yog tus neeg zov me nyuam,36,375 ua rovmobkuaj mob los ntawm cov ntaub ntawv kho mob,38–42,thiab 2 siv kev sib xyaw ua ke ntawm ob txoj hauv kev.43,44Hauv kev tshawb nrhiav kev tshawb nrhiav dav davmob, 43raws li lawv qhov kev ntsuam xyuas ntawm kev xam phaj thaum 32 tso siab rau cov lus nug tus kheej. Nws yuav tsum raug sau tseg tias tsuas yog 1 txoj kev tshawb fawb tau siv cov cuab yeej tshwj xeeb los ntsuas neuropathicmob(Leeds Kev Ntsuam Xyuas Ntawm Cov Mob Neuropathic thiab Cov Cim Qhia, S-LANSS).45Lwm cov kev tshawb fawb tso siab rau cov nplai uas tsis tau tsim tshwj xeeb rau hom nomobxws li Cov Lus QhiaMobCov khoom muag los yog McGillMobQuestionnaire, ib daim ntawv qhia los ntawm cov ntaub ntawv kho mob,38,46los yog kev txiav txim los ntawm ib tug kws kho mob26,47los yog neurologist.41 Feem ntau ntawm cov neeg tshawb xyuas tsis tau hais meej txog qhov kev kuaj mob neuropathic li casmobua.48–53Thaum siv cov tshuaj tsis tshwj xeebmobscale, nws yuav tau inferred los ntawm cov lus ntawm cov lus nug xaiv los ntawm cov neeg mob los piav txog hom ntawmmobmuaj kev paub, raws li loog loog / tingling / hlawv cov tsos mob qee zaum siv los kwv yees kev kuaj mob neuropathicmob.54 Meta-analyses stratified los ntawm kev kawm zoo tsis qhia tias muaj qhov sib txawv hauvmobKev kwv yees ntau dua ntawm cov kev tshawb fawb qis, nruab nrab, lossis siab zoo (Table Ntxiv S15; c2 xeem rau pawg sib txawv: P 0.2 raumob; P 0.09 rau mobmob; P 0.13, rau neuropathicmob). Ib yam li ntawd, rau tag nrho cov txiaj ntsig tau soj ntsuam, qhov kev kwv yees ntau yam tseem tsis tau hloov pauv tom qab tsis suav nrog cov kev tshawb fawb tsis zoo (Table S15 Ntxiv), rov hais dua tias txawm tias qee qhov kev txhawj xeeb txog tag nrho cov kev tshawb fawb zoo suav nrog, qhov no tsis zoo li cuam tshuam rau qib ntawm cov pov thawj ntawm peb. kev kwv yees sib sau.
Ntau tus neeg mob raug kev txom nyem los ntawmmob raum mob, thiabcistanchetxhim kho cov tsos mob thiab tiv thaivlub raum ua haujlwm.
Kev tshaj tawm kev tsis ncaj ncees Begg qhov kev sim tsis tau pom muaj pov thawj rau kev tshaj tawm kev tsis ncaj ncees thaum Egger qhov kev sim tsuas yog ua rau kev tshuaj ntsuam meta ntawmmobthiab neuropathicmobtab sis tsis yog rau mobmob. Thaum stratifying tsis ntev los nomoblos ntawmmob raum mob subgroup, asymmetry tsuas yog nyob rau hauv lublim ntshavpab pawg (Cov duab ntxiv S4 thiab S5).
Hauv cov ntsiab lus no thiab paub txog qhov tsis muaj qhov tsis txaus ntseeg ntawm kev ntsuam xyuas kev tshaj tawm tsis zoo hauv kev tshawb fawb ntau, peb ntseeg tias nws tsis zoo li peb cov txiaj ntsig yuav cuam tshuam los ntawm qib siab ntawm kev tshaj tawm kev tsis ncaj ncees.
