scholarly journals Effectiveness of Hypertonic Saline Nasal Irrigation for Alleviating Allergic Rhinitis in Children: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 8 (1) ◽  
pp. 64 ◽  
Author(s):  
Chia-Ling Li ◽  
Hsiao-Chuan Lin ◽  
Chien-Yu Lin ◽  
Teh-Fu Hsu
Keyword(s):  
Allergic Rhinitis ◽  
Hypertonic Saline ◽  
Meta Analysis ◽  
Isotonic Saline ◽  
Nasal Symptom ◽  
Mean Difference ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Nasal Irrigation ◽  
Symptom Scores

We aimed to explore the efficacy of hypertonic saline nasal irritation (HSNI) for improving nasal symptoms and quality of life, and for decreasing oral antihistamine consumption in children with allergic rhinitis (AR). We conducted a systematic search of PubMed, Medline, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Chinese Electronic Periodicals Service, and Cochrane Library of Controlled Trials databases for prospective randomized, controlled trials assessing HSNI effects in children with AR and published before December 2017. Two authors independently assessed each trial’s quality and extracted data for a meta-analysis. We included four trails comprising 351 patients. HSNI improved patients’ nasal symptom scores (mean difference 1.82 points after treatment; 95% confidence interval (CI), 0.35–3.30; I2 = 64%; p = 0.02) and a significantly lower rescue antihistamine use rate (risk ratio (RR), 0.68; 95% CI, 0.48–0.95; I2 = 28%; p = 0.02). Analyses comparing HSNI with isotonic saline nasal irrigation (ISNI) showed better nasal symptom scores (mean difference, 1.22 points; 95% CI, 1.01–1.44; I2 = 0%; p < 0.001) in patients in the HSNI group, although the antihistamine use (RR, 0.84; 95% CI, 0.64–1.10; I2 = 0%; p = 0.2) and adverse effect rates were similar between groups. Compared with ISNI, HSNI may be a reasonable adjunctive treatment for children with AR.

Hypertonic Saline Versus Isotonic Saline Nasal Irrigation: Systematic Review and Meta-analysis

2018 ◽  
Vol 32 (4) ◽  
pp. 269-279 ◽  
Author(s):  
Dichapong Kanjanawasee ◽  
Kachorn Seresirikachorn ◽  
Wirach Chitsuthipakorn ◽  
Kornkiat Snidvongs
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Hypertonic Saline ◽  
Meta Analysis ◽  
Isotonic Saline ◽  
High Volume ◽  
Mean Difference ◽  
Saline Irrigation ◽  
Nasal Irrigation ◽  
Subgroup Analyses

Background Saline nasal lavage is one of the treatments of sinonasal diseases. Evidence from basic research favors hypertonic saline (HS) over isotonic saline (IS) for mucociliary clearance, but evidence from clinical studies is controversial. Conversely, HS may carry greater side effects. Objective To compare the effects of HS and IS nasal irrigation in treating sinonasal diseases. Methods Systematic search with Ovid MEDLINE, Scopus, PubMed, Google Scholar, and Manual additional sources was conducted. Randomized controlled trials comparing HS with IS nasal irrigation in treating any sinonasal diseases, including rhinitis and rhinosinusitis, were included. Data were pooled for meta-analyses. Outcomes were symptom scores, sinonasal outcome test (SNOT), and adverse events. Heterogeneity was explored by subgroup analyses. Results Nine studies (740 patients) were included. HS nasal irrigation brought greater benefits over IS in symptom reduction (standardized mean difference (SMD) −0.58; 95% confidence interval [CI]: −0.76, −0.40); however, no difference was shown in SNOT-20 improvement (mean difference 1.81; 95% CI: −0.68, 4.30). In subgroup analyses, effects favoring HS on symptoms were larger in 4 subgroups. These were (1) patients with rhinitis (SMD −1.09; 95% CI: −1.42, −0.76) compared with rhinosinusitis (SMD −0.37; 95% CI: −0.58, −0.15), P < .01; (2) patients under the age of 18 years (SMD −1.22; 95% CI: −1.53, −0.91) compared with patients over the age of 18 years (SMD −0.26; 95% CI: −0.49, −0.04), P < .01; (3) saline irrigation using high volume (SMD −0.89; 95% CI: −1.18, −0.60) compared with low volume (SMD −0.39; 95% CI: −0.62, −0.16), P < .01; and (4) saline irrigation with hypertonicity of <3% (SMD −1.09; 95% CI: −1.42, −0.76) and hypertonicity of 3%–5% (SMD −1.20; 95% CI: −1.61, −0.78) compared with hypertonicity of >5% (SMD 0.20; 95% CI: −0.15, 0.55), P < .01. Buffered saline and operative status did not have impact. HS brought greater minor adverse effects. No major adverse effects were reported. Conclusion HS improves symptoms over IS nasal irrigation in treating sinonasal diseases. There is no difference in disease-specific quality of life. However, HS brings greater minor side effects than IS.

