鼻用皮质类固醇激素联合抗组胺药对变应性鼻炎疗效的系统评价

被引:13
作者
简洁君
伍启刚
田磊
郜元坤
机构
[1] 十堰市太和医院(湖北医药学院附属医院)耳鼻喉科
关键词
变应性鼻炎; 皮质类固醇激素; 抗组胺药; 投药,鼻内; 随机对照试验; 系统评价;
D O I
暂无
中图分类号
R765.21 [鼻炎];
学科分类号
100213 [耳鼻咽喉科学];
摘要
目的系统评价鼻内喷雾皮质类固醇激素联合口服或局部喷雾抗组胺药对变应性鼻炎的疗效。方法计算机检索Pub Med,EMbase,Google Scholar,The Cochrane Library,并手工检索相关期刊,全面收集鼻用皮质类固醇激素联合抗组胺药治疗变应性鼻炎的随机对照试验,检索时限均为建库至2015年4月。由2位评价员按照纳入与排除标准独立筛选文献、提取资料和评价纳入研究的方法学质量,采用Rev Man 5.3软件进行Meta分析。结果最终纳入10个研究,共计6568例患者。定性分析显示,相对于口服抗组胺药组或安慰剂组,联合药物治疗在改善临床症状方面有着更好的疗效。Meta分析结果显示,2个研究合并结果后联合治疗和单独鼻内激素治疗在控制症状上无明显统计学差异[WMD=-0.20,95%CI(-0.38,-0.01),P=0.04];6个随机对照试验累积Meta分析显示在提高总的鼻症状评分方面联合治疗方案分别优于单用鼻内皮质类固醇激素治疗[WMD=-1.16,95%CI(-1.49,-0.83),P<0.00001]、单用鼻内抗组胺药治疗[WMD=-1.73,95%CI(-2.08,-1.38),P<0.00001]及安慰剂组[WMD=-2.81,95%CI(-3.16,-2.47),P<0.00001]。结论对于变应性鼻炎,在减轻鼻部症状方面,鼻内皮质类固醇激素联合口服抗组胺药和单用鼻内皮质类固醇激素疗效无明显差异,但优于单用口服抗组胺药物和安慰剂组。鼻部皮质类固醇激素联合鼻部抗组胺药明显优于其他单用治疗方式,是控制变应性鼻炎鼻部症状的有效治疗措施。
引用
收藏
页码:573 / 578
页数:6
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