[关键词]
[摘要]
目的 系统评价大环内酯类药物治疗慢性鼻窦炎的疗效及安全性。方法 计算机检索自建库至2018年3月25日Pubmed、Embase、Cochrane Library、中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)和万方数据库等中英文数据库,筛选符合纳入标准的随机对照试验(RCT)。提取资料,并采用RevMan 5.0和Stata 12.0软件进行Meta-分析。结果 共纳入25项RCT,包括2 106例患者。结果显示,两组患者有效率[OR=5.33,95% CI(4.03,7.04),P=0.000]、显效率[OR=2.65,95% CI(2.20,3.20),P=0.000]等指标比较具有统计学意义。两组患者Lund-Kennedy评分[SMD=-2.18,95% CI(-5.61,1.26),P=0.214]、不良反应发生率[OR=0.81,95% CI(0.40,1.65),P=0.569]等比较无统计学意义。结论 大环内酯类药物治疗慢性鼻窦炎具有较好的疗效,能够显著提高慢性鼻窦炎患者生活质量,提高纤毛清除功能,降低炎性细胞因子水平,减少复发,且具有较好的安全性。
[Key word]
[Abstract]
Objective To systematically analyze the efficacy and safety of macrolides in the treatment of the chronic rhinosinusitis. Methods Randomized controlled trials of related articles from inception to March 25, 2018 were searched from Pubmed、Embase、Cochrane Library, CNKI, CBM and Wanfang data by computer. Meta-analysis were performed using RevMan 5.0 and Stata 12.0 software after data extraction. Results A total of 25 RCTs were included, involving 2106 patients. The results of Meta-analysis showed that the effective rate[OR=5.33, 95% CI(4.03, 7.04), P=0.000], marked effective rate[OR=2.65, 95% CI(2.20, 3.20), P=0.000] and other indicators were statistically significant between the two groups of patients. There were no significant differences in the Lund-Kennedy score[SMD=-2.18, 95% CI(-5.61, 1.26), P=0.214] and incidence of adverse reactions[OR=0.81, 95% CI(0.40, 1.65), P=0.569].Conclusion Macrolides have good efficacy in treating chronic rhinosinusitis, which can significantly improve the quality of life of patients with chronic rhinosinusitis and the function of ciliary clearance, reduce the level of inflammatory cytokines and recurrence, and have good security.
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[基金项目]
中国健康促进基金会医药知识管理专项基金"300种常见疾病药学服务标准与路径"(JJYX-ZX-1800)