中药鼻腔冲洗治疗慢性鼻窦炎术后有效性和安全性的Meta分析

doi:10.6040/j.issn.1673-3770.0.2021.524

摘要/Abstract

摘要： 目的系统评价近10年中药鼻腔冲洗治疗慢性鼻窦炎术后的临床疗效和安全性。方法以中药冲洗、慢性鼻窦炎以及随机对照试验等为检索主题,检索近10年各大中英文数据库:Pubmed、Web of science、The Cochrane Library、Embase和中国知网、万方数据库、维普、中国生物医学数据库等关于以中药冲洗鼻腔为干预措施治疗慢性鼻窦炎术后的随机对照试验,严格按照纳入及排除标准对文献进行筛选,并进行质量评估,使用R软件进行分析。结果纳入47个随机对照实验,分3个研究组参与Meta分析。结果中药鼻腔冲洗组的总有效率、治愈率较生理盐水冲洗组、空白组的更高;在症状评分上,中药冲洗组的VAS评分优于其余对照组,中药冲洗组较西药冲洗组、空白对照组能更好地降低鼻塞、嗅觉减退的症状评分,中药冲洗组较盐水冲洗组、空白对照组能更好地降低流涕症状评分,中药冲洗组较盐水冲洗组、西药冲洗组、空白对照组在降低头面胀痛症状评分上差异无统计学意义;在客观评价上,中药冲洗组在促进术后术腔上皮化、Lund-Kennedy内镜评分、鼻黏膜纤毛传输速率上均优于对照组。11篇文献进行了安全性报道,均未发生不良反应事件。结论中药鼻腔冲洗治疗慢性鼻窦炎术后疗效显著,优于等渗生理盐水冲洗、抗生素、激素溶液冲洗等,具有进一步临床推广价值。

关键词: 中药, 鼻腔冲洗, 鼻窦炎, Meta分析, 循证医学

Abstract: Objective To systematically evaluate the efficacy of nasal irrigation using traditional Chinese medicine(TCM)in treating chronic rhinosinusitis(CRS)after Functional Endoscopic Sinus Surgery(FESS)in the recent decade. Methods Using Chinese herbal irrigation, chronic rhinosinusitis, and randomized controlled trials as the key search terms,we searched the Pubmed、Web of science、the Cochrane Library、Embase、CNKI、VIP、CBM and Wanfang for related studies that were published for the recent ten years. We included randomized controlled trial articles about Chinese herbal irrigation as an intervention for chronic rhinosinusitis. The studies were screened strictly according to inclusion and exclusion criteria,and the quality was assessed; R software were used for data analysis. Results A total of 47 randomized controlled trials were included in the meta-analysis.These articles were divided into three groups. The meta-analysis showed that the total effective and cure rates of the TCM nasal irrigation group were higher than those of the saline irrigation and non-treatment control group. TheVAS score of the TCM nasal irrigation group was better than that for the other groups. Compared with the Western medicine irrigation and the non-treatment control group, the TCM nasal irrigation group reduced symptoms more effectively as evident by the symptom scores relating to nasal obstruction and hyposmia. The TCM nasal irrigation group also reduced the runny nose symptom score more effectively than the saline irrigation and non-treatment control groups. Comparing the saline irrigation,Western medicine irrigation, and blank control groups, there were no statistical differences in symptom scores relating to headache. The TCM irrigation group was superior to the control group in promoting postoperative nasal epithelialization,the Lund-Kennedy endoscopic score, and nasal mucosal ciliary transport rate. Safety was reported in 11 studies and no adverse reactions occurred. Conclusion TCM nasal irrigation is effective for the treatment of chronic sinusitis after surgery. Moreover, it is superior to isotonic saline irrigation, antibiotics, and hormone irrigation.TCM nasal irrigation should be considered in the clinical practice.

Key words: Traditional Chinese medicine, Nasal irrigation, Chronic rhinosinusitis, Meta-analysis, Evidence-based medicine

中图分类号:

R276.1

林曼青,周敏,陈腾宇,李丹,方彩珊,王睿智,朱锦祥,阮岩,徐慧贤,王培源. 中药鼻腔冲洗治疗慢性鼻窦炎术后有效性和安全性的Meta分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 209-225.

LIN Manqing, ZHOU Min, CHEN Tengyu, LI-Dan, FANG Caishan, WANG Ruizhi, ZHU Jinxiang, RUAN-Yan, XU Huixian, WANG Peiyuan. Meta-analysis of the efficacy and safety of traditional Chinese medicine for nasal irrigation in the treatment of chronic rhinosinusitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 209-225.

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