scholarly journals Efficacy and Safety of Bilastine in the Treatment of Allergic Rhinitis: A Systematic Review and Meta-analysis

2022 ◽  
Vol 12 ◽  
Author(s):  
Aranjit Singh Randhawa ◽  
Norhayati Mohd Noor ◽  
Mohd Khairi Md Daud ◽  
Baharudin Abdullah
Keyword(s):  
Allergic Rhinitis ◽  
Symptom Score ◽  
Meta Analysis ◽  
Nasal Symptom ◽  
Comparable Efficacy ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Efficacy And Safety ◽  
Quality Of Evidence

Bilastine is a non-sedating second generation H1 oral antihistamine (OAH) for treating allergic rhinitis (AR) patients. The effect of bilastine has not previously been evaluated in a meta-analysis. The aim of this review was to determine the efficacy and safety of bilastine in treating AR. An electronic literature search was performed using Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Science Direct and Google Scholar up to March 2021. Randomized controlled trials comparing bilastine with placebo and standard pharmacotherapy were included. The included studies must have diagnosis of AR established by clinicians and the outcomes must have a minimum of 2 weeks of follow-up period. The primary outcomes assessed were total symptom score (TSS), nasal symptom score (NSS) and non-nasal symptom score (NNSS). The secondary outcomes were discomfort due to rhinitis, quality of life (QOL) and adverse events. The risk of bias and quality of evidence for all studies were appraised. The meta-analysis was done using Review Manager 5.3 software based on the random-effects model. The search identified 135 records after removal of duplicates. Following screening and review of the records, fifteen full-text articles were assessed for eligibility. Five trials involving 3,329 patients met the inclusion criteria. Bilastine was superior to placebo in improving TSS, NSS, NNSS, rhinitis discomfort score and QOL but has comparable efficacy with other OAHs in TSS, NSS, NNS, rhinitis discomfort score and QOL. There was no difference in adverse effects when bilastine was compared against placebo and other OAHs except for somnolence. Bilastine has fewer incidence of somnolence compared to cetirizine. The overall quality of evidence ranged from moderate to high quality. Bilastine is effective and safe in treating the overall symptoms of AR with comparable efficacy and safety with other OAHs except somnolence. Whilst bilastine has similar efficacy to cetirizine, somnolence is notably less in bilastine.

Efficacy of Hypertonic Saline Irrigation for Nasal Symptoms in Children with Perennial Allergic Rhinitis: A Randomized Double-Blind Study

2021 ◽  
Vol 104 (10) ◽  
pp. 1570-1577
Keyword(s):  
Allergic Rhinitis ◽  
Side Effects ◽  
Hypertonic Saline ◽  
Symptom Score ◽  
Nasal Congestion ◽  
Nasal Symptom ◽  
Perennial Allergic Rhinitis ◽  
Saline Irrigation ◽  
Nasal Irrigation ◽  
Nasal Cytology

