Shaikh Nader, Wald Ellen R, Pi Mina
General Academic Pediatrics, Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA.
Cochrane Database Syst Rev. 2012 Sep 12(9):CD007909. doi: 10.1002/14651858.CD007909.pub3.
The efficacy of decongestants, antihistamines and nasal irrigation in children with clinically diagnosed acute sinusitis has not been systematically evaluated.
To systematically review the efficacy of decongestants, antihistamines and nasal irrigation in children with clinically diagnosed acute sinusitis. We considered the following four interventions: 1) decongestants versus placebo or no medication, 2) antihistamines versus placebo or no medication, 3) decongestant and antihistamine combination versus placebo or no medication, 4) nasal irrigation versus no irrigation. The primary outcomes of the review were symptom resolution (improvement in symptom score from enrolment to day five and overall symptom burden (as measured by average symptom scores while on therapy).
We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2012, Issue 1), which includes the Acute Respiratory Infections Group's Specialized Register, MEDLINE (1950 to January week 3, 2012) and EMBASE (1950 to January 2012).
We included randomized controlled trials (RCTs) and quasi-RCTs which evaluated children less than 18 years of age with acute sinusitis, defined as 10 to 30 days of rhinorrhea, congestion or daytime cough. We excluded trials of children with chronic sinusitis and allergic rhinitis.
Two review authors independently assessed each study for inclusion.
Of the 526 studies found through the electronic searches and handsearching, none met all the inclusion criteria.
AUTHORS' CONCLUSIONS: There is no evidence to determine whether the use of antihistamines, decongestants or nasal irrigation is efficacious in children with acute sinusitis. Further research is needed to determine whether these interventions are beneficial in the treatment of children with acute sinusitis.
减充血剂、抗组胺药和鼻腔冲洗治疗临床诊断为急性鼻窦炎的儿童的疗效尚未得到系统评估。
系统评价减充血剂、抗组胺药和鼻腔冲洗治疗临床诊断为急性鼻窦炎的儿童的疗效。我们考虑了以下四种干预措施：1）减充血剂与安慰剂或不使用药物；2）抗组胺药与安慰剂或不使用药物；3）减充血剂与抗组胺药联合使用与安慰剂或不使用药物；4）鼻腔冲洗与不冲洗。本综述的主要结局为症状缓解（从入组到第5天症状评分的改善）和总体症状负担（通过治疗期间的平均症状评分衡量）。
我们检索了Cochrane对照试验中心注册库（CENTRAL 2012年第1期），其中包括急性呼吸道感染组的专业注册库、MEDLINE（1950年至2012年1月第3周）和EMBASE（1950年至2012年1月）。
我们纳入了随机对照试验（RCT）和半随机对照试验，这些试验评估了年龄小于18岁的急性鼻窦炎儿童，急性鼻窦炎定义为流涕、鼻塞或日间咳嗽持续10至30天。我们排除了慢性鼻窦炎和过敏性鼻炎儿童的试验。
两位综述作者独立评估每项研究是否符合纳入标准。
通过电子检索和手工检索找到的526项研究中，没有一项符合所有纳入标准。
没有证据确定使用抗组胺药、减充血剂或鼻腔冲洗对急性鼻窦炎儿童是否有效。需要进一步研究以确定这些干预措施对治疗急性鼻窦炎儿童是否有益。
