Liu Huixia, Chen Yue, Wang Huan, Luo Xinyi, Xie Dengpiao, Ji Qing, Tian Li
Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Chengdu Medical College, Chengdu, China.
Front Pharmacol. 2024 Feb 7;15:1350063. doi: 10.3389/fphar.2024.1350063. eCollection 2024.
Hyaluronic acid (HA), the main component of the extracellular matrix, has the ability to promote tissue repair and regulate inflammation. It is used in otolaryngology as an adjuvant treatment to alleviate postoperative nasal symptoms. However, there is currently insufficient evidence demonstrating the therapeutic efficacy of HA for patients with nasal inflammatory diseases (NIDs). Therefore, this study aimed to evaluate the efficacy and safety of topical HA in the treatment of NID patients without receiving surgery. In this meta-analysis, comprehensive searches were conducted in PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science. Keywords searched included "hyaluronic acid," "sinusitis," "allergic rhinitis," "rhinitis," and "randomized controlled trials (RCTs)." The Cochrane Collaboration's "Risk of Bias Assessment" tool was used to assess the quality of the included trials, and the meta-analysis was performed using the RevMan 5.3 and STATA 15 statistical software. A total of 11 articles and 825 participants were enrolled. For the primary outcomes, the pooled results revealed that HA significantly improves nasal obstruction (SMD, -0.53; 95% CI, -0.92 to -0.14; = 0.008; and I = 79%) and rhinorrhea (SMD, -0.71; 95% CI, -1.27 to -0.15; = 0.01; and I = 90%) in patients with NIDs. As for the secondary outcomes, the pooled results demonstrated that when compared with the control group, HA could significantly improve nasal endoscopic scores ( < 0.05), rhinitis scores ( < 0.05), rhinomanometry ( < 0.05), nasal neutrophils ( < 0.05), and mucociliary clearance ( < 0.05). However, no significant differences were observed between the two groups regarding nasal itching, sneezing, hyposmia, quality-of-life scores, and nasal eosinophils. For the risk of bias, 54.5% and 45.5% of trials had a low risk of bias in the randomization process and deviation of the intended intervention, respectively. In the present study, the results reveal that HA might ameliorate symptoms of patients with NIDs. However, more clinical trials with larger participant cohorts are required to confirm this result. clinicaltrials.gov, identifier CRD42023414539.
透明质酸（HA）是细胞外基质的主要成分，具有促进组织修复和调节炎症的能力。它在耳鼻喉科中用作辅助治疗，以缓解术后鼻腔症状。然而，目前尚无足够证据证明HA对鼻炎性疾病（NIDs）患者的治疗效果。因此，本研究旨在评估局部应用HA治疗未接受手术的NID患者的疗效和安全性。在这项荟萃分析中，我们在PubMed、Embase、Cochrane对照试验中央注册库和Web of Science中进行了全面检索。检索的关键词包括“透明质酸”、“鼻窦炎”、“变应性鼻炎”、“鼻炎”和“随机对照试验（RCTs）”。使用Cochrane协作网的“偏倚风险评估”工具评估纳入试验的质量，并使用RevMan 5.3和STATA 15统计软件进行荟萃分析。共纳入11篇文章和825名参与者。对于主要结局，汇总结果显示，HA可显著改善NID患者的鼻塞（标准化均数差，-0.53；95%置信区间，-0.92至-0.14；P = 0.008；I² = 79%）和鼻漏（标准化均数差，-0.71；95%置信区间，-1.27至-0.15；P = 0.01；I² = 90%）。至于次要结局，汇总结果表明，与对照组相比，HA可显著改善鼻内镜评分（P < 0.05）、鼻炎评分（P < 0.05）、鼻阻力测量（P < 0.05）、鼻中性粒细胞（P < 0.05）和黏液纤毛清除率（P < 0.05）。然而，两组在鼻痒、打喷嚏、嗅觉减退、生活质量评分和鼻嗜酸性粒细胞方面未观察到显著差异。对于偏倚风险，分别有54.5%和45.5%的试验在随机化过程和预期干预的偏差方面存在低偏倚风险。在本研究中，结果显示HA可能改善NID患者的症状。然而，需要更多纳入更大样本量参与者的临床试验来证实这一结果。clinicaltrials.gov，标识符CRD42023414539。
