内舒拿联合孟鲁司特钠治疗腺样体肥大的Meta分析  

Nasonex and montelukast sodium in the treatment of adenoidal hypertrophy:a Meta-analysis

作　　者：谷婷婷 刘岩[1] 张悦[1] 于丹[1] 文连姬[1] GU Tingting;LIU Yan;ZHANG Yue;YU Dan;WEN Lianji(Department of Otorhinolaryngology&Head and Neck surgery,The Second Hospital of Jilin University,Changchun 130022,Jilin,China)

机构地区：[1]吉林大学第二医院耳鼻咽喉头颈外科,吉林长春130022

出　　处：《山东大学耳鼻喉眼学报》2021年第1期47-55,共9页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：吉林省自然科学基金(20200201455JC)。

摘　　要：目的评价内舒拿联合孟鲁司特钠治疗儿童腺样体肥大的疗效。方法系统检索PubMed、万方、中国知网、维普网数据库2010~2020年内舒拿联合孟鲁司特钠治疗小儿腺样体肥大的相关文献。按照纳入和排除标准进行筛选文献,使用“Cochrane偏倚风险评估”工具进行文献质量评价,对纳入文献采用RevMan 5.3软件进行META分析。该研究共10篇文献入选META分析,总样本量865例。结果统计数据表明内舒拿联合孟鲁司特钠(以下称为联合用药)治疗儿童腺样体肥大总有效率高于单纯使用内舒拿(以下称为单药)治疗,差异具有统计学意义(OR=4.29,95%CI[2.72,6.77],P<0.00001)。对于缩小鼻咽部侧位片腺样体厚度与鼻咽腔前后径宽度的比值(A/N)优于单纯使用内舒拿治疗,差异具有统计学意义(MD=-0.06,95%CI[-0.10,-0.03],P<0.0001)对于缓解临床症状积分效果优于单药组,差异具有统计学意义(MD=-1.40,95%CI[-1.57,-1.23],P<0.00001),对睡眠质量改善优于单药组,差距具有统计学意义(MD=-1.40,95%CI[-1.60,-1.20],P<0.00001),对于日常功能的影响小于单药组,差距具有统计学意义(MD=-1.07,95%CI[-1.22,-0.93],P<0.00001)。结论基于目前的研究和分析,内舒拿联合孟鲁司特钠治疗儿童腺样体肥大具有显著的临床疗效,缓解各种临床症状及缩小腺样体体积明显优于单纯使用内舒拿治疗,文献均未报道明显的不良反应。Objective To evaluate the efficacy of Nasonex and montelukast sodium in the treatment of adenoidal hypertrophy.Methods We conducted a systematic literature search of Pub Med,Wangfang,and the Chinese National Knowledge VIP database 2010-2020 for Nasonex and montelukast sodium treatment in children with adenoidal hypertrophy.Standard articles were screened according to inclusion and exclusion criteria.The methodological quality of trials was evaluated with the Cochrane Handbook criteria,and the Review Manager 5.3 Revman5.1 software used for Meta-analyses.Finally,eleven articles,describing 865 patients,were selected,and included in the meta-analysis.Results The meta-analysis showed that the total effective rate of Nasonex combined with montelukast sodium(“the combination drug”)was significantly higher than that of Nasonex alone(“the single drug”)in the treatment of adenoidal hypertrophy in children(OR=4.29,95%CI[2.72,6.77],P<0.00001).The combination drug also caused a significant decrease in the A/N ratio(adeniod/nasopharynx ratio)(MD=-0.06,95%CI[-0.10,-0.03],P<0.0001),and lowered clinical symptoms(MD=-1.40,95%CI[-1.57,-1.23]).The combination drug significantly improved the quality of sleep in comparison to the single drug(MD=-1.40,95%CI[-1.60,-1.20],P<0.00001).The combination group also demonstrated lower effects on the impact on daily functioning than the single drug group(MD=-1.07,95%CI[-1.22,-0.93],P<0.00001).Conclusion Based on the current research and analysis,Nasonex combined with montelukast sodium has a significant clinical effect in the treatment of adenoidal hypertrophy in children.It is also a better choice to relieve various clinical symptoms and reduce the volume of adenoids than Nasonex alone.There was no literature that reported obvious adverse reactions.

关 键 词：腺样体肥大 孟鲁司特钠(顺尔宁) 内舒拿 有效率 随机对照实验 

分 类 号：R766.18[医药卫生—耳鼻咽喉科]