Li Zewen, Guo Junyu, Zhou Jie, Yan Fubo, Yang Zhimin, Ding Zhuhua
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Nov;29(21):1868-72.
To evaluate the effectiveness of glucocorticoid in the management of olfaction in patients with chronic rhinosinusitis accompanied with nasal polyposis.
The published studies of the effectiveness of glucocorticoid in the management of chronic rhinosinusitis with nasal polyposis were searched in the Medline, Cochrane, EMBASE, Springer and CNKI databases(from the date of establishment of the databases to December 2014). The trails selection based on inclusion criteria and the quality of the included studies was assessed and meta-analysis was performed with RevMan 5. 3 software.
A total of 5 trials involving 325 patients were included. The Meta-analysis showed that oral glucocorticoid showed more significant improvement in subjective olfaction scores compared to placebo [SMD = -2.22, 95% CI (-3.94 - -0. 49), P < 0.05], oral glucocorticoid also showed significant improvement in objective olfaction scores compared to placebo [SMD = 0.65, 95% CI (0.28-1.01), P < 0.05]. But subsequent use of nasal glucocorticoid had no impact on subjective and objective olfaction scores [SMD = -2.15, 95% CI (-5.67-1.38), P > 0.05], [SMD = 0.28, 95% CI (-0.08-0.64) P > 0.05].
According to current evidence, oral glucocorticoid can significantly improve subjective and objective olfaction among patients with CRSwNP, but nasal glucocorticoid cannot improve subjective or objective olfaction dysfunction.
评估糖皮质激素治疗慢性鼻窦炎伴鼻息肉患者嗅觉障碍的有效性。
在Medline、Cochrane、EMBASE、Springer和CNKI数据库（自建库至2014年12月）中检索已发表的关于糖皮质激素治疗慢性鼻窦炎伴鼻息肉有效性的研究。根据纳入标准进行文献筛选，评估纳入研究的质量，并使用RevMan 5.3软件进行荟萃分析。
共纳入5项试验，涉及325例患者。荟萃分析显示，与安慰剂相比，口服糖皮质激素在主观嗅觉评分方面改善更显著[标准化均数差（SMD）=-2.22，95%置信区间（CI）（-3.94--0.49），P<0.05]；与安慰剂相比，口服糖皮质激素在客观嗅觉评分方面也有显著改善[SMD=0.65，95%CI（0.28-1.01），P<0.05]。但后续使用鼻用糖皮质激素对主观和客观嗅觉评分无影响[SMD=-2.15，95%CI（-5.67-1.38），P>0.05]，[SMD=0.28，95%CI（-0.08-0.64），P>0.05]。
根据现有证据，口服糖皮质激素可显著改善慢性鼻窦炎伴鼻息肉患者的主观和客观嗅觉，但鼻用糖皮质激素不能改善主观或客观嗅觉功能障碍。
