Sun L N, Liu S Y, Shuai C J, Mao X M, Yin Z D
Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Dec 20;31(24):1896-1903;1909. doi: 10.13201/j.issn.1001-1781.2017.24.008.
To perform a systematic review of the efficacy and safety of endonasal phototherapy in the treatment of AR, and to provide evidence of evidence-based medicine for clinical application. Databases were from PubMed, Embase, Cochrane Library, Chinese Academic Journal Full-text Database (CNKI) and Wanfang database. A randomized controlled trial (RCT) or clinical study literature on intranasal phototherapy for adult AR is available, and the deadline is March 2017. Based on the literature inclusion and exclusion criteria, the related literatures were selected and the quality was evaluated by using the Cochrane inclusion bias assessment table. Meta-analysis was performed with Revman 5.3 software. For continuous outcomes, the weighted mean difference (WMD) and its 95% confidence intervals (CI) were calculated, forest maps and funnel plots were drew. For uncontinuous outcomes, the odds ratio (OR) and its 95%CI were calculated, and forest maps and funnel plots were drew. The efficacy included total nasal symptom scores (TNSS), rhinoconjunctivitis quality of life questionnaire (RQLQ) and palate itching scores, and the safety was assessed by incidence rate of severe drying and mild drying of nasal mucosa. A total of 12 articles were selected, including 5 RCT and 7 clinical studies, and there were 615 adult AR patients. The Meta-analysis shows that endonasal phototherapy significantly reduced the TNSS, RQLQ and palate itching scores, the incidence rate of mild drying of nasal mucosa was higher in comparison with pretreated values, and the difference was statistically significant (<0.05). The rate of severe drying of nasal mucosa was higher, but the difference was not statistically significant (>0.05). It also shows that endonasal phototherapy significantly reduced the TNSS, RQLQ and palate itching scores, and the rate of mild drying of nasal mucosa was higher in comparison with placebo and antihistamines groups, and the difference was statistically significant. The rate of severe drying of nasal mucosa was higher, but the difference was not statistically significant. Endonasal phototherapy can improve the symptoms of TNSS, RQLQ and palate itching score in patients, and the safety is also confirmed.Patients who are not satisfied with symptom relief may choose to use it.
对鼻内光疗治疗变应性鼻炎(AR)的疗效和安全性进行系统评价,为临床应用提供循证医学依据。数据库来源于PubMed、Embase、Cochrane图书馆、中国学术期刊全文数据库(CNKI)和万方数据库。纳入2017年3月前发表的关于成人AR鼻内光疗的随机对照试验(RCT)或临床研究文献。根据文献纳入和排除标准筛选相关文献,采用Cochrane偏倚风险评估表进行质量评价。使用Revman 5.3软件进行Meta分析。对于连续性结局,计算加权均数差(WMD)及其95%置信区间(CI),绘制森林图和漏斗图。对于非连续性结局,计算比值比(OR)及其95%CI,绘制森林图和漏斗图。疗效指标包括总鼻症状评分(TNSS)、变应性鼻炎生活质量问卷(RQLQ)和腭部瘙痒评分,安全性通过鼻黏膜严重干燥和轻度干燥发生率进行评估。共纳入12篇文章,其中5篇RCT和7篇临床研究,共615例成人AR患者。Meta分析结果显示,鼻内光疗能显著降低TNSS、RQLQ和腭部瘙痒评分,鼻黏膜轻度干燥发生率较治疗前升高,差异有统计学意义(<0.05);鼻黏膜严重干燥发生率升高,但差异无统计学意义(>0.05)。与安慰剂和抗组胺药组相比,鼻内光疗也能显著降低TNSS、RQLQ和腭部瘙痒评分,鼻黏膜轻度干燥发生率升高,差异有统计学意义;鼻黏膜严重干燥发生率升高,但差异无统计学意义。鼻内光疗可改善患者TNSS、RQLQ和腭部瘙痒评分症状,安全性也得到证实。对症状缓解不满意的患者可选择使用。