Background: Nasal saline irrigation was an adjunctive therapy of allergic rhinitis (AR). It has been suggested that the use of hypertonic saline (HS) is better than normal saline (NSS) in treatment of AR. Reduction of mucosal edema by hypertonicity induced water transport through nasal mucosa, nasal congestion reduction and mucociliary clearance improvement. Objective: To compare total nasal symptom score (TNSS) between 3% HS and NSS irrigation in perennial allergic rhinitis children. Materials and Methods: The present study was conducted at the Allergy Center of Bhumibol Adulyadej Hospital (BAH), Royal Thai Airforce, Bangkok, Thailand between January and March 2021. Sixty-two perennial AR children were enrolled and categorized in severity level, namely mild, moderate or severe. Subjects were randomized into two groups. Each participant was blind-randomized to nasal irrigation of either 3% HS or NSS twice-daily for 4 weeks by the same investigator. The primary outcome was TNSS improvement between both groups. Secondary outcomes were quality of life, nasal congestion severity improvement, nasal cytology change and side effects. Results: TNSS improvement of 3% HS was more than NSS group (4.03±2.36 versus 2.73±3.06, p=0.034). Nasal congestion was the only symptom that differed significantly between the two groups (1.32±1.01 in 3% HS versus 0.70±1.24 in NSS, p=0.024). Reduction of congestion severity by physical examination, nasal cytology changes and side effects were comparable. Conclusion: Nasal irrigation with 3% HS in children with perennial AR had more improvement than NSS in TNSS., especially nasal congestion. Keyword: Hypertonic saline; Nasal irrigation; Allergic rhinitis; Nasal symptom score

Intranasal Azelastine and Fluticasone as Combination Therapy for Allergic Rhinitis: Systematic Review and Meta-analysis

2019 ◽  
Vol 161 (3) ◽  
pp. 412-418
Author(s):  
Peter M. Debbaneh ◽  
Anna K. Bareiss ◽  
Sarah K. Wise ◽  
Edward D. McCoul
Keyword(s):  
Systematic Review ◽  
Allergic Rhinitis ◽  
Combination Therapy ◽  
Randomized Controlled Trials ◽  
Nasal Spray ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Patient Reported ◽  
Symptom Scores

Objective Combination therapy with intranasal azelastine and fluticasone propionate is an option for treatment of allergic rhinitis. This systematic review and meta-analysis examines existing literature to determine efficacy in treating allergic rhinitis compared to monotherapy. Data Sources The PubMed, EMBASE, Cochrane, and MEDLINE databases were systematically searched for randomized controlled trials using AzeFlu nasal spray. Review Methods Randomized, controlled trials that reported symptom relief of allergic rhinitis in males and females of all ages were included. Results were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard. Results Systematic review identified 8 articles suitable for review. The risk of bias was generally low. All studies exhibited a greater decrease in patient-reported symptom scores in patients treated with combination therapy compared to monotherapy or placebo. Meta-analysis revealed superiority of combination therapy in reducing Total Nasal Symptom Score compared to placebo (mean change from baseline: −2.41; 95% confidence interval [CI], −2.82 to −1.99; P < .001; I 2 = 60%), azelastine (mean change from baseline: −1.40; 95% CI, −1.82 to −0.98; P < .001; I 2 = 0%), and fluticasone (mean change from baseline: −0.74; 95% CI, −1.17 to −0.31; P < .001; I 2 = 12%). Conclusion Current evidence supports both efficacy and superiority of combination intranasal azelastine and fluticasone in reducing patient-reported symptom scores in patients with allergic rhinitis. Combination nasal spray should be considered as second-line therapy in patients with allergic rhinitis that is not controlled with monotherapy.

scholarly journals The effectiveness and safety of cupping therapy for stroke survivors: A systematic review and meta-analysis of randomized controlled trials

2021 ◽  
Vol 42 (4) ◽  
pp. 75-112
Author(s):  
Mikyung Kim ◽  
Chang-ho Han
Keyword(s):  
Randomized Controlled Trials ◽  
Motor Function ◽  
Upper Limb ◽  
Meta Analysis ◽  
Mean Difference ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Stroke Survivors ◽  
Randomized Controlled ◽  
Standard Mean Difference