Qib ntawm cov pov thawj
Qhov tseeb nyob rau hauv tag nrho cov kev kwv yees prevalence tau suav hais tias yog tsawg raumob(vim kev tsis sib haum xeeb thiab kev pheej hmoo ntawm kev tsis ncaj ncees), nruab nrab rau mob ntevmob(vim muaj kev pheej hmoo ntawm kev tsis ncaj ncees), thiab tsawg heev rau neuropathicmob(vim kev tsis sib haum xeeb, kev pheej hmoo ntawm kev tsis ncaj ncees, thiab kev tsis ncaj ncees). Txawm hais tias kev soj ntsuam rhiab heev qhia tau hais tias kev suav nrog cov kev tshawb fawb qis lossis nruab nrab zoo-raws li Newcastle-Ottawa nplai-tsis cuam tshuam rau peb qhov kev kwv yees los yog qib heterogeneity, tag nrho cov kev tshawb fawb tau txo qis los ntawm 1 qib vim muaj kev txhawj xeeb loj txog kev pheej hmoo. xaiv bias. Qhov tseeb tiag, cov neeg koom tau raug coj mus kuaj ntau dhau los ntawm cov pej xeem uas tsis tuaj yeem suav tias yog tus sawv cev ntawm qhov davmob raum mob cov pej xeem vim yog nrhiav neeg los ntawm ib lub chaw thiab tsis tshua muaj kev siv random sampling. Kev txo qis kuj tau tshwm sim los ntawm qib siab heterogeneity pom thoob plaws cov kev tshawb fawb tshawb nrhiavmobthiab neuropathicmob. Kev ntsuas tsis ncaj ntawm qhov mob neuropathic los ntawm cov cuab yeej tsis tshwj xeeb kuj tseem txo qis peb qib kev ntseeg siab hauv kev kwv yees sib sau ua ke rau qhov tshwm sim no. Hais txog qhov chaw tshwj xeebmobRaws li heterogeneity thiab kev pheej hmoo ntawm kev tsis ncaj ncees tau txwv dua peb qhov kev ntseeg siab hauv kev kwv yees, tag nrho cov txiaj ntsig tshwj tsis yog fibromyalgia tau muab pov thawj qis. Vim yog qhov qis dua I2 (74 feem pua tag nrho, 0 feem pua ntawm KTRs, 64 feem pua hauvlim ntshavsubgroup), qhov tseeb tau suav tias yog qhov nruab nrab rau fibromyalgia. GRADE cov lus muaj nyob rau hauv Cov Table S16 ntxiv rau qhov tshwm sim ntawm qhov mob thiab cov Table S17 ntxiv rau qhov tshwm sim ntawm qhov mob tshwj xeeb.
Kev soj ntsuam rhiab heev
Cov txiaj ntsig ntawm rhiab heev tsom xam tshawb txog qhov cuam tshuam ntawm thaj chaw thiabmobCov nplais muaj nyob rau hauv Cov Khoom Siv Ntxiv S3, Cov Lus Ntxiv S18, thiab Cov Duab Ntxiv S6-S8.
