糖皮质激素治疗伴鼻息肉的慢性鼻-鼻窦炎患者嗅觉有效性的Meta分析  

Meta-analysis of The olfaction effectiveness of glucocorticoid in the management of chronic rhinosinusitis with nasal polyposis

作　　者：李泽文[1] 郭俊宇[1] 周洁[1] 严福波[1] 杨志敏 丁珠华 

机构地区：[1]孝感市中心医院耳鼻咽喉科,湖北孝感432100 [2]孝感市第一人民医院五官科

出　　处：《临床耳鼻咽喉头颈外科杂志》2015年第21期1868-1872,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:系统评价糖皮质激素治疗伴鼻息肉的慢性鼻-鼻窦炎患者嗅觉的有效性。方法:计算机检索Medline、Cochrane、EMBASE、Springer和CNKI等数据库,文献检索起至时间从建库到2014年12月止,收集公开发表的所有关于糖皮质激素治疗伴鼻息肉的慢性鼻-鼻窦炎患者嗅觉的随机对照研究,按纳入标准筛选文献并评价纳入研究质量后,应用RevMan 5.3软件进行Meta分析。结果:共纳入5个随机对照研究,共计325例患者。Meta分析结果显示,与对照组相比,口服糖皮质激素不仅能显著提高患者的主观嗅觉评分[SMD=-2.22,95%CI(-3.94^-0.49),P<0.05],而且也能显著提高患者的客观嗅觉评分[SMD=0.65,95%CI(0.28~1.01),P<0.005]。但后期鼻内应用糖皮质激素却不能改善患者的主、客观嗅觉评分[SMD=-2.15,95%CI(-5.67,1.38),P>0.05],[SMD=0.28,95%CI(-0.08~0.64),P>0.05]。结论:目前证据证明,口服糖皮质激素能显著提高患者的主、客观嗅觉功能,而鼻内应用糖皮质激素则不能改善患者的主、客观嗅觉障碍。Objective：To evaluate the effectiveness of glucocorticoid in the management of olfaction in patients with chronic rhinosinusitis accompanied with nasal polyposis. Method：The published studies of the effectiveness of glucocorticoid in the management of chronic rhinosinusitis with nasal polyposis were searched in the Medline, Cochrane, EMBASE, Springer and CNKI databases（from the date of establishment of the databases to December 2014）. The trails selection based on inclusion criteria and the quality of the included studies was assessed and meta-analysis was performed with Rev- Man 5. 3 software. Result：A total of 5 trials involving 325 patients were included. The Meta-analysis showed that oral glucocorticoid showed more significant improvement in subjective olfaction scores compared to placebo[SMD： - 2.22, 95% CI（- 3. 94- 0. 49）, P〈 0. 057, oral glucocorticoid also showed significant improvement in objective olfaction scores compared to placebol-SMD= 0. 65,95 % CI （ 0. 28 - 1.01 ）, P〈 0. 05]. But subsequent use of nasal glucocorticoid had no impact on subjective and objective olfaction scores[SMD= -2.15,95 %CI（- 5.67-1.38）, P〉0. 05-], [SMD= 0. 28,95 % CI（- 0. 08-0. 64）, P〉0. 05]. Conclusion： According to current evidence, oral glucocorticoid can significantly improve subjective and objective olfaction among patients with CRSwNP, but nasal glucocorticoid cannot improve subjective or objective olfaction dysfunction.

关 键 词：糖皮质激素 慢性鼻-鼻窦炎 嗅觉 META分析 随机对照试验 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]