Rank Matthew A, Adolphson Cheryl R, Kita Hirohito
Division of Allergic Diseases, Mayo Clinic, Rochester, Minnesota 55905, USA.
Curr Opin Allergy Clin Immunol. 2009 Feb;9(1):67-72. doi: 10.1097/ACI.0b013e328320d279.
Chronic rhinosinusitis is a debilitating disease seen frequently by allergist-immunologists. Recent research examining the pathophysiological mechanisms and treatment options for chronic rhinosinusitis have yielded contradicting results, particularly in regard to the role of fungi and antifungal therapies.
Recent studies using antifungal therapies for chronic rhinosinusitis will be critically evaluated with careful attention to sample selection, length of the intervention, drug delivery system, drug stability and handling, assessment of compliance to study medications, and choice of outcome measures with attention to study power (both primary and secondary). Using this framework to evaluate currently available studies reveals limitations in studies showing a benefit for antifungal therapy and in studies showing no benefit (or harm).
Limitations in studies that either support or refute the benefit of antifungal therapy for chronic rhinosinusitis prevent any firm conclusions about its efficacy.
慢性鼻窦炎是一种使患者虚弱的疾病,过敏症专科医生-免疫学家经常会遇到。近期对慢性鼻窦炎病理生理机制及治疗方案的研究产生了相互矛盾的结果,尤其是在真菌和抗真菌治疗的作用方面。
近期使用抗真菌疗法治疗慢性鼻窦炎的研究将得到严格评估,重点关注样本选择、干预时长、给药系统、药物稳定性及处理、对研究药物的依从性评估以及结局指标的选择,并留意研究效能(主要和次要方面)。运用此框架评估现有研究发现,表明抗真菌治疗有益的研究及表明无益(或有害)的研究均存在局限性。
支持或反驳抗真菌疗法对慢性鼻窦炎有益的研究存在局限性,这使得无法就其疗效得出任何确凿结论。