Kev sib tham
Lub nra hnyav ntawm qhov mob tau pom nyob rau hauv cov neeg mob uas muaj mob raum nrog kev kwv yees tag nrho ntawm 60 feem pua rau qhov mob hnyav, 48 feem pua rau mob ntev, thiab 10 feem pua rau cov mob neuropathic. KTRs tshwm sim muaj qhov mob tsawg (46 feem pua ; 95 feem pua CI: 37 feem pua -56 feem pua ) dua li cov neeg mob tau lim ntshav (63 feem pua ; 95 feem pua CI: 57 feem pua – 68 feem pua ) thiab cov neeg mob raum mob uas tsis yog-dialysis (63 feem pua ; 95 feem pua CI: 55 feem pua – 70 feem pua ), tab sis cov mob plab siab tau pom tshwj xeeb hauv pab pawg neeg no (41 feem pua; 95 feem pua CI: 7 feem pua –86 feem pua). Ntawm cov neeg mob uas tau lim ntshav los yog raug tswj xyuas kev saib xyuas, peb tau pom qhov muaj feem ntau ntawm cov mob musculoskeletal, nrog rau qhov tshwm sim zoo sib xws hauv ob pawg (45 feem pua thiab 42 feem pua, feem). Cov txiaj ntsig ntawm kev hloov lub raum hla kev kho mob ntshav qab zib tau hais qhia nyob rau hauv kev tshuaj xyuas yav dhau los uas cov kws tshawb fawb tau tshaj tawm tag nrho cov neeg tuag tsawg dua thiab lub neej zoo dua.55 Ntau qhov kev tshawb fawb kuj tau tshaj tawm cov qhab nia zoo dua hauv KTR pawg piv nrog rau cov kab mob raum tsis zoo56thiab pab pawg hemodialysis.56,57Txawm li cas los xij, nws yuav tsum tau hais tias yuav luag ib nrab ntawm KTRs tseem qhia txog qee yam kev mob, ib qho kev nthuav dav uas tseem siab dua li qhov tau pom hauv cov pej xeem. Peb kuj tau pom muaj qhov tshwm sim ntawm qhov mob mus sij hawm ntev, nrog ze li ib nrab ntawm cov neeg mob raum mob uas muaj mob ntev thiab 10 feem pua ntawm cov mob neuropathic. Raws li qhov taw qhia ntawm kev sib piv, qhov mob hnyav tau kwv yees tias yuav cuam tshuam txog 20 feem pua ntawm cov pej xeem thoob ntiaj teb,58 Raws li Lub Koom Haum Thoob Ntiaj Teb rau Kev Tshawb Fawb Txog Kev Mob, thiab qhov mob neuropathic nyob nruab nrab ntawm 6.9 feem pua thiab 10 feem pua , muab peb cov neeg mob raum mob rau ntawm qhov kawg ntawm cov pej xeem kwv yees.59
Peb cov txiaj ntsig tau qhia tias qhov mob ntawm cov neeg mob tau txais hemodialysis lossis peritoneal dialysis zoo ib yam. Qhov tshwm sim ntawm qhov mob tshwj xeeb xws li mob plab lossis mob taub hau kuj zoo ib yam. Stratification los ntawm cov kab mob raum ntev tau pom tias cov neeg mob raum mob raum theem 3 thiab 4 tuaj yeem raug kev txom nyem ntau npaum li cov neeg mob raum tsis ua haujlwm tswj kev tswj hwm. Kev siv cov kev kho mob palliative yoog rau cov neeg mob uas mob raum kab mob theem 5 tau tswj hwm kev saib xyuas zoo li txo qis me ntsis ntawm qhov mob hauv pab pawg no. Txawm hais tias muaj ntau qhov sib txawv siv tsis tau pab pawg loj, stratifying los ntawm qhov kev ntsuam xyuas mob tau piav qhia txog ib feem ntawm kev soj ntsuam ntawm-kev kawm heterogeneity. Peb ntseeg hais tias cov lus sib txawv (piv txwv li, qhov mob uas tsis yog cov kev mob niaj hnub no rau Cov Lus Qhia luv luv Cov Mob Ncauj Lus, qhov mob lossis tsis xis nyob hauv EuroQol 5 qhov ntev) thiab ntau lub sijhawm rov qab los (xws li, yav dhau los 24 teev rau Edmonton Symptom Assessment System , yav dhau los 3 lossis 7 hnub rau Palliative Care Outcome Scale-Symptoms Renal) siv thoob plaws ntau yam ntawm cov cuab yeej mob yuav piav qhia txog qhov tseem ceeb ntawm kev soj ntsuam heterogeneity. Txawm hais tias feem ntau cov kws tshawb nrhiav tau siv cov ntsuas ntsuas thaum tshawb xyuas qhov mob lossis mob ntev, qhov no tsis yog qhov xwm txheej thaum ntsuas qhov mob neuropathic. Tseeb tiag, tsuas yog 1 ntawm 12 cov kev tshawb fawb suav nrog tso siab rau cov cuab yeej tsim nyog, txhais tau tias yog cov cuab yeej tshwj xeeb tsim los tshawb xyuas qhov mob neuropathic, xws li S-LANSS, Neuropathic Pain Questionnaire, lossis Douleur Neuropathique 4 Cov Lus Nug.
