摘要:目的:评价孟鲁司特用于过敏性鼻炎的临床疗效和安全性。方法:计算机检索PubMed、维普及CNKI数据库,手工收集有关孟鲁司特用于过敏性鼻炎治疗的临床研究,根据纳入和剔除标准汇集文献,采用Jadad量表进行纳入文献质量评价,对总体治疗有效性使用Revman4.2软件进行Meta分析。结果:疗效评价共纳入9个临床随机对照研究共650例。有效率孟鲁司特组高于对照组,异质性检验显示各亚组及其合并总有效率P值均大于0.1,I2lt;50%,采用固定效应模型计算。2周时孟鲁司特组和对照组无统计学差异(Pgt;0.1),但2月、3月时二组均有显著性统计学差异(Plt;0.000 01),三个亚组综合分析孟鲁司特组和对照组有显著性统计学差异(Plt;0.000 01),不良反应差异无统计学意义。结论:现有临床证据显示孟鲁司特较传统抗过敏药物对过敏性鼻炎的治疗有效,但由于纳入研究存在选择性偏倚和测量性偏倚的可能性,势必影响结果的论证强度。故期待更多高质量的随机双盲对照试验性研究,以提供更高质量的证据。Abstract: Objective: To evaluate montelukast for allergic rhinitis clinical efficacy and safety. Methods: We searched the PubMed,VIP and CNKI databases, manual collection of clinical study about allergic rhinitis treatment of montelukast, based on inclusion and exclusion criteria for pooling of literature, Jadad scale used for quality assessment of the literature. Then use Revman4.2 Meta analysis software to evaluate the overall effectiveness. Results: Nine RCT clinical study have been included, The results showed that montelukast group was higher than control group on efficient control, Heterogeneity test showed that the subgroup and its total effective rate is Pgt;01,I2lt;50%. Therefore, we adopted a fixed effects model. After 2 weeks montelukast group and the control group no significant difference (Pgt;0.1). But after 2,3 month the two groups were statistically significant differences(Plt;0.000 01). On a comprehensive analysis of the three subgroups, montelukast group and the control group statistically significant differences(Plt;0.000 01), adverse drug reactions was no significant difference. Conclusion: The available clinical evidence to show that montelukast for the treatment of allergic rhinitis and effective, However, due to the existence of selection and measurement bias, This may affect the outcome of the argument strength.Therefore look forward to more highquality randomized and doubleblind controlled trials to provide highquality evidence.
ObjectiveTo investigate the common inhalant allergens causing allergic rhinitis in underage patients, and provide references for clinical prevention of allergic rhinitis. MethodsUnderage patients with allergic rhinitis admitted to our hospital between January 2010 and June 2013 were screened and skin prick test (SPT) was applied to investigate the response intensity to 22 kinds of common inhalant allergens and analyze the correlation of the positive rates and grades of allergens with age and sex. ResultsA total of 402 patients were included, and 77.6% (312/402) of them reported positive reaction of SPT; and the top five allergens were dust mites (242/402, 60.2%), house dust (235/402, 58.5%), housefly (142/402, 35.3%), spring pollen Ⅲ (133/402, 33.1%) and mulberry silk (121/402, 30.1%), respectively. Compared with patients whose age was younger than 5 years, both the positive rates and grades of SPT were significantly higher in patients above 5 years old. Additionally, the higher positive rates and grades of SPT were also observed much more in male patients than female patients. ConclusionThe most common inhalant allergens causing allergic rhinitis in underage patients are dust mites and house dust. And the SPT response intensity of inhalant allergens can be affected by age and gender.
