不同浓度盐水冲洗鼻腔辅助治疗变应性鼻炎疗效的Meta分析

韩卓琴; 程冯丽; 赵长青; 王云; 李强; 朱梦璐; 赵薇

doi:10.13201/j.issn.1001-1781.2018.24.005

不同浓度盐水冲洗鼻腔辅助治疗变应性鼻炎疗效的Meta分析

- 1 山西医科大学(太原, 030001);
- 2 山西医科大学第二医院耳鼻咽喉头颈外科
基金项目:
国家自然科学基金面上项目 (No:81670914, No:81870707)

山西省重点研发计划项目 (No:201703D12111212)

详细信息

通讯作者: 赵长青, E-mail:fahyj@126.com

中图分类号: R765.21

收稿日期: 2018-09-30

Nasal irrigation with different concentrations of saline as an adjunctive treatment in allergic rhinitis:A systematic review and Meta-analysis

- 1 Shanxi Medical University, Taiyuan, 030001, China;
- 2 Department of Otolaryngology Head and Neck Surgery, the Second Hospital of Shanxi Medical University

More Information

Corresponding author: ZHAO Changqing, E-mail: fahyj@126.com

Received Date: 30 September 2018

摘要

摘要: 目的: 通过Meta分析比较不同浓度盐水冲洗鼻腔辅助治疗变应性鼻炎的临床疗效。方法: 检索的数据库有Pubmed、Web of science、The Cochrane Library、Embase和中国知网、万方数据库、维普、中国生物医学等,检索以盐水冲洗鼻腔为干预措施辅助治疗变应性鼻炎的随机对照试验,严格按照纳入及排除标准对文献进行筛选,并进行质量评估,使用RevMan 5.3软件进行分析。结果: 最终纳入14个随机对照实验,共1 457例患者,其中生理盐水冲洗鼻腔组739例,高渗盐水冲洗鼻腔组350例,无盐水冲洗鼻腔组368例。Meta分析结果显示:生理盐水冲洗鼻腔组较无盐水冲洗鼻腔组VAS评分更低[95%CI(-1.57,-0.15),P=0.02]、鼻部RQLQ评分更低[95%CI(-3.93,-0.43),P=0.01]、有效率更高[95%CI(1.15,1.45),P<0.01],以上结果2组间差异均有统计学意义;高渗盐水冲洗鼻腔组较生理盐水冲洗鼻腔组的有效率更高[95%CI(1.19,1.47),P<0.01],鼻症状和体征评分更低[95%CI(-1.68,-0.63),P<0.01],以上结果2组间差异均有统计学意义。结论: 盐水冲洗鼻腔辅助治疗变应性鼻炎疗效显著,其中高渗盐水冲洗鼻腔疗效优于生理盐水冲洗鼻腔。
- 盐水 /
- 鼻腔冲洗 /
- 鼻炎 /
- 变应性 /
- Meta分析
Abstract: Objective: To compare the clinical efficacy of different concentrations of saline irrigation in adjuncative treatment of allergic rhinitis by Meta-analysis. Method: According to the inclusion and exclusion criteria, the studies using random controlled trials were retrieved from the Pubmed, Web of science, The Cochrane Library, Embase et al. The Mata-analysis was performed by using RevMan 5.3 software. Result: In total, 1 457 patients were enrolled in 14 randomized controlled trials, including 739 in the isotonic saline group, 350 in the hypertonic saline group,Times New Roman 368 without saline irragation. The results of Meta-analysis showed that the VAS score of saline irrigation group was lower than no saline irrigation group[95%CI(-1.57, -0.15), P=0.02], the nasal RQLQ score was lower[95%CI(-3.93, -0.43), P=0.01], and the effective rate was higher[95%CI(1.15, 1.45), P<0.01]; The score of nasal symptoms and signs in hypertonic saline group was lower than that in normal saline group[95%CI(-1.68, -0.63), P<0.01], and the effective rate was higher[95%CI(1.19, 1.47), P<0.01]. There were significant differences between the two groups.Conclusion: The efficacy of saline irrigation as an adjunctive treatment in allergic rhinitis is significant. The effect of hypertonic saline irrigation was better than that of isotonic saline.
- saline /
- nasal irrigation /
- rhinitis /
- allergic /
- Meta-analysis

HTML全文

参考文献(31)