Kev kub siab, nrog rau BMI siab dua, ob qho tib si tseem ceeb cuam tshuam nrog ntau dua ntawm qhov mob neuropathic. Hauv kev txheeb xyuas ntau yam, peb kuj pom cov pov thawj rau kev koom tes ntawm feem pua ntawm cov neeg mob ntshav qab zib thiab qhov tshwm sim ntawm qhov mob neuropathic. Qhov kev tshawb pom no tsis xav tsis thoob vim tias ntshav qab zib neuropathy yog ib qho teeb meem ntawm ntshav qab zib. Cov hauj lwm yav dhau los ua nyob rau hauv pab pawg ntawm cov neeg mob ntshav qab zib hom 1 tau pom tias kev kub siab kuj ua rau mob neuropathic,60 los ntawm impairing paj conduction.61Kev koom tes nrog BMI yog ua raws li cov pov thawj yav dhau los qhia tias kev rog rog ua rau muaj kev pheej hmoo62thiab kev siv zog63ntawm neuropathic mob, tej zaum yog los ntawm ib tug mechanism ntawm kab mob inflammation inducing paj puas. Cov kev tshawb fawb yav dhau los tau tshaj tawm qhov mob musculoskeletal raws li qhov mob tshwm sim feem ntau ntawm cov neeg mob kho nrog hemodialysis.64 Hauv peb qhov kev txheeb xyuas, nws yog hom mob ntau tshaj plaws nyob rau hauv ob qho tib si mob raum kab mob nondialysis thiab dialysis subgroups. Raws li musculoskeletal suav nrog cov pob txha / pob qij txha, qhov no tuaj yeem cuam tshuam rau cov kab mob hauv lub raum ntev-Mineral thiab Pob Txha, ib qho teeb meem ntawm cov kab mob raum ntev ua rau muaj kev cuam tshuam hauv calcium thiab phosphorus homeostasis, ua rau theem nrab hyperparathyroidism. Qhov tshwm sim muaj xws li cov pob txha thiab mob pob qij txha thiab muaj kev pheej hmoo siab ntawm pob txha (txog li 4 npaug siab dua ntawm KTRs piv nrog cov pej xeem) ntsig txog kev hloov pauv ntawm cov pob txha thiab cov metabolism.65Cov tsos mob ntawm tus kab mob raum ntev-Mineral thiab Pob Txha Disorder feem ntau tshwm sim nyob rau theem siab ntawm cov kab mob raum ntev, uas tuaj yeem piav qhia txog qhov muaj feem ntau ntawm cov pob txha / pob qij txha hauv cov kev tshawb fawb peb suav nrog.66 Kev ntsuam xyuas thiab paub txog qhov mob no yog qhov tseem ceeb heev vim nws yuav xav tau kev kho mob tshwj xeeb - txawv los ntawm kev kho mob raws plab - nrog cov pov thawj tsis ntev los no qhia tias mob pob txha tom qab hloov lub raum tuaj yeem teb rau bisphosphonate.65
Qhov tseem ceeb tshaj plaws thiab qhov muaj feem ntau ntawm qhov mob plab tau pom ntawm KTRs yuav muaj feem cuam tshuam nrog cov txiaj ntsig zoo ntawm kev tiv thaiv kev tiv thaiv kab mob thiab tuaj yeem nquag tshwj xeeb ntawm cov neeg mob kho nrog mycophenolate mofetil.67thiab sirolimus.68 Tej zaum cov txheej txheem hauv qab lub luag haujlwm rau cov kev mob plab siab no suav nrog mob tom qab phais tas li; visceral hyperalgesia; cov tshuaj toxicity ntawm cov tshuaj tiv thaiv kab mob ua rau mob mucosal raug mob, ulceration, kab mob diverticular, thiab nyob rau hauv cov ntaub ntawv phem tshaj perforation; 69 los yog ntau niaj hnub cov tshuaj.67
