系统评价鼻窦炎口服液治疗鼻-鼻窦炎(RS)的有效性与安全性。计算机检索中国知网(CNKI)、万方(Wanfang)、中国生物医学文献服务系统(SinoMed)、维普(VIP)、Cochrane Library、PubMed、EMbase、Web of Science、Ovid数据库,搜集鼻窦炎口...系统评价鼻窦炎口服液治疗鼻-鼻窦炎(RS)的有效性与安全性。计算机检索中国知网(CNKI)、万方(Wanfang)、中国生物医学文献服务系统(SinoMed)、维普(VIP)、Cochrane Library、PubMed、EMbase、Web of Science、Ovid数据库,搜集鼻窦炎口服液治疗RS患者的随机对照试验(RCT),并手工检索相关研究的参考文献和灰色文献。2位研究者独立筛选文献、提取资料,根据Cochrane推荐的偏倚风险工具(RoB 2.0)对纳入研究进行质量评价,采用RevMan 5.3、Stata 12.0统计软件进行Meta分析,使用GRADE系统推荐分级方法进行证据质量评价。共纳入54篇RCTs(联合用药35篇、单独用药19篇),包含7511例患者,其中试验组3973例,对照组3538例。Meta分析结果显示,鼻窦炎口服液+常规治疗在提高RS患者的总有效率(RR=1.19,95%CI[1.15,1.24],P<0.00001),降低Lund-Kennedy评分(MD=-1.94,95%CI[-2.61,-1.26],P<0.00001)、Lund-Mackay评分(MD=-2.14,95%CI[-2.98,-1.31],P<0.00001)、视觉模拟量表(VAS)评分(MD_(总VAS评分)=-1.28,95%CI[-1.56,-1.01],P<0.00001;MD_(鼻塞VAS评分)=-0.58,95%CI[-0.89,-0.27],P=0.0002;MD_(流涕VAS评分)=-0.61,95%CI[-0.93,-0.29],P=0.0002;MD_(嗅觉障碍VAS评分)=-0.43,95%CI[-0.52,-0.34],P<0.00001;MD_(头面部胀痛VAS评分)=-0.41,95%CI[-0.57,-0.26],P<0.00001),改善鼻黏膜纤毛传输速率(MTR)(MD=1.64,95%CI[1.08,2.20],P<0.00001),降低炎症因子水平{肿瘤坏死因子-α(TNF-α)(SMD=-1.95,95%CI[-2.57,-1.33],P<0.00001);白细胞介素-6(IL-6)(SMD=-2.64,95%CI[-4.08,-1.21],P=0.0003)}方面优于单纯常规治疗,且不会增加不良反应的发生(RR=0.83,95%CI[0.44,1.57],P=0.57)。单用鼻窦炎口服液在提高总有效率(RR=1.25,95%CI[1.18,1.32],P<0.00001),降低Lund-Kennedy评分(P<0.01)、Lund-Mackay评分(P<0.05),改善VAS评分(P_(总VAS评分)<0.01、P_(鼻塞VAS评分)<0.01、P_(流涕VAS评分)<0.01、P_(嗅觉障碍VAS评分)<0.05、P_(头面部胀痛VAS评分)<0.01),降低不良反应发生率(P=0.03)方面均优于常规治疗。结果表明,单用鼻窦炎口服液或鼻窦炎口服液+常规治疗均能提高总有效率,降低Lund-Kennedy评分、Lund-Mackay评分,并改善患者的主要症状。此外,鼻窦炎口服液+常规治疗还能改善患者的MTR,同时降低TNF-α、IL-6炎症因子的表达,且未有严重不良事件的发生。但因纳入研究的方法学质量有限,今后仍需开展更多大样本、高质量的RCT提供证据支撑。展开更多
Objective： To observe the impacts of electro-acupuncture（EA） and psychological intervention（PI） on impulsive behavior among internet addiction（IA） adolescents. Methods： Thirty-two IA adolescents were allocated...Objective： To observe the impacts of electro-acupuncture（EA） and psychological intervention（PI） on impulsive behavior among internet addiction（IA） adolescents. Methods： Thirty-two IA adolescents were allocated to either EA（16 cases） or PI（16 cases） group by a randomized digital table. Subjects in the EA group received EA treatment and subjects in the PI group received cognition and behavior therapy. All adolescents underwent 45-d intervention. Sixteen healthy volunteers were recruited into a control group. Barratt Impulsiveness Scale（BIS-11） scores, Young＇s Internet Addiction Test（IAT） as well as the ratio of brain N-acetyl aspartate（NAA） to creatine（NAA/Cr） and choline（Cho） to creatine（Cho/Cr） were recorded by magnetic resonance spectroscopy before and after intervention respectively. Results： The IAT scores and BIS-11 total scores in both EA and PI group were remarkably decreased after treatment（P〈0.05）, while EA group showed more significant decrease in certain BIS-11 sub-factors（P〈0.05）. Both NAA/Cr and Cho/Cr were significantly improved in EA group after treatment（P〈0.05）; however, there were no significant changes of NAA/Cr or Cho/Cr in PI group after treatment（P〉0.05）. Conclusions： Both EA and PI had significantly positive effect on IA adolescents, especially in the aspects of psychological experiences and behavioral expressions, EA might have an advantage over PI in terms of impulsivity control and brain neuron protection. The mechanism underlying this advantage might be related to the increased NAA and Cho levels in prefrontal and anterior cingulate cortices.展开更多
基金Supported by the National Natural Science Foundation of China(No.81072852,No.81574047)The Training Funds of Academic and Technical Leader in Sichuan Province+1 种基金Fok Ying-dong Education Foundation on Basic Research Project(No.131106)People-Benefiting Technology Research and Development Project of Chengdu Science and Technology Bureau(No.2014-HM01-00180-SF)
文摘Objective： To observe the impacts of electro-acupuncture（EA） and psychological intervention（PI） on impulsive behavior among internet addiction（IA） adolescents. Methods： Thirty-two IA adolescents were allocated to either EA（16 cases） or PI（16 cases） group by a randomized digital table. Subjects in the EA group received EA treatment and subjects in the PI group received cognition and behavior therapy. All adolescents underwent 45-d intervention. Sixteen healthy volunteers were recruited into a control group. Barratt Impulsiveness Scale（BIS-11） scores, Young＇s Internet Addiction Test（IAT） as well as the ratio of brain N-acetyl aspartate（NAA） to creatine（NAA/Cr） and choline（Cho） to creatine（Cho/Cr） were recorded by magnetic resonance spectroscopy before and after intervention respectively. Results： The IAT scores and BIS-11 total scores in both EA and PI group were remarkably decreased after treatment（P〈0.05）, while EA group showed more significant decrease in certain BIS-11 sub-factors（P〈0.05）. Both NAA/Cr and Cho/Cr were significantly improved in EA group after treatment（P〈0.05）; however, there were no significant changes of NAA/Cr or Cho/Cr in PI group after treatment（P〉0.05）. Conclusions： Both EA and PI had significantly positive effect on IA adolescents, especially in the aspects of psychological experiences and behavioral expressions, EA might have an advantage over PI in terms of impulsivity control and brain neuron protection. The mechanism underlying this advantage might be related to the increased NAA and Cho levels in prefrontal and anterior cingulate cortices.