Objectives: ncluding stroke. The aim of this study was to systematically review the clinical evidence of CT for stroke.Methods: To identify randomized controlled trials (RCTs) reporting the effectiveness and/or safety of CT, seven databases including PubMed, EMBASE, and Cochrane Library were searched for articles published from January 2000 to February 2021 without language restrictions. Meta-analysis was performed using Review Manager 5.4 software and the results were presented as mean difference (MD) or standard mean difference (SMD) for continuous variables and odds ratio (OR) for diverse variables with 95% confidence intervals (CIs). Assessment of the methodological quality of the eligible trials was conducted using the Cochrane Collaboration tool for risk of bias in RCTs.Results: Twenty-two RCTs with 1653 participants were included in the final analysis. CT provided additional benefit in improving upper limb motor function (Fugl-Meyer assessment for upper limb motor function, MD 6.91, 95% CI 4.64 to 1.67, P<0.00001) and spasticity (response rate, OR 3.28, 95% CI 1.31 to 8.22, P=0.08) in stroke survivors receiving conventional medical treatment. These findings were supported with a moderate level of evidence. CT did not significantly increase the occurrence of adverse events.Conclusions: This study demonstrated the potential of CT to be beneficial in managing a variety of complications in stroke survivors. However, to compensate for the shortcomings of the existing evidence, rigorously designed large-scale RCTs are warranted in the future.

scholarly journals The Efficacy of Ferumoxytol for Iron Deficiency Anemia: A Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 142 (3) ◽  
pp. 125-131 ◽  
Author(s):  
Yanping Shao ◽  
Wenda Luo ◽  
Haiyan Xu ◽  
Li Zhang ◽  
Qunyi Guo
Keyword(s):  
Iron Deficiency ◽  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Iron Deficiency Anemia ◽  
Meta Analysis ◽  
Mean Difference ◽  
Deficiency Anemia ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled

Introduction: This systematic review and meta-analysis aims to explore the influence of ferumoxytol versus placebo on iron deficiency anemia. Methods: We search for randomized controlled trials (RCTs) assessing the effect of ferumoxytol on iron deficiency anemia on PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases. This meta-analysis is performed using the random-effects model. Results: Four RCTs are included in the meta-analysis. Compared with the control group for iron deficiency anemia, intravenous ferumoxytol can significantly improve the proportion of patients with a ≥20 g/L hemoglobin (Hb) increase (RR = 18.43; 95% CI = 7.29–46.57; p < 0.00001), the proportion of patients with an Hb level ≥120 g/L (RR = 18.55; 95% CI = 8.66–39.72; p < 0.00001), transferrin saturation (mean difference = 11.08; 95% CI = 9.86–12.31; p < 0.00001) and FACIT-fatigue score (mean difference = 4.60; 95% CI = 3.21–6.00; p < 0.00001), but has no remarkable influence on adverse events (RR = 1.33; 95% CI = 0.84–2.10; p = 0.22), serious adverse events (RR = 1.22; 95% CI = 0.74–2.02; p = 0.44), and death (RR = 0.32; 95% CI = 0.05–1.95; p = 0.22). Conclusions: Intravenous ferumoxytol can provide the important benefits for iron deficiency anemia.

Clinical Efficacy and Safety of Omalizumab in the Treatment of Allergic Rhinitis: A Systematic Review and Meta-analysis of Randomized Clinical Trials

2019 ◽  
Vol 34 (2) ◽  
pp. 196-208 ◽  
Author(s):  
Chenjie Yu ◽  
Kaijian Wang ◽  
Xinyan Cui ◽  
Ling Lu ◽  
Jianfei Dong ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Adverse Events ◽  
Symptom Score ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Life Questionnaire ◽  
Efficacy And Safety ◽  
Significant Difference ◽  
Symptom Scores