Rau peb txoj kev paub, qhov no yog thawj qhov kev tshuaj xyuas thiab kev tshuaj ntsuam meta nrog rau txhua qhov mob phenotypes thiab cov tswv yim tswj kab mob raum ntev. Kev tshawb fawb zoo tshaj plaws rau cov ntaub ntawv luam tawm thiab tsis tau tshaj tawm nrog rau kev siv cov txheej txheem dav dav tso cai rau peb los npog cov ncauj lus kom ntau li ntau tau thiab ua tiav cov ntaub ntawv muaj zog. Tsis tas li ntawd, peb kuj tseem tuaj yeem qhia tau tias tsis suav nrog cov kev tshawb fawb uas muaj kev pheej hmoo siab ntawm kev tsis ncaj ncees ua rau peb qhov kev kwv yees tag nrho tsis hloov pauv. Cov txheej txheem pob tshab siv thiab tus naj npawb ntawm cov kev soj ntsuam rhiab heev tau ua kom ntseeg tau qhov sib xws thiab kev ntseeg tau ntawm peb qhov kev kwv yees ntau.
Txawm li cas los xij, qee qhov kev txwv yuav tsum tau sau tseg. Muaj ntau ntau yam kev tshawb fawb tau suav nrog, qee qhov tshwj xeeb tshawb xyuas qhov tshwm sim ntawm qhov mob ntawm cov neeg mob uas muaj kab mob raum ntev thaum lwm tus qhia txog ntau yam tsos mob thiab tsis nruj me ntsis rau qhov mob, feem ntau ua rau cov ntaub ntawv tsis meej thiab tsis tshua muaj qauv. Qhov tsis muaj tus qauv hauv kev ntsuas qhov mob nrog ntau yam mob txhais tau hais tias, lub sijhawm rov qab los, thiab ntsuas qhov ntsuas qhov mob yuav yog lub luag haujlwm rau ntau yam heterogeneity uas tseem tsis tau piav qhia. Metaregression tsis tuaj yeem ua tau ib txwm ua vim tsis muaj cov yam ntxwv qhia hauv qee qhov kev tshawb fawb. Txawm hais tias nws tsis zoo li cuam tshuam rau peb qhov kev kwv yees ntau, nws yuav tsum tau muab sau tseg tias qhov kev tshawb fawb zoo tsis sib haum. Ntau tus tau ua nyob rau hauv ib lub chaw, thiab cov neeg soj ntsuam tsawg heev (13 feem pua) tau siv cov random sampling thiab piv cov yam ntxwv ntawm cov neeg teb thiab cov neeg tsis teb cov lus teb ua rau muaj kev tsis ncaj ncees nyob rau hauv qhov piv txwv. Cov txiaj ntsig ntsuas kev tsis ncaj ncees kuj tseem cuam tshuam rau peb cov txiaj ntsig raws li cov lus nug uas tus kheej tswj hwm tsis tuaj yeem ua tiav los ntawm cov neeg mob tsis zoo uas muaj kev mob siab ntau thaum kev xam phaj tuaj yeem ua rau muaj kev xav tsis thoob hauv zej zog. Nws tau pom tias cov kev tshawb fawb lim ntshav txwv tsis pub lawv cov kev tshawb fawb rau cov neeg mob tuaj yeem ua kom tiav daim ntawv nug yam tsis muaj kev pab yuav ua rau cov txiaj ntsig tsis raug, thiab kev ntsuam xyuas siv qhov kev xam phaj tau pom zoo los ntawm cov neeg tshawb xyuas.70 Raws li GRADE cov qhab nia, tag nrho peb cov kev kwv yees tau muab tso rau ib qho. qib ntawm cov pov thawj xws li qis heev mus rau nruab nrab rau cov laj thawj uas tau hais hauv no; Yog li ntawd, yog tias qhov tseeb qhov tshwm sim ntawm qhov mob ntev yuav nyob ze rau peb qhov kwv yees, nws yog qhov sib txawv rau qhov mob neuropathic. Cov pov thawj ntxiv, uas yog ua los ntawm cov qauv neeg sawv cev, siv cov cuab yeej tshwj xeeb tsim los ntsuas qhov mob neuropathic yog li yuav tsum tau ua.
