过敏性鼻炎中的鼻腔抗胰岛素和皮质类固醇:系统性审查和元分析
Bernardo Sousa-Pinto1, Rafael José Vieira1, Jan Brozek2
1CINTESIS@RISE, Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal; MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
大多数鼻入药物有效地治疗过敏性鼻炎 (AR) 症状,并改善生活质量,与安慰剂相比. 然而,证据的确定性在不同治疗方法之间有很大差异.
科学领域:
- 过敏和免疫学 过敏和免疫学
- 药理学 药理学是指药理学的学科.
- 基于证据的医学基于证据的医学.
背景情况:
- 对过敏性鼻炎 (AR) 个体鼻内药物疗效的系统证据有限.
- 本综述解决了对鼻内皮质类固醇和抗胰岛素与安慰剂的比较数据的需求.
研究的目的:
- 系统地审查和比较鼻内皮质类固醇和抗胰岛素与安慰剂在治疗AR鼻腔和眼部症状中的疗效.
- 评估这些治疗对永久性或季节性AR患者生活质量的影响.
主要方法:
- 从多个数据库中对随机对照试验进行了系统审查.
- 包括评估季节性或多年性AR的成年患者的研究,比较鼻入药物与安慰剂.
- 利用元分析来评估症状得分和生活质量,使用GRADE方法评估证据确定性.
主要成果:
- 包括151项初级研究,其中大多数显示治疗方法在长期和季节性AR方面都比安慰剂更有效.
- 在季节性AR中,阿泽拉斯丁-流他,流他酸和流他 propionate 显示出显著鼻腔症状和生活质量改善的最高概率.
- 阿泽拉斯-弗卢蒂卡松对眼部症状改善的概率最高;证据的确定性各不相同,在46个分析中的23个分析中,证据的确定性"中等".
结论:
- 鼻内药物通常有效改善AR症状和生活质量.
- 在AR的不同鼻内治疗方法之间,证据确定性存在显著差异.
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