鼻内镜下翼管神经切断术对鼻黏膜高反应性疾病有效性的meta分析

Meta-analysis of the efficiency of endoscopic vidian neurectomy in the treatment of nasal mucosal hyperactive rhinopathy

目的评价鼻内镜下翼管神经切断手术对鼻黏膜高反应性疾病的疗效,为临床治疗高反应性鼻病提供循证医学证据。方法搜索PubMed、Medline、EMbase、Cochrane Library、中国生物医学文献数据库(CBMdisc)和中国期刊全文数据库(CJFD),检索所有翼管神经切断手术治疗变应性鼻炎和血管运动性鼻炎的文献。依据文献纳入和排除标准,进行文献筛选,采用非随机研究的系统评价方法对纳入文献进行质量评价对纳入文献进行质量评价。用Review Manager 5.3和Stata 12.1软件进行荟萃分析,对计量资料计算加权均数差及其95%可信区间,并绘制森林图。采用鼻部症状视觉模拟量表(visual analogue score,VAS)以及鼻结膜炎生活质量问卷(rhinoconjunctivitis quality of life questionnaire,RQLQ)评分指标,评价翼管神经切断手术对于鼻黏膜高反应疾病的治疗效果。结果最终共纳入7篇文献中的9个研究,共402名患者。荟萃分析显示:翼管神经切断术能有效改善患者总体鼻部症状,能显著改善患者流涕及喷嚏症状,能显著降低患者的RQLQ评分,差别有统计学意义(P<0.05)。结论鼻内镜下翼管神经切断术是鼻黏膜高反应性疾病的有效辅助治疗手段。

Objective To evaluate the treatment outcomes of the vidian neurectomy on patients with hyperreactive rhinopathy,and to provide a basis for optimizing clinical therapeutic strategies.Methods PubMed,Medline,EMbase,Cochrane Library,CBMdisc and Chinese Journal Full-text Database(CJFD)were searched,and all the literatures on the treatment for rhinitis were retrieved.Based on the literature inclusion and exclusion criteria,the related literatures were selected and the quality was evaluated by using the systematic evaluation method of nonrandom study,the weighted mean difference(WMD)and 95%confidence intervals(CI)were calculated.The forest plots were drawn.The treatment outcomes included visual analog scale score(VAS)and rhinoconjunctivitis quality of life(RQLQ)score.Results A total of 402 patients were included in the 9 clinical trails of 7 literatures.The meta-analysis shows that the vidian neurectomy can effectively improve the overall nasal symptoms of the patients,it can also effectively improve the symptoms of rhinorrhea and sneezing.Besides,vidian neurectomy significantly reduces the RQLQ score of the patients,and the difference is of statistical significance.Conclusion The endoscopic vidian neurectomy is an effective means of adjuvant treatment for the hyperreactive rhinopathy.