Lub nra ntawm qhov mob yog siab heev nyob rau hauv cov neeg mob uas muaj kab mob raum, tshwj xeeb tshaj yog nyob rau hauv cov mob raum kab mob uas tsis yog-dialysis subgroup thiab cov neeg kho nrog dialysis, ntxiv dag zog rau cov txiaj ntsim ntawm lub raum transplantation ntawm lub neej zoo. Txawm li cas los xij, lub nra ntawm qhov mob ntawm cov neeg mob raum hloov pauv tsis yog qhov tseem ceeb. Kev ntsuam xyuas qhov mob tau zoo yuav tsum vam khom cov ntsuas ntsuas. Kev paub ntau dua ntawm cov tsos mob no yog qhov tseem ceeb los txo nws txoj kev pheej hmoo thiab tiv thaiv kev txom nyem tsis tsim nyog hauv ib pawg neeg mob uas
Lub neej zoo yog twb hloov los ntawm cov kab mob raum ntev.
Raws li lub nra ntawmmobhauv cov neeg mob nrogmob ntevraumkab mobyog siab heev, lub ntsiab lus tseem ceeb yog tso lubmob, txhim kho lub raum ua haujlwm, thiab txhim kho lub neej zoo ntawm cov neeg mob.Cistanchetuaj yeem tiv thaiv lub raum thiab txhim kholub raum ua haujlwm.
Qhia tawm
Txhua tus kws sau ntawv tshaj tawm tsis muaj kev sib tw txaus siab.
TXOJ CAI
EL tau txais Ph.D. kawm ntawv los ntawm University of Dundee.
SUPPLEMENTARY KHOOM
Cov ntaub ntawv ntxiv (PDF)
Tab S1. MEDLINE nrhiav tswv yim.
Cov khoom siv ntxiv S1. Daim ntawv teev cov khoom suav nrog hauv daim ntawv rho tawm cov ntaub ntawv.
Cov khoom siv ntxiv S2. Newcastle-Ottawa scale tau yoog rau cov kev tshawb fawb hla ntu.
Cov khoom siv ntxiv S3. Cov txheej txheem thiab cov txiaj ntsig ntawm kev tshuaj ntsuam rhiab heev.
Tab S2. Qee qhov kev tshawb fawb thiab cov neeg koom tau suav nrog hauv txhua qhov tshwm sim rau qhov mob dav dav (A) thiab qhov mob tshwj xeeb (B).
Tab S3. Txheej txheem cej luam ntawm cov kev tshawb fawb suav nrog hauv meta-kev tshuaj xyuas ntawm qhov mob. Tab S4. Txheej txheem cej luam ntawm cov kev tshawb fawb suav nrog hauv meta-kev tshuaj ntsuam xyuas ntawm qhov mob ntev.
Tab S5. Txheej txheem cej luam ntawm cov kev tshawb fawb suav nrog hauv meta-kev tshuaj xyuas ntawm qhov mob neuropathic.
Tab S6. Txheej txheem cej luam ntawm cov kev tshawb fawb muaj nyob rau hauv meta-kev tshuaj ntsuam ntawm musculoskeletal mob.