Background Patients with moderate to severe allergic rhinitis (AR) who are treated according to the current rhinitis management guidelines may be inadequately controlled. These patients are at risk of serious comorbidities, such as asthma and chronic sinusitis. These symptoms, sneezing and an itchy, runny, stuffy nose, may have a negative impact on patients’ daily functioning. Omalizumab is being developed as a new choice for the treatment of AR. We therefore undertook a meta-analysis to assess the efficacy and safety of omalizumab in the treatment of AR. Methods We systematically searched PubMed, Cochrane Library, and MEDLINE databases for randomized controlled studies on the treatment of AR with omalizumab. Our evaluation outcomes were symptom scores, medication efficacy, combined symptom and medication scores, and adverse events. We descriptively summarized and quantitatively synthesized original data to evaluate the efficacy and safety of omalizumab in the treatment of AR by using Stata12.0 software for meta-analyses. Results The results of our meta-analysis showed that there were statistically significant differences between the omalizumab group and the control group in the following aspects: daily nasal symptom score (standardized mean difference [SMD] = –0.443, 95% confidence interval [CI]: –0.538 to –0.347, P < .001); daily ocular symptom score (SMD = –0.385, 95% CI: –0.5 to –0.269, P < .001); daily nasal medication symptom scores (SMD = –0.421, 95% CI: –0.591 to –0.251, P < .001); proportion of days of emergency drug use (risk ratio [RR] = 0.488, 95% CI: 0.307 to 0.788, P < .005); rhinoconjunctivitis-specific quality of life questionnaire (SMD = –0.286, 95% CI: –0.418 to –0.154, P < .001); and overall evaluation (RR = 1.435, 95% CI: 1.303–1.582, P < .001). There was no statistically significant difference in safety indicator: adverse events (RR = 1.026, 95% CI: 0.916–1.150, P = .655). Conclusion Omalizumab is effective and relatively safe in patients with AR; omalizumab used in conjunction with special immunotherapy has shown promising results, especially in reducing adverse events.

Efficacy and Safety of Sublingual Immunotherapy for Allergic Rhinitis in Pediatric Patients: A Meta-Analysis of Randomized Controlled Trials

2017 ◽  
Vol 31 (1) ◽  
pp. 27-35 ◽  
Author(s):  
Bohai Feng ◽  
Jueting Wu ◽  
Bobei Chen ◽  
Haijie Xiang ◽  
Ruru Chen ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Randomized Controlled Trials ◽  
Pediatric Patients ◽  
Meta Analysis ◽  
Symptom Relief ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Symptom Scores

Background Allergic rhinitis (AR) has become a global health problem that constantly affects a large part of the general population, especially children. Objective Sublingual allergen immunotherapy (SLIT) has been used extensively for pediatric AR, although its efficacy and safety are often questioned. In this meta-analysis of randomized controlled trials (RCT), we evaluated the use of SLIT for pediatric AR. Methods A number of medical literature data bases were searched through January 2016 to identify RCTs that examined the use of SLIT for pediatric AR and that assessed clinical outcomes related to efficacy. Descriptive and quantitative information was abstracted. Standardized mean differences (SMD) were calculated by using fixed- and random-effects models. Subgroup analyses were performed. Heterogeneity was assessed by using the I2 metric. A network meta-analysis was used to estimate SMDs between two SLIT protocols for pediatric seasonal AR. All data were extracted from publications or received from the authors. Results Twenty-six studies were eligible for inclusion in the meta-analysis of rhinitis or rhinoconjunctivitis symptom scores, and 19 studies were eligible for the meta-analysis of medication scores. Descriptive and quantitative data were extracted. SLIT differed significantly from placebo in terms of symptom scores (SMD -0.55 [95% confidence interval {CI}, -0.86 to -0.25]; p = 0.0003, I2 = 90%) and medication scores (SMD -0.67 [95% CI, -0.96 to -0.38J; p < 0.00001, I2 = 83%). Oral pruritus was the adverse effect, which occurred most commonly in children who were receiving SLIT. Network meta-analysis revealed no significant difference between the pre-coseasonal and continuous SLIT protocols for seasonal AR in symptom scores (SMD -6.55 [95% CI, -25.38 to 12.29]; p = 0.496) and medication scores (SMD -8.83 [95% CI, -22.10 to 4.43]; p = 0.192). Conclusions Our meta-analysis results indicated that SLIT provided significant symptom relief and reduced the need for medication in pediatric patients Moreover, the safety of SLIT needs to be confirmed in RCTs with larger samples.

scholarly journals Systematic Review and Network Meta-Analysis of Noninvasive Brain Stimulation on Dysphagia after Stroke

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Lingling Li ◽  
Hailiang Huang ◽  
Yuqi Jia ◽  
Ying Yu ◽  
Zhiyao Liu ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Brain Stimulation ◽  
Meta Analysis ◽  
Mean Difference ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Noninvasive Brain Stimulation ◽  
Randomized Controlled ◽  
Standard Mean Difference ◽  
Swallowing Dysfunction

