Abstract：
BACKGROUND: Leukotrienes play a significant role in the pathogenesis of adenoid hypertrophy (A.H.). Therefore, we aimed to analyse the role of montelukast, a leukotriene receptor antagonist, alone or in combination with mometasone, a potent local intranasal steroid, for the treatment of A.H.
METHODS: Participants were children with A.H. were treated with montelukast alone or montelukast and mometasone furoate. The main outcome measures were effect of montelukast on clinical symptoms of A.H. A literature review was conducted using online search engines, Cochrane Library, PubMed, Web of Science and Scopus, for randomized clinical trials assessing children with A.H. treated with montelukast alone or montelukast and mometasone furoate. Seven randomized clinical trials (RCTs) were included with 742 children.
RESULTS: Our study reveals that montelukast alone or in combination with intranasal mometasone furoate significantly improves clinical symptoms of adenoid hypertrophy such as snoring, sleeping disturbance, mouth breathing and A/N ratio. Montelukast was superior to placebo in decreasing snoring (SMD = -1.00, 95% CI [-1.52, -0.49]), sleep discomfort (SMD = -1.26, 95% CI [-1.60, -0.93]), A/N ratio (MD = -0.11, 95% CI [-0.14, -0.09]) and mouth breathing (SMD = -1.36, 95% CI [-1.70, -1.02]). No difference was detected between montelukast and mometasone versus mometasone alone in snoring (SMD = -0.21, 95%CI [-0.69, 0.27]); however, the combination group was superior to the mometasone alone in mouth breathing (SMD = -0.46, 95% CI [-0.73, -0.19]).
CONCLUSIONS: The limitation of studies included a small sample size, with an overall low to medium quality. Thus, further larger, higher-quality RCTs are recommended to provide more substantial evidence.
METHODS: Participants were children with A.H. were treated with montelukast alone or montelukast and mometasone furoate. The main outcome measures were effect of montelukast on clinical symptoms of A.H. A literature review was conducted using online search engines, Cochrane Library, PubMed, Web of Science and Scopus, for randomized clinical trials assessing children with A.H. treated with montelukast alone or montelukast and mometasone furoate. Seven randomized clinical trials (RCTs) were included with 742 children.
RESULTS: Our study reveals that montelukast alone or in combination with intranasal mometasone furoate significantly improves clinical symptoms of adenoid hypertrophy such as snoring, sleeping disturbance, mouth breathing and A/N ratio. Montelukast was superior to placebo in decreasing snoring (SMD = -1.00, 95% CI [-1.52, -0.49]), sleep discomfort (SMD = -1.26, 95% CI [-1.60, -0.93]), A/N ratio (MD = -0.11, 95% CI [-0.14, -0.09]) and mouth breathing (SMD = -1.36, 95% CI [-1.70, -1.02]). No difference was detected between montelukast and mometasone versus mometasone alone in snoring (SMD = -0.21, 95%CI [-0.69, 0.27]); however, the combination group was superior to the mometasone alone in mouth breathing (SMD = -0.46, 95% CI [-0.73, -0.19]).
CONCLUSIONS: The limitation of studies included a small sample size, with an overall low to medium quality. Thus, further larger, higher-quality RCTs are recommended to provide more substantial evidence.
摘要：
背景：白三烯在腺样体肥大（A.H.）的发病机制中起重要作用。因此,我们旨在分析孟鲁司特的作用，白三烯受体拮抗剂，单独或与莫米松联合使用，一种有效的局部鼻内类固醇，治疗A.H.
方法：受试者为A.H.患儿，接受孟鲁司特单用或孟鲁司特和糠酸莫米松治疗。主要结局指标是孟鲁司特对A.H.临床症状的影响。使用在线搜索引擎进行文献综述，科克伦图书馆,PubMed,WebofScience和Scopus,用于评估单独使用孟鲁司特或孟鲁司特和糠酸莫米松治疗的A.H.儿童的随机临床试验。7项随机临床试验（RCT）纳入742名儿童。
结果：我们的研究表明，孟鲁司特单用或联合鼻内糠酸莫米松可显著改善腺样体肥大的临床症状，如打鼾，睡眠障碍,口呼吸和A/N比。孟鲁司特在减少打鼾方面优于安慰剂（SMD=-1.00，95％CI[-1.52，-0.49]），睡眠不适（SMD=-1.26，95%CI[-1.60，-0.93]），A/N比（MD=-0.11,95%CI[-0.14,-0.09]）和口呼吸（SMD=-1.36,95%CI[-1.70,-1.02]）。孟鲁司特和莫米松与单用莫米松在打鼾中没有检测到差异(SMD=-0.21,95CI[-0.69,0.27]);然而,在口腔呼吸方面,联合用药组优于单用莫米松(SMD=-0.46,95%CI[-0.73,-0.19]).
结论：研究的局限性包括样本量小，总体质量低到中等。因此，更大,建议使用更高质量的RCT来提供更多实质性证据.
方法：受试者为A.H.患儿，接受孟鲁司特单用或孟鲁司特和糠酸莫米松治疗。主要结局指标是孟鲁司特对A.H.临床症状的影响。使用在线搜索引擎进行文献综述，科克伦图书馆,PubMed,WebofScience和Scopus,用于评估单独使用孟鲁司特或孟鲁司特和糠酸莫米松治疗的A.H.儿童的随机临床试验。7项随机临床试验（RCT）纳入742名儿童。
结果：我们的研究表明，孟鲁司特单用或联合鼻内糠酸莫米松可显著改善腺样体肥大的临床症状，如打鼾，睡眠障碍,口呼吸和A/N比。孟鲁司特在减少打鼾方面优于安慰剂（SMD=-1.00，95％CI[-1.52，-0.49]），睡眠不适（SMD=-1.26，95%CI[-1.60，-0.93]），A/N比（MD=-0.11,95%CI[-0.14,-0.09]）和口呼吸（SMD=-1.36,95%CI[-1.70,-1.02]）。孟鲁司特和莫米松与单用莫米松在打鼾中没有检测到差异(SMD=-0.21,95CI[-0.69,0.27]);然而,在口腔呼吸方面,联合用药组优于单用莫米松(SMD=-0.46,95%CI[-0.73,-0.19]).
结论：研究的局限性包括样本量小，总体质量低到中等。因此，更大,建议使用更高质量的RCT来提供更多实质性证据.
