糖皮质激素鼻喷剂联合黏液溶解促排剂治疗分泌性中耳炎疗效的Meta分析

Effect of Intranasal Steroid Sprays Combined with Mucolytics on Secretary Otitis Media: A Meta-analysis

关键词:  分泌性中耳炎  糖皮质激素  鼻喷剂  黏液溶解促排剂  Meta分析

Key words:  secretory otitis media  steroid  intranasal sprays  mucolytics  Meta analysis

摘要:

目的 研究糖皮质激素鼻喷剂联合黏液溶解促排剂治疗分泌性中耳炎的疗效及安全性。方法 通过电子检索万方数据库、中国期刊全文数据库(CNKI)、维普数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、EMbase及Cochrane 图书馆数据库，检索时间为从建库至2013年10月。根据Cochrane 协作网手册评估随机对照试验研究(RCT)的方法学质量，对所纳入的关于糖皮质激素鼻喷剂联合黏液溶解促排剂治疗分泌性中耳炎的随机对照试验结果进行Meta分析，采用RevMan 5.2软件对各研究原始数据进行统计处理并绘制相应的森林图。结果 共5篇文献纳入本次研究，累计治疗组226 例(311耳)，对照组188 例(251耳)。Meta分析结果显示糖皮质激素鼻喷剂联合黏液溶解促排剂治疗分泌性中耳炎效果优于常规治疗，差异具有统计学意义[OR=3.75，95% CI (2.27，6.18)，P<0.00 001]。结论 糖皮质激素鼻喷剂联合黏液溶解促排剂可以提高分泌性中耳炎的治疗效果，但目前相关研究仍然偏少，该治疗方法的疗效仍有待于更多高质量大样本、多中心的随机对照试验来证实。

Abstract:

OBJECTIVE To assess the efficacy and safety of intranasal steroid sprays combined with mucolytics in the treatment of secretory otitis media. METHODS It was searched that articles in Wanfang database, CNKI and VIP databases, CBM, PubMed, EMBASE and Cochrane Library published until October 2013. Randomized controlled trails (RCT) included in research were assessed with Cochrane Collaboration Guideline, and the Meta analysis was done with the software RevMan 5.2. RESULTS Five RCT studies fulfilled the inclusion criteria were collected for Meta-analysis with a total sample size of 414 patients (562 ears), including 226 patients (311 ears) of treatment group and 188 patients (251 ears) of control. Meta-analysis showed that treatment with intranasal steroid sprays combined with mucolytics was more effective than conventional treatment [OR=3.75, 95% CI(2.27, 6.18), P<0.000 01]. CONCLUSION Intranasal steroid sprays combined with mucolytics is an effective therapeutic strategy for the patients with secretory otitis media. However, because of the rare relative researches, it needs further more large samples, multi-center studies to provide more sufficient evidences.