Background. Dysphagia is a common sequelae after stroke. Noninvasive brain stimulation (NIBS) is a tool that has been used in the rehabilitation process to modify cortical excitability and improve dysphagia. Objective. To systematically evaluate the effect of NIBS on dysphagia after stroke and compare the effects of two different NIBS. Methods. Randomized controlled trials about the effect of NIBS on dysphagia after stroke were retrieved from databases of PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP, and CBM, from inception to June 2021. The quality of the trials was assessed, and the data were extracted according to the Cochrane Handbook for Systematic Reviews of Interventions. A statistical analysis was carried out using RevMan 5.3 and ADDIS 1.16.8. The effect size was evaluated by using the standardized mean difference (SMD) and a 95% confidence interval (CI). Results. Ultimately, 18 studies involving 738 patients were included. Meta-analysis showed that NIBS could improve the dysphagia outcome and severity scale (DOSS) score (standard mean difference SMD = 1.44 , 95% CI 0.80 to 2.08, P < 0.05 ) and the water swallow test score ( SMD = 6.23 , 95% CI 5.44 to 7.03, P < 0.05 ). NIBS could reduce the standardized swallowing assessment (SSA) score ( SMD = − 1.04 , 95% CI -1.50 to -0.58, P < 0.05 ), the penetration-aspiration scale (PAS) score ( SMD = − 0.85 , 95% CI -1.33 to -0.36, P < 0.05 ), and the functional dysphagia scale score ( SMD = − 1.05 , 95% CI -1.48 to -0.62, P < 0.05 ). Network meta-analysis showed that the best probabilistic ranking of the effects of two different NIBS on the DOSS score is rTMS   P = 0.52 > tDCS   P = 0.48 , the best probabilistic ranking of the SSA score is rTMS   P = 0.72 > tDCS   P = 0.28 , and the best probabilistic ranking of the PAS score is rTMS   P = 0.68 > tDCS   P = 0.32 . Conclusion. Existing evidence showed that NIBS could improve swallowing dysfunction and reduce the occurrence of aspiration after stroke, and that rTMS is better than tDCS. Limited by the number of included studies, more large-sample, multicenter, double-blind, high-quality clinical randomized controlled trials are still needed in the future to further confirm the results of this research.

scholarly journals Ma-Huang-Fu-Zi-Xi-Xin Decoction for Allergic Rhinitis: A Systematic Review

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Juan Zhong ◽  
Dan Lai ◽  
Yun Zheng ◽  
Gang Li
Keyword(s):  
Allergic Rhinitis ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Small Sample ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Evidence Quality ◽  
Ma Huang ◽  
Xi Xin

Background. The treatment effects and safety of Ma-Huang-Fu-Zi-Xi-Xin decoction for patients with allergic rhinitis have yet to be clarified. Objectives. The aim of this study is to evaluate the effects and safety of Ma-Huang-Fu-Zi-Xi-Xin decoction in patients with allergic rhinitis. Methods. We searched PubMed, EMBASE (Excerpta Medical Database), Cochrane Library, Chinese Cochrane Centre’s Controlled Trials Register Platform, Wanfang Chinese Digital Periodical and Conference Database, China National Knowledge Infrastructure (CNKI) Database, and VIP Chinese Science and Technique Journals Database to collect randomized controlled trials of Ma-Huang-Fu-Zi-Xi-Xin decoction (MHFZXXD) for allergic rhinitis (AR) prior to May 8, 2017. RevMan 5.3 software was used to conduct a meta-analysis. GRADE methodology was applied to evaluate the evidence quality for each outcome. Results. Six randomized controlled trials (RCTs) involving 576 participants (10–78 years old) were included. A meta-analysis revealed that the overall effect of MHFZXXD for AR was not better than western medical treatment (RR: 0.41; 95% CI: 0.26–0.65; P=0.0001) for all included studies. However, the evidence quality of these western medical intervention studies was low or very low due to a high risk of bias, small sample sizes, and poor-quality design.

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