Objective To evaluate the safety of intranasal use of beclomethasone dipropionate, budesonide, fluticasone propionate and mometasone for adults and children with chronic sinusitis/nasal polyps and allergic rhinitis. Methods Randomized controlled trials were located. Study quality was evaluated by two researchers independently. RevMan 4.2 was used for meta-analysis. Results Seven RCTs involving 826 patients were included. Compared with placebo, local use of fluticasone proprionate in adults showed no statistically significant trend to increase incidence of acute sinusitis (OR 16.87, 95% CI 0.87 to 301.62), but no significant difference was seen for epistaxis (OR 7.76, 95% CI 0.38 to 157.14): 1 trial, 60 patients. In another trial, no cases of nasal atrophy were reported in either fluticasone or placebo groups. No significant differences were seen between local use ofbudesonide and placebo in adults for dryness of nasal mucosa (OR 3.38, 95%CI 0.66 to 17.18) and epistaxis (OR 2.20, 95%CI 0.39 to 12.32): 1 trial, 193 participantions. No significant difference was seen between budesonide and pollinex for headache (OR 1.71, 95%CI 0.52 to 5.62). No differences were seen between placebo and fluticasone propionate in children for epistaxis (OR 0.85, 95%CI 0.20 to 3.66), headache (OR 0.25, 95%CI 0.02 to 2.83), plasma cortisol concentration (OR 1.56, 95%CI 0.06 to 38.69) and dryness of nasal mucosa (OR 4.76, 95%CI 0.25 to 89.54). Beclomethasone dipropionate in children showed no statistical differences for dryness of nasal mucosa (OR 0.51, 95%CI 0.14 to 1.87), epistaxis (OR 0.68, 95%CI 0.26 to 1.73) and rhinitis (OR 0.47, 95%CI 0.04 to 5.36). No decrease of plasma cortisol concentration was detected in either group. Mometasone and placebo showed no significant differences in children for epistaxis (OR 1.57, 95%CI 0.41 to 5.95), rhinitis (OR 0.33, 95%CI 0.01 to 8.22) or headache (OR 0.33, 95%CI 0.01 to 8.22). Decrease of plasma cortisol concentration was not detected. Conclusions According to this systematic review, long term intranasal use of steroid for adults and children may be safe based on the two high quality, four moderate quality trials and one with b bias. High quality studies with larger sample sizes and in other languages are needed to provide ber evidence.
Objective To evaluate the clinical effectiveness and safety of compound loratadine capsule in the treatment of allergic rhinitis. Methods A multi-center randomized single blind controlled trial (by using a random number table generated random sequence and the sequence was concealed by sealed envelopes) was designed. Two hundred and forty outpatients with allergic rhinitis who met the inclusion and exclusion criteria were randomized to the treatment group (n=120 with compound loratadine capsule, 1 capsule q 24 h) or the control group (n=120 with loratadine tablet, 1 tablet q 12 h). All patients were given standard therapy. Results ① At the end of the treatment, in the compound loratadine group, 101 patients completed the study, and 19 patients withdrew. In the loratadine group, 103 patients completed the study, 17 patients withdrew. According to intention-to-treat analysis (ITT), the improvement rates of the treatment and control groups were 89.17% (107/120) and 88.33% (106/120) respectively. No significant difference was seen between the two groups (rank sum test, u=-1.8348, P＞0.05). According to per-protocol analysis (PP), the improvement rates of the treatment and control groups were 96.04% (97/101) and 91.26% (94/103) respectively. No significant difference was seen between the two groups (rank sum test, u=-1.625 7, P＞0.05). ② Adverse events were slight to moderate.The adverse event rates were 22.5% (27/120) and 21.67% (26/120) in the treatment and control groups respectively. No significant difference was seen between the two groups ( χ2 test, P＞0.05). Conclusion Compound loratadine capsule is effective and safe for allergic rhinitis.
Objective This review compared clinical effectiveness, cardiac safety and economics of astemizole, loratadine, cetirizine and terfenadine to provide evidence for adjustment of Essential Drug List in China. Search strategy We searched Medline, Cochrane Library, Embase and Chinese Biomedical Database. Fourteen databases for drug safety and pharmaceutical economics were additionally searched. Selection Criteria Randomized controlled trials and systematic reviews, published in English and Chinese and comparing two or more of these four antihistamines for allergic rhinitis and urticaria were included for study of effectiveness. Non-randomized clinical trials were additionally included for economic evaluation. Cardiac safety studies of antihistamines for allergic diseases of any type were included. Quality Appraisal Jadad scale was primarily applied to randomized controlled trials. Allocation concealment and intention-to-treat analysis were also appraised. The QUOROM statement was applied to systematic reviews and meta-analysis. Data extraction and analyses For the study of effectiveness, composite data were primarily extracted and analyzed by fixed effect model. Sensitivity analysis was done to explore the heterogeneity. For the study of cardiac safety, cases of adverse drug reactions and death were summarized. Difference of occurrence rate in sex and age were analyzed if possible.Electrocardiography and clinical symptoms were summarized. Results No studies on economic evaluation were identified. 27 and 6 randomized controlled trials, including 3 227 participants, for allergic rhinitis and urticaria were identified. Cetirizine was superior to loratadine (n=709) in symptom score and onset of action, superior to terfenadine (n=645) in Quality of Life and superior to astemizole (n=498) in patient satisfaction and onset of action. 73 h-ADR cases were identified in astemizole, 27 cases in terfenadine, 1 case in loratadine and none in cetirizine. No deaths were identified. Combination of terfenadine plus grapefruit juice (n=l8), itraconazole (n=6), nefazodone (n=67), and loratadine administration concomitant with cemitidine (n=30) significantly prolonged QTc interval. Conclusions Cetirizine was superior to other three antihistamines in terms of clinical effectiveness and drug safety. Astemizole and terfenadine could cause significantly more cardiac-related adverse reactions than cetirizine and loratadine.
