Zhang Xu, Lan Feng, Zhang Yuan, Zhang Luo
Department of Otolaryngology Head and Neck Surgery and Department of allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China.
Allergy Asthma Immunol Res. 2018 Jan;10(1):34-42. doi: 10.4168/aair.2018.10.1.34.
Chinese herbal medicine (CHM) has been widely used in China to treat allergic rhinitis (AR). However, several studies have produced conflicting data with regard to the efficacy of the medicine. Our aim was to perform a meta-analysis of randomized clinical trials (RCTs) to evaluate the relative efficacy of CHM.
We systematically searched the PubMed, Medline, and Springer electronic databases up to March 2017 for RCTs comparing the efficacy of CHM versus placebo for the treatment of patients with AR. Total nasal symptoms and quality of life were assessed through pooling mean difference (MD) with its 95% confidence interval (CI). Moreover, sensitivity and subgroup analyses according to control design and quality of life assessment were performed to evaluate the source of heterogeneity.
Eleven RCTs were enrolled in the meta-analysis. Assessment of overall heterogeneity indicated significant heterogeneity among the individual studies (I²=100%, P<0.00001), and thus ransomed effects model was used to pool data. CHM was found to significantly enhance quality of life compared with placebo (MD=-0.88, (95% CI: -1.55, -0.21); P=0.01). The symptom of itchy nose, sneezing or total nasal symptoms scores were not significantly improved after CHM treatment, although the improvement in itchy nose just failed to reach significance (MD=0.09, (95% CI: 0.00, 0.18); P=0.06).
This study suggests that CHM appears to improve the quality of life of AR patients. However, these findings, as well as the findings for the effect of CHM on sneezing, total nasal symptoms, and the symptom of itchy nose, need to be substantiated in larger cohorts of AR patients by further well-designed studies.
中草药(CHM)在中国已被广泛用于治疗过敏性鼻炎(AR)。然而,关于该药物疗效的几项研究得出了相互矛盾的数据。我们的目的是进行一项随机临床试验(RCT)的荟萃分析,以评估CHM的相对疗效。
我们系统检索了截至2017年3月的PubMed、Medline和Springer电子数据库,以查找比较CHM与安慰剂治疗AR患者疗效的RCT。通过合并平均差(MD)及其95%置信区间(CI)来评估总鼻症状和生活质量。此外,根据对照设计和生活质量评估进行敏感性和亚组分析,以评估异质性来源。
11项RCT纳入了荟萃分析。总体异质性评估表明各研究间存在显著异质性(I²=100%,P<0.00001),因此采用随机效应模型合并数据。发现与安慰剂相比,CHM能显著提高生活质量(MD=-0.88,(95%CI:-1.55,-0.21);P=0.01)。CHM治疗后,鼻痒、打喷嚏症状或总鼻症状评分虽未显著改善,不过鼻痒症状的改善仅未达到显著水平(MD=0.09,(95%CI:0.00,0.18);P=0.06)。
本研究表明CHM似乎能改善AR患者的生活质量。然而,这些发现以及CHM对打喷嚏、总鼻症状和鼻痒症状影响的发现,需要通过进一步精心设计的研究在更大规模的AR患者队列中得到证实。