加味小青龙汤治疗变应性鼻炎临床疗效的Meta分析

Meta Analysis of the Clinical Efficacy of Modified Xiaoqinglong Decoction for Treating Al⁃lergic Rhinitis

目的:对加味小青龙汤治疗变应性鼻炎的临床疗效进行系统评价。方法:检索从建库至2022年9月的8个数据库。对符合加味小青龙汤治疗变应性鼻炎的随机对照试验(RCT)及共同结局指标的文献,使用Cochrane评价手册评估其偏倚风险、RevMan5.4软件进行Meta分析。结果:符合纳入的研究16篇,Meta分析结果显示观察组治疗变应性鼻炎的总有效率高于对照组[OR=4.39,95%CI(3.09,6.24),P<0.00001],差异有统计学意义;3篇研究显示观察组加味小青龙汤治疗变应性鼻炎患者的总鼻部症状的效果优于对照组[MD=-2.60,95%CI(-2.82,-2.38),P<0.00001];5项研究出现了不良反应,均为暂时性的不良反应,无需医疗干预[OR=1.01,95%CI(0.59,1.73),P=0.98],差异无统计学意义。结论:观察组治疗变应性鼻炎的临床疗效及缓解患者总鼻部症状方面均优于对照组,且相对安全;由于纳入的研究数量少,试验设计质量不高,可能影响其结果的稳定性,然而,加味小青龙汤治疗变应性鼻炎更准确的循证医学证据应在未来的大规模、多中心和严密设计的随机对照试验中得到验证。

Objective:To evaluate the clinical efficacy of modified Xiaoqinglong decoction in the treatment of allergic rhinitis.Methods:8 databases were retrieved from its establishment to September 2022.For the liter⁃ature that conforms to the randomized controlled trial(RCT)and common outcome indicators of the treatment of allergic rhinitis with modified Xiaoqinglong decoction,Cochrane evaluation manual was used to assess the risk of bias,and RevMan5.4 software was used for meta analysis.Results:16 studies were included.Meta-analysis showed that the total effective rate of the observation group was higher than that of the control group[OR=4.39,95%CI(3.09,6.24),P<0.00001].The difference was statistically significant.Three studies showed that the observation group was better than the control group in the treatment of total nasal symptoms of allergic rhini⁃tis with Xiaoqinglong decoction[MD=-2.60,95%CI(-2.82,-2.38),P<0.00001].Adverse reactions oc⁃curred in 5 studies,all of which were temporary and did not require medical intervention[OR=1.01,95%CI(0.59,1.73),P=0.98],and the difference was not statistically significant.Conclusions:The observation group is better than the control group in the treatment of allergic rhinitis in clinical efficacy and relief of total na⁃sal symptoms,and is relatively safe.Due to the small number of included studies and the low quality of the trial design,the stability of the results may be affected.However,More accurate evidence-based medical evidence for the treatment of AR with modified Xiaoqinglong Decoction should be verified in future large-scale,multicentered and rigorously designed randomized controlled trials.