糖皮质激素治疗鼻—鼻窦炎性疾病嗅觉障碍的系统评价：meta分析

发布时间：2019-01-05 20:27

【摘要】：目的应用系统评价的方法通过Meta分析对糖皮质激素治疗鼻—鼻窦炎性疾病嗅觉障碍的患者的疗效进行评价。方法按Cochrane协作组织的要求，全面检索Elsevier数据库、SPRINGER数据库、EBSCO检索平台(ASP、BSP、ERIC、HRC、LISTA、MEDLINE...）、ISI Web of Knowledge平台(SCI、ISTP、CCR/IC)、MEDLINE数据库、Micromedex临床暨循证医药学数据库、PubMed数据库、OVID医学电子全文期刊数据库（LWW）、Nature电子刊、Science电子刊以及CRG专业注册数据库、Cochrane对照试验数据库、EMBASE、CINAHL、LILACS、SCISEARCH等数据库；检索SCI、临床试验注册库等，，中文检索中国生物医学文献数据库（CBM）、万方、维普数据库及手工检索国内核心耳鼻喉科专业期刊。严格制定纳入排除标准，筛查出高质量文献，并用Cochrane协作网提供Revman5软件进行统计分析。以主客观的嗅觉改善情况为评价标准（嗅阈值检测、主观评分），进行异质性检验后选择相应的效应模型，合并统计量分析敏感性和偏倚。结果筛选后有8篇文献符合要求。Meta分析后结果提示：局部治疗与全身治疗相比，嗅觉改善率P＜0.05差异有统计学意义，嗅觉下降率和嗅阈值改善情况P＞0.05差异无统计学意义；局部治疗与安慰剂组相比，嗅觉改善情况QD组与安慰剂组比P＞0.05差异无统计学意义，QD组与BID组、BID组与安慰剂组比均P＜0.05差异有统计学意义；全身治疗组与安慰剂组相比P＜0.05差异有统计学意义；全身联合局部治疗组与单纯局部治疗组比P＞0.05差异无统计学意义。结论在糖皮质激素治疗鼻—鼻窦炎性疾病嗅觉障碍的患者时。全身治疗是有效的，而且全身治疗的效果要优于局部治疗。但是全身治疗在阻止患者嗅觉进一步下降的效果与局部治疗无异。全身治疗在改善嗅阈值方面也与局部治疗相仿。局部治疗受剂量的限制比如莫米松200ugBIDSp有效，200ugQDSp则效果不明显。全身联合局部治疗与单纯的局部治疗之间的效果无差异。
[Abstract]:Objective to evaluate the efficacy of glucocorticoid in the treatment of olfactory disorders of rhinosinusitis by Meta. Methods according to the requirements of Cochrane cooperative organization, Elsevier database, SPRINGER database, EBSCO retrieval platform (SCI,ISTP,CCR/IC), MEDLINE database) were searched. Micromedex clinical and evidence-based medicine database, PubMed database, OVID electronic full text journal database (LWW), Nature electronic journal, Science electronic journal, CRG professional registration database, Cochrane control trial database, EMBASE,CINAHL,LILACS,SCISEARCH database; To search the SCI, clinical trial registry, Chinese biomedical literature database (CBM), Wanfang, Weip database and hand search of the domestic core otolaryngology professional journals. Strict inclusion exclusion criteria were established, high quality documents were screened, and Revman5 software was provided by Cochrane cooperation network for statistical analysis. The subjective and objective olfactory improvement was used as the evaluation criterion (olfactory threshold detection, subjective score), and the corresponding effect model was selected after heterogeneity test, and the sensitivity and bias of statistical analysis were combined. Results after screening, 8 articles met the requirements. The results of Meta analysis showed that there was a significant difference in olfactory improvement rate between local treatment and systemic therapy (P < 0. 05). There was no significant difference in the decrease rate of olfactory and the improvement of olfactory threshold (P > 0.05). Compared with placebo group, there was no significant difference in olfactory improvement between QD group and placebo group (P > 0. 05). There was significant difference between QD group and BID group, BID group and placebo group (P < 0. 05). Compared with placebo group, the whole body treatment group had significant difference (P < 0.05), but there was no significant difference between the whole body combined local treatment group and the simple local treatment group (P > 0.05). Conclusion in the treatment of nasal-sinusitis patients with olfactory disorder by glucocorticoid. Systemic therapy is effective, and the effect of systemic therapy is superior to that of local treatment. But systemic therapy has the same effect as local therapy in preventing a further decline in smell. Systemic therapy is similar to local treatment in improving olfactory threshold. Local treatment is limited by dose, such as amisone 200ugBIDSp is effective, 200ugQDSp is not significant effect. There was no difference between local therapy and local therapy alone.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R765

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