孟鲁司特钠联合布地奈德治疗变应性鼻炎疗效与安全性的Meta分析  

Meta-analysis of efficacy and safety of montelukast sodium combined with budesonide in the treatment of allergic rhinitis

作　　者：孙雨浩 许莞菁 秦娜娜 李钦[3] Sun Yuhao;Xu Wanjing;Qin Nana;Li Qin(School of Clinical Medicine,Weifang Medical University,Weifang 261000,China;Qingdao University Qingdao Medical College,Qingdao 266000,China;Department of Otorhinolaryngology,Linyi People's Hospital,Linyi 276000,China)

机构地区：[1]潍坊医学院临床医学院,潍坊261000 [2]青岛大学青岛医学院,青岛266000 [3]山东省临沂市人民医院耳鼻咽喉科,临沂276000

出　　处：《国际耳鼻咽喉头颈外科杂志》2023年第2期63-69,共7页International Journal of Otolaryngology-Head and Neck Surgery

摘　　要：目的应用Meta分析系统性评价孟鲁司特钠联合布地奈德治疗变应性鼻炎(AR)的疗效、安全性及血清炎性因子的变化。方法计算机检索PubMed、Embase、CochraneLibrary、Web of Science、万方数据库、中国知网(CNKI)和维普(VIP)于2016-01-01至2021-12-31收录的有关孟鲁司特钠联合布地奈德治疗成年国人AR的随机对照试验(randomized controlled trials,RCTs)和回顾性队列研究(实验组使用孟鲁司特钠联合布地奈德,对照组单纯使用布地奈德)。由2名研究者按照纳入与排除标准筛选出文献后,应用Cochrane风险评估工具和NOS量表分别对RCTs和回顾性队列研究进行质量评价。采用Review Manager 5.4软件进行Meta分析。结果共纳入9项RCTs和4项回顾性队列研究,共计1189例患者(实验组604例,对照组585例)。Meta分析结果显示,血清炎性因子方面,实验组患者血清中白细胞介素6(IL-6)和IL-8均低于对照组患者(WMD=-41.83,95%CI:-44.56~-39.11,P<0.00001;WMD=-26.33,95%CI:-29.00~-23.66,P<0.00001),IL-10高于对照组(WMD=4.07,95%CI:3.56~4.58,P<0.00001),差异均有统计学意义;有效性方面,实验组患者的显效率和总有效率均明显优于对照组(OR=2.34,95%CI:1.74~3.15,P<0.00001;OR=4.23,95%CI:2.66~6.73,P<0.00001),差异均有统计学意义;安全性方面,实验组与对照组患者用药后相关不良反应发生率的差异无统计学意义(OR=1.04,95%CI:0.45~2.39,P=0.93)。结论孟鲁司特钠联合布地奈德治疗成年国人AR安全性较好,较单独使用布地奈德在改善患者血清炎性因子指标及提高疗效方面具有显著优势。Objective To systematically evaluate the efficacy,safety and changes of serum inflammatory factors of montelukast sodium combined with budesonide in the treatment of allergic rhinitis(AR)by meta-analysis.Methods Computer searched PubMed,Embase,Cochrane Library,Web of Science,Wanfang Database,CNKI and VIP(from 2016-01-01 to 2021-12-31)about the combination of montelukast sodium randomized controlled trials(RCTs)and retrospective cohort studies of budesonide in the treatment of AR in Chinese adults(the experimental group used montelukast sodium combined with budesonide,and the control group used budesonide alone).After 2 investigators screened the literature according to the inclusion and exclusion criteria,the Cochrane risk assessment tool and NOS scale were used to evaluate the quality of RCTs and retrospective cohort studies,respectively.Meta-analysis was performed using Review Manager 5.4 software.ResultssA total of 9 RCTs and 4 cohort retrospective studies were included,with a total of 1189 patients(604 patients in the experimental group and 585 patients in the control group).The results of Meta-analysis showed that in terms of serum inflammatory factors,IL-6 and IL-8 in the experimental group patients were lower than those in the control group(WMD=-41.83,95%CI:-44.56--39.11,P<0.00001;WMD=-26.33,95%CI:-29.00--23.66,P<0.00001),IL-10 was higher than that in the control group(WMD=4.07,95%CI:3.56-4.58,P<0.00001),the difference was statistically significant;In terms of effectiveness,the markedly effective rate and total effective rate of the experimental group were significantly better In the control group(OR=2.34,95%CI:1.74-3.15,P<0.00001;OR=4.23,95%CI:2.66-6.73,P<0.00001),the difference was statistically significant;in terms of safety,there was no significant difference in the incidence of adverse reactions between the experimental group and the control group after treatment(OR=1.04,95%CI:0.45-2.39,P=0.93).Conclusions Montelukast sodium combined with budesonide in the treatment of Chinese adults AR is safe and ha

关 键 词：鼻炎 过敏 安全性 META分析 布地奈德 孟鲁司特钠 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]