成年慢性鼻炎的医疗疗法:一个系统的审查
Luke Rudmik1, Zachary M Soler2
1Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Calgary, Calgary, Alberta.
JAMA
|September 2, 2015
概括
每天用盐水灌和局部用皮质类固醇是慢性鼻炎的有效第一线治疗方法. 对于特定的患者群体,特别是鼻息肉患者,可以考虑使用其他疗法,如全身皮质类固醇或抗生素.
科学领域:
- 耳鼻喉科
- 过敏和免疫学
- 药理学
背景情况:
- 慢性鼻炎是一种常见的炎症性疾病,持续3个月,影响生活质量,并造成大量的医疗费用.
- 有效的医疗管理对于优化患者的治疗结果和预防恶化至关重要.
研究的目的:
- 系统地审查有关成年慢性鼻炎的医学治疗的最高质量的证据.
- 为优化慢性鼻炎治疗提供基于证据的方法.
主要方法:
- 进行了随机临床试验 (RCT),系统审查和元分析的系统审查.
- 在Ovid MEDLINE,EMBASE和Cochrane数据库中进行了搜索.
- 证据根据维持与间歇性/救援疗法以及鼻的存在或不存在进行分类.
主要成果:
- 与没有治疗相比,每日用盐水灌显著改善了症状.
- 局部皮质类固醇改善了整体症状,减少了多体大小,并且减少了多体在手术后的复发.
- 系统性皮质类固醇,多西环素和白血抗体对鼻息肉患者有好处,而类固醇则改善了没有息肉的患者的生活质量.
结论:
- 建议将大量的盐水与局部皮质类固醇治疗结合起来,作为慢性鼻炎的第一线治疗方法.
- 系统性皮质类固醇,多西环素或白血抗体的短期疗程是鼻息肉患者的选择.
- 在没有鼻的慢性鼻炎患者中,可以考虑长期服用宏利酸抗生素.
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