CAJ | 학술논문

目的系统评价鼻用抗组胺药物治疗变应性鼻炎(AR)的临床疗效,为优化AR药物治疗提供循证参考.方法计算机检索OVID、PubMed、EMBASE和Cochrane Librar、中国学术期刊全文数据库、万方数据库,检索时间为1985年1月至2014年1月,纳入有关鼻用抗组胺药物治疗AR的随机对照研究,经2位研究者独立进行文献筛选、资料提取和方法学质量评价后,采用RevMan 5.1软件进行Meta分析.结果经检索和筛选,共纳入13个随机对照试验进行研究.Meta分析结果显示:鼻用抗组胺药物组的鼻部症状总分及鼻塞、流涕、喷嚏各项症状评分较安慰剂组降低,差异有统计学意义[加权均数差(WMD)=-1.96,95％可信区间(CI)为-2.06～-1.85;WMD=-0.18,95％ CI为-0.28～-0.08;WMD=-0.45,95％ CI为-0.52～-0.38;WMD=-0.41,95％ CI为-0.58～-0.24;P值均＜0.01].鼻用抗组胺药物组的鼻部症状总分与鼻用糖皮质激素组差异无统计学意义(WMD=-1.51,95％ CI为-3.51～0.49,P=0.14);而鼻用抗组胺药组的鼻塞、流涕、喷嚏评分较鼻用糖皮质激素组降低,差异有统计学意义(WMD=-0.23,95％ CI为-0.40 ～-0.06;WMD=-0.35,95％ CI为-0.65～-0.05;WMD=-0.25,95％ CI为-0.42～-0.08,P值均＜0.05).与口服抗组胺药组相比,鼻用抗组胺药组的鼻部症状总评分降低,差异有统计学意义(WMD=-0.88,95％ CI为-1.51～-0.25,P＜0.01).结论鼻用抗组胺药物能有效改善AR患者的鼻部症状.
목적 계통평개비용항조알약물치료변응성비염(AR)적림상료효,위우화AR약물치료제공순증삼고.방법 계산궤검색OVID、PubMed、EMBASE화Cochrane Librar、중국학술기간전문수거고、만방수거고,검색시간위1985년1월지2014년1월,납입유관비용항조알약물치료AR적수궤대조연구,경2위연구자독립진행문헌사선、자료제취화방법학질량평개후,채용RevMan 5.1연건진행Meta분석.결과 경검색화사선,공납입13개수궤대조시험진행연구.Meta분석결과현시:비용항조알약물조적비부증상총분급비새、류체、분체각항증상평분교안위제조강저,차이유통계학의의[가권균수차(WMD)=-1.96,95％가신구간(CI)위-2.06～-1.85;WMD=-0.18,95％ CI위-0.28～-0.08;WMD=-0.45,95％ CI위-0.52～-0.38;WMD=-0.41,95％ CI위-0.58～-0.24;P치균＜0.01].비용항조알약물조적비부증상총분여비용당피질격소조차이무통계학의의(WMD=-1.51,95％ CI위-3.51～0.49,P=0.14);이비용항조알약조적비새、류체、분체평분교비용당피질격소조강저,차이유통계학의의(WMD=-0.23,95％ CI위-0.40 ～-0.06;WMD=-0.35,95％ CI위-0.65～-0.05;WMD=-0.25,95％ CI위-0.42～-0.08,P치균＜0.05).여구복항조알약조상비,비용항조알약조적비부증상총평분강저,차이유통계학의의(WMD=-0.88,95％ CI위-1.51～-0.25,P＜0.01).결론 비용항조알약물능유효개선AR환자적비부증상.
Objective To systematically evaluate the efficacy of intranasal antihistamine in the treatment of allergic rhinitis.Methods The randomized controlled trials (RCT) about intranasal antihistamines for the treatment of allergic rhinitis between January 1985 and January 2014 were searched in OVID,PubMed,EMBASE,CNKI,WanFang Data and Cochrane Library.Two reviewers independently screened the literatures,extracted the data,and evaluated the methodological quality,then meta-analysis was performed by using RevMan 5.1 software.Results A total of thirteen RCTs were included.The results of meta-analysis showed that the efficacy of intranasal antihistamine group was superior to the placebo group in total nasal symptom scores (TNSS),the difference was significant [WMD =-1.96,95％ CI (-2.06; -1.85),P ＜ 0.01],and individual nasal symptom scores (blocked nose,rhinorrhea,and sneezing)[WMD=-0.18,95％CI (-0.28;-0.08); WMD=-0.45,95％CI (-0.52;-0.38) ;WMD=-0.41,95％ CI (-0.58 ;-0.24),all P ＜ 0.01],with significant differences.There was no significant difference between the intranasal antihistamine group and the corticosteroid group in TNSS [WMD =-1.51,95％ CI (-3.51; 0.49),P =0.14],but the intranasal antihistamines group was superior to the corticosteroid group in individual nasal symptom scores (blocked nose,rhinorrhea,and sneezing) [WMD =-0.23,95％ CI (-0.40;-0.06) ; WMD =-0.35,95％ CI (-0.65 ;-0.05) ; WMD =-0.25,95％ CI (-0.42;-0.08),all P ＜ 0.05],with significant differences.The intranasal antihistamine group was superior to the oral antihistamines group in TNSS [WMD =-0.88,95％ CI (-1.51 ;-0.25),P ＜ 0.01].Conclusion Intranasal antihistamine is effective in the control of nasal symptoms in AR patients.