孟鲁司特在哮喘合并过敏性鼻炎患者中的疗效:荟萃分析

摘要

目的 荟萃哮喘合并过敏性鼻炎患者的临床随机对照研究(RCT)评估孟鲁司特疗效.方法 用关键词途径,对MEDLINE和Cochrane Library数据库从建库至2017年1月发表的孟鲁司特相关临床试验进行荟萃分析.入选标准为:研究哮喘合并鼻炎患者;持续≥14天;对照组为安慰剂、吸入型糖皮质激素(ICS)或ICS联合支气管扩张剂,治疗组加用孟鲁司特;临床终点为鼻部症状评分和最大呼吸流量(PEF).结果 最终纳入5篇可合并研究(2701例),鼻部症状评分的均数差(MD)及其95％置信区间(95％CI)为-0.09[-0.12,-0.06](P=0.0001),异质性P值为0.83.PEF的MD及95％CI为4.50[-2.24,11.24](P=0.19),异质性P值为0.004.鼻塞、喷嚏和流涕症状有明显下降.结论 在安慰剂组或其他药物基础上加用孟鲁司特能够显著改善哮喘合并鼻炎患者的鼻炎症状.鼻塞、喷嚏和流涕症状均明显缓解.%Objective Pool the published data of randomized -controlled trials (RCT) to explore the effect of montelukast in patients diagnosed with concomitant diagnosis of bronchial asthma and allergic rhinitis ( AR ) . Methods Prospective randomized controlled trials ( RCTs) published before 2017 Jan in English were collected from MEDLINE, and Cochrane Library for meta-analysis.The inclusion criteria were:the subjects were patients diagnosed with concomitant diagnosis of AR and bronchial asthma;the study lasted at least 14 days;addition of montelukast to inhaled corticosteroids (ICS), inhaled corticosteroids/long acting beta -agonists (ICS/LABA) or placebo as the treatment group and ICS , ICS/LABA, or placebo as the control group; and nasal symptom scores , and peak flow (PEF)wereusedasendpoints.Results 2701patientsin8RCTswereincluded,1355inmontelukastgroup,and 1346 in control group.The standardized mean difference (SMD) of daily symptom scores was -0.09[ -0.12,-0.06](P=0.0001), with P=0.83 for heterogeneity.The SMD of PEF was 4.50 [ -2.24,11.24], with P=0.004 for heterogeneity .Conclusion Montelukast significantly improves nasal symptom in patients with asthma and AR.