[1]	梁美君, 徐睿, 许庚.变应性鼻炎研究新进展[J].临床耳鼻咽喉头颈外科杂志, 2015, 29 (3):202-206.
[2]	BROZEK J L, BOUSQUET J, AGACHE I, et al.Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016revision[J].J Allergy Clin Immunol, 2017, 140:950-958.
[3]	SPECTOR S, WALLACE D, NICKLAS R, et al.Comments on Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines[J].J Allergy Clin Immunol, 2011, 127:1641-1642.
[4]	BERNSTEIN J A.Allergic and mixed rhinitis:Epidemiology and natural history[J].Allergy Asthma Proc, 2010, 31:365-369.
[5]	BAUCHAU V, DURHAM S R.Prevalence and rate of diagnosis of allergic rhinitis in Europe[J].Eur Respir J, 2004, 24:758-764.
[6]	MELTZER E O, BLAISS M S, NACLERIO R M, et al.Burden of allergic rhinitis:allergies in America, Latin America, and Asia-Pacific adult surveys[J].Allergy Asthma Proc, 2012, 33 Suppl 1:S113-141.
[7]	SEIDMAN M D, GURGEL R K, LIN S Y, et al.Clinical practice guideline:allergic rhinitis[J].Otolaryngol Head Neck Surg, 2015, 152:197-206.
[8]	CHENG L.[New clinical practice guideline for allergic rhinitis in China] [J].Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 2016, 51:2-5.
[9]	邱昕, 王洪田.儿童鼻炎意见书:欧洲变态反应与临床免疫学会推荐[J].国际耳鼻咽喉头颈外科杂志, 2015, 39 (2):116-121.
[10]	HAUPTMAN G, RYAN M W.The effect of saline solutions on nasal patency and mucociliary clearance in rhinosinusitis patients[J].Otolaryngol Head Neck Surg, 2007, 137:815-821.
[11]	KEOJAMPA B K, MAI H N, RYAN M W.Effects of buffered saline solution on nasal mucociliary clearance and nasal airway patency[J].Otolaryngol Head Neck Surg, 2004, 131:679-682.
[12]	HOMER J J, DOWLEY A C, CONDON L, et al.The effect of hypertonicity on nasal mucociliary clearance[J].Clin Otolaryngol Allied Sci, 2010, 25:558-560.
[13]	高小平, 周宇, 冯宁宇, 等.鼻用糖皮质激素结合鼻腔冲洗治疗变应性鼻炎的疗效观察[J].临床耳鼻咽喉头颈外科杂志, 2016, 30 (9):702-706.
[14]	李娟, 程杰, 何艳.鼻腔冲洗联合糠酸莫米松鼻喷雾剂治疗变应性鼻炎的疗效观察[J].重庆医学, 2016, 45 (25):3506-3507.
[15]	王维安, 齐伟平, 同娟, 等.鼻用激素联合鼻腔冲洗治疗变应性鼻炎的临床效果[J].临床医学研究与实践, 2018, 3 (8):96-97, 104.
[16]	吴明海, 王秋萍, 张恺, 等.鼻腔冲洗治疗变应性鼻炎的疗效观察[J].临床耳鼻咽喉头颈外科杂志, 2014, 28 (5):287-289.
[17]	余长青, 刘转娣, 谢瑞兰.鼻腔冲洗在变应性鼻炎治疗中的疗效观察[J].中国实用医药, 2018, 13 (19):20-21.
[18]	姜梁, 胡晓艳, 黄英, 等.鼻腔冲洗治疗儿童变应性鼻炎的临床观察[J].中国中西医结合耳鼻咽喉科杂志, 2015, 23 (6):411-413.
[19]	XIONG M, FU X, DENG W, et al.Tap water nasal irrigation in adults with seasonal allergic rhinitis:a randomized double-blind study[J].Eur Arch Otorhinolaryngol, 2014, 271:1549-1552.
[20]	NGUYEN S A, PSALTIS A J, SCHLOSSER R J.Isotonic saline nasal irrigation is an effective adjunctive therapy to intranasal corticosteroid spray in allergic rhinitis[J].Am J Rhinol Allergy, 2014, 28:308-311.
[21]	马少欣.高渗盐水与生理盐水鼻腔冲洗治疗儿童变应性鼻炎的效果比较[J].世界临床医学, 2017, 11 (4):168-168.
[22]	汪姬婵.高渗盐水和生理盐水鼻腔冲洗对儿童变应性鼻炎的治疗效果评价[J].检验医学与临床, 2016, 13 (1):106-108.
[23]	杨笑染, 庞康, 刘为民, 等.2%高渗盐水鼻腔冲洗治疗变应性鼻炎的临床研究[J].华北理工大学学报 (医学版), 2012, 14 (5):624-625.
[24]	叶圣博.高渗盐水鼻腔冲洗在变应性鼻炎患者中的应用效果[J].临床合理用药杂志, 2017, 10 (27):149-150.
[25]	MARCHISIO P, VARRICCHIO A, BAGGI E, et al.Hypertonic saline is more effective than normal saline in seasonal allergic rhinitis in children[J].Int J Immunopathol Pharmacol, 2012, 25:721-730.
[26]	SATDHABUDHA A, POACHANUKOON O.Efficacy of buffered hypertonic saline nasal irrigation in children with symptomatic allergic rhinitis:a randomized double-blind study[J].Int J Pediatr Otorhinolaryngol, 2012, 76:583-588.
[27]	SZILASI M, GÁLFFY G, FÓNAY K, et al.A survey of the burden of allergic rhinitis in Hungary from a specialist's perspective[J].Multidiscip Respir Med, 2012, 7:49-49.
[28]	张虹, 王俊阁.鼻腔冲洗应用研究新进展[J].国际耳鼻咽喉头颈外科杂志, 2016, 40 (4):250-253.
[29]	HAUPTMAN G, RYAN M W.The effect of saline solutions on nasal patency and mucociliary clearance in rhinosinusitis patients[J].Otolaryngol Head Neck Surg, 2007, 137:815-821.
[30]	RABAGO D, ZGIERSKA A.Saline nasal irrigation for upper respiratory conditions[J].Am Fam Physician, 2009, 80:1117-1119.
[31]	GARAVELLO W, ROMAGNOLI M, SORDO L, et al.Hypersaline nasal irrigation in children with symptomatic seasonal allergic rhinitis:a randomized study[J].Pediatr Allergy Immunol, 2010, 14:140-143.