Systematic review and Meta-analysis of efficacy and safety of Bidouyan Oral Liquid in treatment of rhinosinusitis
This study aimed to systematically review the efficacy and safety of Bidouyan Oral Liquid in the treatment of rhinosinu-sitis(RS).CNKI,Wanfang,SinoMed,VIP,Cochrane Library,PubMed,EMbase,Web of Science,and Ovid were searched for the randomized controlled trial(RCT)of Bidouyan Oral Liquid for the treatment of RS patients.Moreover,the reference lists and the grey literature were searched manually.Two researchers independently screened the literature and extracted data.The Cochrane collabora-tion′s tool for assessing risk of bias(RoB 2.0)in randomized trial was used to assess the methodological quality of the included stu-dies.Meta-analysis was performed in RevMan 5.3 and Stata 12.0,and the grades of recommendation,assessment,development and evaluation(GRADE)was employed to evaluate the quality of evidence.A total of 54 RCTs(35 with drug combinations and 19 with single drugs)comprising 7 511 patients(3 973 in the observation group and 3 538 in the control group)were included.Meta-analysis showed that Bidouyan Oral Liquid + conventional treatment was superior to conventional treatment alone in increasing the total response rate(RR=1.19,95%CI[1.15,1.24],P<0.000 01)and decreasing the Lund-Kennedy scores(MD=-1.94,95%CI[-2.61,-1.26],P<0.000 01),Lund-Mackay scores(MD=-2.14,95%CI[-2.98,-1.31],P<0.000 01),and visual analogue scale(VAS)scores(MDtotal VAS scores =-1.28,95%CI[-1.56,-1.01],P<0.000 01;MDnasal congestion VAS scores =-0.58,95%CI[-0.89,-0.27],P=0.000 2;MDrunny nose VAS scores =-0.61,95%CI[-0.93,-0.29],P= 0.000 2;MDolfactory dysfunction VAS scores =-0.43,95%CI[-0.52,-0.34],P<0.000 01;MDhead and facial pain VAS scores =-0.41,95%CI[-0.57,-0.26],P<0.000 01).Furthermore,the com-bined treatment outperformed conventional treatment alone in improving the mucociliary transport rate(MTR)(MD=1.64,95%CI[1.08,2.20],P<0.000 01)and lowering the levels of inflammatory cytokines{tumor necrosis factor-α(TNF-α)(SMD=-1.95,95%CI[-2.57,-1.33],P<0.000 01),interleukin-6(IL-6)(SMD=-2.64,95%CI[-4.08,-1.21],P=0.000 3)}in RS pa-tients.In addition,the combined treatment did not increase the incidence of adverse reactions(RR=0.83,95%CI[0.44,1.57],P=0.57).Bidouyan Oral Liquid was superior to conventional treatment in increasing total response rate(RR=1.25,95%CI[1.18,1.32],P<0.000 01),decreasing the Lund-Kennedy(P<0.01)and Lund-Mackay scores(P<0.05),alleviating major symptoms(Ptotal VAS scores<0.01;Pnasal congestion VAS scores<0.01;Prunny nose VAS scores<0.01;Polfactory dysfunction VAS scores<0.05;Phead and facial pain VAS scores<0.01),and decreasing adverse reactions(P=0.03).The results showed that either Bidouyan Oral Liquid or Bidouyan Oral Liquid + conven-tional treatment can increase the total response rate,decrease the Lund-Kennedy and Lund-Mackay scores,and mitigate major symp-toms.In addition,Bidouyan Oral Liquid + conventional treatment improved MTR and reduced the expression of TNF-α and IL-6 with-out causing serious adverse events.However,due to the limited methodological quality of the included studies,large-sample and high-quality RCTs are needed to provide evidence support.
NETL
NSTL
万方数据
维普
