克拉霉素治疗鼻咽癌放疗后鼻窦炎疗效的Meta分析

Efficacy of clarithromycin in the treatment of sinusitis after radiotherapy for nasopharyngeal carcinoma: a Meta-analysis study

摘要:

目的 通过对克拉霉素治疗鼻咽癌（NPC）放疗后鼻窦炎疗效的系统评价，以明确该药的临床应用价值并提供相关循证学证据。方法 检索英文数据库（PubMed、Embase、Cochrane library）及中文数据库（知网、CBM、维普），检索时间为各数据库建库至2020年10月24日，按是否为NPC放疗后鼻窦炎及是否用克拉霉素治疗的标准筛选检索文献后获取相应临床研究资料，使用Review Manager 5.4对纳入的研究进行Meta分析。结果 本文共纳入7篇文献，共516例，研究结果显示克拉霉素对NPC放疗后鼻窦炎的安全性有统计学意义[RR=1.33，95%CI（1.19，1.48），P<0.01]，视觉模拟评分法（VSA）具有统计学意义[MD=-2.24，95%CI（-2.51，-1.97），P<0.01]。倒漏斗图分析敏感性较低，提示本研究分析结果较稳定。结论 对于NPC放疗后鼻窦炎的治疗，克拉霉素治疗具有明显的优势且不良反应小，故临床可优先选用克拉霉素。

关键词:鼻咽癌;放疗;鼻窦炎;克拉霉素;Meta分析

Abstract:

Objective Through the systemic evaluation of the efficacy of clarithromycin in the treatment of sinusitis after radiotherapy for nasopharyngeal carcinoma, to clarify the clinical application value of the drug and provide relevant evidence-based medicine.Methods The english database search (PubMed, Embase, the Cochrane library) and Chinese database (CNKI, CBM, VIP) were retrieved from the establishment of each database to October 24, 2020. According to the criteria of whether it is sinusitis after radiotherapy for nasopharyngeal carcinoma, and whether it is treated with clarithromycin, the relevant clinical research data were obtained after literature screening and retrieval. A meta-analysis study was performed using Review Manager 5.4.Results The reporting studies of seven articles were included in the analysis with a total number of 516 patients. And the results showed that clarithromycin had a statistically significant effect on sinusitis after radiotherapy for nasopharyngeal carcinoma[RR=1.33，95%CI(1.19，1.48)，P<0.01], and VSA score was statistically significant [MD=-2.24,95%CI(-2.51,-1.97),P<0.01]. The low sensitivity of the funnel-plot analysis suggested that the analysis results of this study are relatively stable.Conclusion Clarithromycin has obvious advantages and small adverse reactions for the treatment of sinusitis after radiotherapy for nasopharyngeal carcinoma, so the clarithromycin is preferred.

Key words:Nasopharyngeal Carcinoma;Radiotherapy;Sinusitis;Clarithromycin;Meta-Analysis