ObjectiveTo systematically review the efficacy and safety of dust mite sublingual immunotherapy (SLIT) in the treatment of children with allergic rhinitis. MethodsRandomized controlled trials (RCTs) about SLIT treating allergic rhinitis in pediatric patients was searched in PubMed, EMbase, CBM, Ovid, The Cochrane Library (Issue 5, 2014), CNKI, VIP and WanFang Data from inception to May 2014. Two reviewers independently screened literature according to inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Then meta-analysis was conducted using RevMan 5.3 software. ResultsA total of nine RCTs including 663 patients were finally included. The results of meta-analysis indicated that:the trial group was superior to the control group in reducing the scores of drug use (SMD=-0.61, 95%CI-0.94 to-0.27, P=0.000 4) and mite-specific serum IgE levels (follow-up time > 22 weeks:SMD=0.71, 95%CI 0.31 to 1.12, P=0.000 5). However, no significant difference was found between the two groups in the scores of nasal symptoms (SMD=0.06, 95%CI-0.13 to 0.25, P=0.55) and the incidence of adverse reaction (OR=1.3, 95%CI 0.89 to 1.90, P=0.17). ConclusionSLIT could decrease the use frequency of antihistamine, β-agonist and nasal spray steroids, and it has less adverse reaction and better safety in the treatment of children with allergic rhinitis. But SLIT could neither effectively alleviate nasal symptoms nor reduce mite-specific serum IgE levels of pediatric patients with allergic rhinitis in a short time.
Objective To review the research progress of the feasibility of a new treatment method for atrophic rhinitis (ATR) based on tissue engineering technology (seed cells, scaffold materials, and growth factors), and provide new ideas for the treatment of ATR. MethodsThe literature related to ATR was extensively reviewed. Focusing on the three aspects of seed cells, scaffold materials, and growth factors, the recent research progress of ATR treatment was reviewed, and the future directions of tissue engineering technology to treat ATR were proposed. Results The pathogenesis and etiology of ATR are still unclear, and the effectiveness of the current treatments are still unsatisfactory. The construction of a cell-scaffold complex with sustained and controlled release of exogenous cytokines is expected to reverse the pathological changes of ATR, promoting the regeneration of normal nasal mucosa and reconstructing the atrophic turbinate. In recent years, the research progress of exosomes, three-dimensional printing, and organoids will promote the development of tissue engineering technology for ATR. ConclusionTissue engineering technology can provide a new treatment method for ATR.
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。
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 观察低温等离子射频治疗阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea-hypopnea syndrome，OSAHS）合并变应性鼻炎的疗效。 方法 对2010年1－5月收治的42例OSAHS合并变应性鼻炎患者，采用低温等离子射频双下鼻甲减容、鼻腔内蝶腭神经及筛前神经末梢阻滞，并配合鼻中隔成形等手术。使用Epworth嗜睡评分量表（epworth sleepiness scale， ESS）和视觉模拟评分法（visual analogue scale，VAS）对治疗前及治疗3个月后的总体感受评分。 结果 ESS评分与VAS评分均符合正态分布，手术前、后ESS评分[（14.22±4.21）分，（6.78±4.12）分]与VAS评分[（8.34±2.72）分，（3.96±1.02）分]差异有统计学意义（Plt;0.05）。 结论 低温等离子射频治疗OSAHS合并变应性鼻炎疗效较好。【Abstract】 Objective To observe the clinical effect of treatment by low-temperature plasma radio frequency on obstructive sleep apnea-hypopnea syndrome (OSAHS) complicated with allergic rhinitis. Methods A total of 42 patients with OSAHS complicated with allergic rhinitis between January 2010 and May 2010 were chosen. All of the patients were treated by low-temperature plasma radio frequency nerve block, concha nasalis inferior ablation and other operations such as nasal septal construction. The nerve terminals of sphenopalatine nerve and anterior ethmoid nerve were blocked by ablation. Epworth sleepiness scale (ESS) and visual analogue scale (VAS) were used to estimate the curative effects. Results The results of ESS and VAS were consistent with gaussian distribution. There were statistical significant difference between the scores of pre-and post-operation (Plt;0.05). Conclusion The low-temperature plasma radio frequency treatment for OSAHS complicated with allergic rhinitis is easy，safe and efficient.
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.
【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.
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.