背景:慢性鼻炎是指鼻腔发炎和发炎,导致鼻塞等症状,流鼻涕,打喷嚏,持续至少12周的鼻后滴注。虽然各种药物治疗可用于慢性鼻炎,研究表明,患者通常不遵守治疗或报告无效。鼻粘膜的冷冻疗法是一种手术选择,对这些患者显示出希望,有可接受的副作用。
目的:我们的目标是评估现有文献中关于冷冻疗法作为慢性鼻炎治疗的有效性和安全性。
方法:我们检索了四个电子数据库以进行相关研究。筛选程序后,从纳入的研究中提取数据。使用随机效应模型,我们计算了连续结局的合并平均差(MD)和分类结局的合并比例.I2测试用于检测异质性。使用Cochrane偏倚风险评估工具2评估随机对照试验(RCT)的方法学质量,同时使用美国国立卫生研究院的工具评估观察性研究和单臂研究。
结果:我们的研究包括21项研究;18项符合分析条件,1663例慢性鼻炎患者。我们所有的评估结果显示冷冻疗法比基线状态有所改善。我们汇总的鼻部症状总评分(rTNSS)MD,鼻结膜炎生活质量问卷(RQLQ),鼻塞症状评估(NOSE)评分如下:(-3.58,95%CI[-3.80,-3.37],p<0.001),(-1.48,95%CI[-1.68,-1.27],p<0.001),和(-26.65,95%CI[-33.98,-19.31],p<0.001),分别。关于鼻塞和鼻漏,在完全缓解亚组中,冷冻疗法在61%和52%的患者中有效,在<50%缓解亚组中,分别为26%和34%。分别。
结论:我们观察到我们的测量结果如rTNSS、RQLQ,和NOSE得分与基线状态相比,证明冷冻疗法的功效。这种改善在随后的所有随访期间都是一致的。然而,我们需要更多高质量的RCT来推广更有力的证据.
BACKGROUND: Chronic rhinitis is when the nasal passages become inflamed and irritated, causing symptoms like nasal congestion, runny nose, sneezing, and postnasal drip that last for at least 12 weeks. While various medical treatments are available for chronic rhinitis, studies have shown that patients often do not comply with the treatment or report that it is ineffective. Cryotherapy for the nasal mucosa is a surgical option that has shown promise for these patients, with acceptable side effects.
OBJECTIVE: Our goal is to evaluate the existing literature regarding the effectiveness and safety of cryotherapy as a treatment for chronic rhinitis.
METHODS: We searched four electronic databases for relevant studies. Data were extracted from the included studies after screening procedures. Using the random effect model, we calculated the pooled mean difference (MD) for our continuous outcomes and pooled proportions for categorical outcomes. The I2 test was used to detect heterogenicity. Randomized controlled trials (RCTs) were assessed for methodological quality using the Cochrane risk of bias assessment tool 2, while observational studies and single-arm studies were assessed using the National Institutes of Health\'s tools.
RESULTS: Our study comprised 21 studies; eighteen were eligible for analysis, with 1663 patients with chronic rhinitis. All of our assessed outcomes showed improvement with cryotherapy from their baseline status. Our pooled MDs for Total Nasal Symptom Score (rTNSS), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), and Nasal Obstruction Symptom Evaluation (NOSE) scores were as follows: ( - 3.58, 95% CI [ - 3.80, - 3.37], p < 0.001), ( - 1.48, 95% CI [ - 1.68, - 1.27], p < 0.001), and ( - 26.65, 95% CI [ - 33.98, - 19.31], p < 0.001), respectively. Regarding nasal obstruction and rhinorrhea, cryotherapy showed effectiveness in 61% and 52% of patients in the complete relief subgroup and 26% and 34% in the < 50%-relief subgroup, respectively.
CONCLUSIONS: We observed significant improvement in our measured outcomes as rTNSS, RQLQ, and NOSE scores compared to the baseline state, demonstrating the cryotherapy\'s efficacy. This improvement was consistent in all subsequent follow-up periods. However, we need more high-quality RCTs for stronger evidence to be generalized.