This paper reports the study and design of a visualization system of the ultrasonic rhinitis therapeutic apparatus with the function of endoscopic sinus. On Linux operating platform, we captured the video data of a video capture card that connected the endoscopic sinus using Video4Linux (V4L2) that was provided by the operating system. The video images were displayed by Qt. The visualization system solved the problem that the current ultrasonic rhinitis therapeutic apparatus had to rely on the large and expensive endoscopy equipment. And this simplified the doctors' operation, met the need of monitoring nasal cavity in the process of operating, greatly reduced the costs of treatment and would contribute to the promotion of the instrument. As a result, it has been tested that the nasal endoscopic image achieved by the system is clear and smooth, and fully meet the clinical needs of ultrasonic treatment of rhinitis.
【摘要】 目的 观察鼻内镜下激光治疗变应性鼻炎的疗效。 方法 2005年6月－2008年7月采用鼻内镜下Nd:YAG激光治疗变应性鼻炎患者384例，其中男206例，女178例；年龄13~74岁，平均31岁。病程1~33年，平均7.7年。按照2004年制定的《变应性鼻炎诊治原则及推荐方案》评分均gt;6分。术前及术后1、6、24个月时分别对患者症状和体征进行评分和分析。 结果 所有患者均获随访，随访时间1~24个月，平均22.7个月。其中术后1、6、24个月分别有384、380和358例患者获随访。统计术前及术后1、6、24个月时症状以及体征评分总分分别为（11.32±1.03）、（3.06±1.17）、（3.32±1.37）、（4.09±2.03）分，术后各时间点评分均较术前显著改善，差异有统计学意义（Plt;0.05）；术后各时间点间差异均有统计学意义（Plt;0.05），其中以术后1个月效果最好。 结论 鼻内镜下激光治疗变应性鼻炎疗效确切，但远期有一定复发率。【Abstract】 Objective To explore the clinical efficacy of operation by laser under nasal endoscope for the treatment of allergic rhinitis. Methods A total of 384 patients with allergic rhinitis undergoing operation by Nd : YAG laser under nasal endoscope from June 2005 to July 2008 were enrolled in the study, including 208 males and 178 females with their age ranged from 13 to 74 years old averaging at 31.2 years. The course of the disease ranged from 1 to 33 years averaging at 7.7 years. According to The Treatment Principle and Recommending Program for Allergic Rhinitis regulated in 2004, the scores of these cases were all higher than 6. Scoring and analysis of patients’ symptoms and body signs were performed before operation and 1, 6, and 24 months after operation. Results All the patients were followed up with the time period ranged from 1 to 24 months averaging at 22.7 months. A total of 384, 380 and 358 patients were followed up respectively 1, 6, and 24 months after operation. The general score of symptoms and body signs before operation, 1, 6, 24 months after operation were respectively 11.32±1.03, 3.06±1.17, 3.32±1.37, and 4.09±2.03. The scores after operation were significantly better than that before operation (Plt;0.05). The curative effect at the first month was the best. Conclusion Operation by laser under nasal endoscope is one of the valid, feasible methods for the treatment of allergic rhinitis, but during the long-term period, recurrence in some cases is possible.
目的:分析三种不同术式治疗慢性肥厚性鼻炎的临床疗效。方法: 对206例慢性肥厚性鼻炎患者分别采用低温等离子消融术,改良的传统下鼻甲部分切除术及下鼻甲成形术三种术式,比较其临床疗效。结果: 206例患者中8例因术后创面出血而愈合时间延长,2例出现鼻腔干燥结痂,2例因头痛症状不能改善到神经内科治疗,其余患者症状均获显著改善。结论: 下鼻甲成形术、下鼻甲等离子消融术能更好地体现微创手术的理念,疗效优于传统下鼻甲部分切除术。