Wu Shunyu, Cheng Yin, Lin Shunzhang, Liu Huanhai
Department of Otolaryngological, Shanghai Changzheng Hospital, Shanghai, China.
Front Surg. 2021 Dec 22;8:739360. doi: 10.3389/fsurg.2021.739360. eCollection 2021.
To perform a systematic review and meta-analysis to compare the efficacy of and complications associated with antifungal drugs and traditional antiseptic medication for the treatment of otomycosis. The PubMed, EMBASE, GeenMedical, Cochrane Library, CBM, CNKI, VIP and other databases were searched from January 1991 to January 2021. The systematic literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials (RCTs) and non-randomized studies (case-control, cohort, and case series) were included to assess the topical use of antifungal drugs and traditional antiseptic medication in patients with otomycosis. The research subjects were patients who were clinically diagnosed with otomycosis and whose external auditory canal secretions were positive for fungi. Funnel plots were used to detect bias, and the Q test was used to assess heterogeneity. The random-effects model was used for meta-analysis. The -test was used to assess significance. Of the 324 non-duplicate studies screened, 16 studies met the criteria for full-text review, and 7 were included in the meta-analysis. Four studies reported recovery conditions ( = 0.01). Six common complications after medication use were compared, and there were no significant differences. The authors further conducted subgroup analysis according to complications. The differences in the rates of ear distension ( = 0.007), earache ( = 0.03) and tinnitus ( = 0.003) were statistically significant. The results of this meta-analysis and literature review showed that antifungal drugs and traditional antiseptic medication were effective in relieving symptoms in patients with otomycosis, and the two treatments were associated with different complications. Otolaryngologists have the option to use one medication or a combination of two drugs on the basis of the condition. Future research in this area should include RCTs with long-term follow-up to guide the development of otomycosis guidelines to overcome some of the weaknesses found in the literature. https://www.crd.york.ac.uk/PROSPERO/#myprospero.
进行一项系统评价和荟萃分析，以比较抗真菌药物与传统抗菌药物治疗耳真菌病的疗效及相关并发症。检索了1991年1月至2021年1月期间的PubMed、EMBASE、GeenMedical、Cochrane图书馆、中国生物医学文献数据库（CBM）、中国知网（CNKI）、维普资讯（VIP）等数据库。系统文献评价遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南。纳入随机对照试验（RCT）和非随机研究（病例对照、队列和病例系列），以评估抗真菌药物和传统抗菌药物在耳真菌病患者中的局部应用。研究对象为临床诊断为耳真菌病且外耳道分泌物真菌检测阳性的患者。采用漏斗图检测偏倚，Q检验评估异质性。采用随机效应模型进行荟萃分析。采用t检验评估显著性。在筛选出的324项非重复研究中，16项研究符合全文审查标准，7项纳入荟萃分析。四项研究报告了恢复情况（P = 0.01）。比较了用药后六种常见并发症，差异无统计学意义。作者进一步根据并发症进行亚组分析。耳部胀满率（P = 0.007）、耳痛率（P = 0.03）和耳鸣率（P = 0.003）差异有统计学意义。该荟萃分析和文献综述结果表明，抗真菌药物和传统抗菌药物均可有效缓解耳真菌病患者症状，且两种治疗方法相关并发症不同。耳鼻喉科医生可根据病情选择使用一种药物或两种药物联合使用。该领域未来研究应包括长期随访的RCT，以指导耳真菌病指南的制定，克服文献中发现的一些不足。https://www.crd.york.ac.uk/PROSPERO/#myprospero