Tab S7. Txheej txheem cej luam ntawm cov kev tshawb fawb muaj nyob rau hauv meta-kev tshuaj ntsuam mob taub hau.
Tab S8. Txheej txheem cej luam ntawm cov kev tshawb fawb muaj nyob rau hauv meta-kev tshuaj ntsuam ntawm mob plab.
Tab S9. Txheej txheem cej luam ntawm cov kev tshawb fawb muaj nyob rau hauv meta-kev tshuaj ntsuam ntawm mob hauv siab.
Tab S10. Txheej txheem cej luam ntawm cov kev tshawb fawb muaj nyob rau hauv meta-analysis ntawm fibromyalgia.
Tab S11. Meta-regression qhia cov txiaj ntsig ntawm cov qauv sib txawv thiab ntau yam sib txawv rau qhov mob, mob ntev, thiab mob neuropathic. Daim duab S1. Hav zoov zaj dab neeg ntawm qhov mob ntev stratified los ntawm cov kab mob raum ntev tswj lub tswv yim tom qab tshem tawm txoj kev tshawb fawb los ntawm Frazao li al.
Daim duab S2: Npuas cov phiaj xwm ntawm qhov mob neuropathic prevalence los ntawm feem pua ntawm cov neeg mob cuam tshuam los ntawm (A) kub siab, (B) txhais tau tias BMI, thiab (C) feem pua ntawm cov poj niam hauv cov qauv kawm.
Tab S12. Cov ntsiab lus ntawm cov phiaj xwm hav zoov rau qhov mob cuam tshuam rau lub cev tshwj xeeb thiab fibromyalgia.
Daim duab S3. Npuas cov phiaj xwm ntawm fibromyalgia prevalence los ntawm lub hnub nyoog nruab nrab ntawm cov neeg koom hauv cov qauv kawm.
Tab S13. Summary Risk of Bias assessment with all study-level risk of bias-studies soj ntsuam qhov mob.
Tab S14. Summary Risk of Bias assessment with all study-level risk of bias-studies soj ntsuam qhov mob tshwj xeeb.
Tab S15. Cov ntsiab lus ntawm meta-analyses (txog hav zoov) ntawm qhov mob, mob ntev, thiab mob neuropathic stratified los ntawm kev kawm zoo (kev pheej hmoo ntawm kev tsis ncaj ncees). Daim duab S4. Funnel zaj duab xis rau qhov mob (A), mob ntev (B), thiab mob neuropathic (C) logit hloov pauv ntau.
Daim duab S5. Funnel cov phiaj xwm kev tshawb fawb qhia qhov mob tshwm sim los ntawm cov kab mob raum ntev.
Tab S16. GRADE lub rooj qhia txog qib ntawm cov pov thawj rau kev mob tshwm sim.
Tab S17. GRADE lub rooj qhia txog qib ntawm cov pov thawj rau qhov tshwm sim ntawm qhov mob tshwj xeeb.
Tab S18. Cov ntsiab lus ntawm meta-analyses (txog hav zoov) ntawm qhov mob, mob ntev, thiab mob neuropathic stratified los ntawm thaj chaw.
Daim duab S6. Forest plot pooling cov kev tshawb fawb qhia txog qhov mob ntawm cov neeg mob uas muaj kab mob raum ntev-ND, stratified los ntawm kev ntsuas qhov mob.
Daim duab S7. Forest plot pooling cov kev tshawb fawb qhia txog qhov tshwm sim ntawm qhov mob hauv cov neeg mob uas tau lim ntshav, stratified los ntawm kev ntsuas qhov mob.
Daim duab S8. Forest plot pooling cov kev tshawb fawb qhia txog qhov tshwm sim ntawm qhov mob ntev (ywj siab ntawm kev tswj hwm kab mob raum ntev) stratified los ntawm kev ntsuas qhov mob.
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