鼻内光疗治疗成人变应性鼻炎的疗效及安全性的Meta分析孙俪娜刘淑云帅常娟毛雪梅殷泽登西南医科大学附属医院耳鼻咽喉头颈外科摘要：目的：系统评价鼻内光疗治疗成人AR的疗效及安全性，为临床应用提供循证医学证据。方法:搜索PubMccLEmbasc>Cochrane图书馆、中国学术期刊全文数据库(C¥K1)、万方数据库，检索鼻内光疗治疗AR的随机对照试骑(RCT)或临床研究文献，截止时间为2017年3月。依据文献纳入和排除标准进行文献筛选，采用Cochrane偏倚风险评估表对纳入文献进行质量评价。用Revman5.3软件进行Meta分析，对计量资料计算加权均数差及其95%可信区间(CI),并绘制森林图及漏斗图，对计数资料计算比值比(0R)及其95%CI,并绘制森林图及漏斗图。采用鼻症状总评分(TNSS)、鼻结膜炎生活质量问卷(RQLQ)及上颛痒评分等指标评价鼻内光疗对成人AR的治疗效果，用鼻黏膜严重干燥及轻微干燥发牛率评估安全性。结果:共纳入12篇文献，其中包括5篇RCT及7篇临床研究，包括615例成人AR患者。Meta分析显示:鼻内光疗患者治疗后较治疗前TNSS、RQLQ及上瓠痒评分降低，鼻黏膜轻微干燥发生率较治疗前高，差异有统计学意义(P<0.05)，鼻黏膜严重干燥发生率高于治疗前，但差异无统计学意义(P>0.05)。与安慰剂及抗组胺剂组比较，鼻内光疗组患者TNSS、RQLQ及上瓠痒评分降低，鼻黏膜轻微干燥发生率较高，差异有统计学意义(P<0.05),鼻黏膜严重干燥发生率较高，但差异无统计学意义(P>0.05)。结论:鼻内光疗能改善患者的TNSS.RQLQ及上频痒症状，安全性较好。对症状缓解不满意的患者可选择使用。关键词：鼻内光疗;鼻炎，变应性;Meta分析;疗效;安全性;作者简介：殷泽登，E-ma订:877241861@qq.com收稿日期：2017-07-03EfficacyandsafetyofendonasalphototherapyinthetreatmentofaduItallergicrhinitis:AMeta-analysisSUNLinaLIUShuyunSHUAIChangjuanMAOXuemeiYINZedengDepartmentofOtorhinolaryngologyHeadandNeckSurgery,AffiliatedHospitalofSouthwestMedicalUniversity;Abstract：Objective:ToperformasystematicreviewoftheefficacyandsafetyofendonasalphototherapyinthetreatmentofAR,andtoprovideevidenceofevidence-basedmedicineforclinicalapplication.Method:DatabaseswerefromPubMed,Embase,CochraneLibrary,ChineseAcademicJournalFull-textDatabase(CNKI)andWanfangdatabase.Arandomizedcontrolledtrial(RCT)orclinicalstudyliteratureonintranasalphotothcrapyforadultARisavailable,andthedeadlineisMarch2017.Basedontheliteratureinclusionandexclusioncriteria,therelatedliteratureswereselectedandthequalitywasevaluatedbyusingtheCochraneinclusionbiasassessmenttable.Meta-analysiswasperformedwithRevman5.3software.Forcontinuousoutcomes,theweightedmeandifference(WMD)andits95%confidenceintervals(CI)werecalculated,forestmapsandfunnelplotsweredrew.Foruncontinuousoutcomes,theoddsratio(OR)andits95%CTwerecalculated,andforestmapsandfunnelplotsweredrew.Theefficacyincludedtotalnasalsymptomscores(TNSS),rhinoconjunctivitisqualityoflifequestionnairc(RQLQ)andpalateitchingscores,andthesafetywasassessedbyincidencerateofseveredryingandmilddryingofnasalmucosa.Result:Atotalof12articleswereselected,including5RCTand7clinicalstudies,andtherewere615adultARpatients.TheMeta-analysisshowsthatendonasalphototherapysignificantlyreducedtheTNSS,RQLQandpalateitchingscores,theincidencerateofmilddryingofnasalmucosawashigherincomparisonwithpretreatedvalues,andthedifferencewasstatisticallysignificant(P<0.05).Therateofseveredryingofnasalmucosawashigher,butthedifferencewasnotstatisticallysignificant(P>0.05).ItalsoshowsthatendonasalphototherapysignificantlyreducedtheTNSS,RQLQandpalateitchingscores,andtherateofmilddryingofnasalmucosawashigherincomparisonwithplaceboandantihistaminesgroups,andthedifferencewasstatisticallysignifiednt...