비부비동염의 한약 외용제에 대한 체계적 문헌고찰 및 메타분석
Systematic Review and Meta-Analysis of Nasal Topical Herbal Therapy for Rhinosinusitis
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초록
Objective: This study aimed to systematically review the efficacy of nasal topical herbal therapy for rhinosinusitis and evaluate its clinical utility by comparing it with conventional treatments, including Western medicine and herbal oral administration. Methods: A comprehensive search was conducted across eight databases from January 2005 to October 2024 without language restrictions, focusing on randomized controlled trials (RCTs). Participants included patients diagnosed with rhinosinusitis, regardless of demographic factors such as age, sex, or ethnic background. The risk of bias was assessed using the Cochrane Group's RoB tool, and meta-analyses were performed using Cochrane RevMan 8.9.0. Effect sizes were estimated using risk ratios (RR), mean differences (MD), or standardized mean differences (SMD) with 95% confidence intervals (CI). Heterogeneity across studies was assessed using chi-square tests and Higgins' I² statistics. Results: In the treatment of acute rhinosinusitis, nasal topical herbal therapy demonstrated effects comparable to Western topical treatment in improving mucociliary transport and alleviating subjective symptoms, with significantly higher treatment effectiveness. However, comparisons of topical herbal therapy combined with pharmacotherapy versus pharmacotherapy alone showed high heterogeneity. For chronic rhinosinusitis, topical herbal therapy showed significant improvement in subjective discomfort. Nevertheless, high heterogeneity was also observed in studies comparing topical herbal therapy with conventional treatments. Conclusion: This study synthesized evidence on the efficacy and safety of topical herbal therapy, identifying its potential as an alternative to nasal steroids or as an adjunct to conventional treatments. The findings provide a foundation for the clinical application of topical herbal therapy and the development of treatment guidelines. Further well-designed studies using more standardized and objective methodologies are required.
Abstract
Objective: This study aimed to systematically review the efficacy of nasal topical herbal therapy for rhinosinusitis and evaluate its clinical utility by comparing it with conventional treatments, including Western medicine and herbal oral administration. Methods: A comprehensive search was conducted across eight databases from January 2005 to October 2024 without language restrictions, focusing on randomized controlled trials (RCTs). Participants included patients diagnosed with rhinosinusitis, regardless of demographic factors such as age, sex, or ethnic background. The risk of bias was assessed using the Cochrane Group's RoB tool, and meta-analyses were performed using Cochrane RevMan 8.9.0. Effect sizes were estimated using risk ratios (RR), mean differences (MD), or standardized mean differences (SMD) with 95% confidence intervals (CI). Heterogeneity across studies was assessed using chi-square tests and Higgins' I² statistics. Results: In the treatment of acute rhinosinusitis, nasal topical herbal therapy demonstrated effects comparable to Western topical treatment in improving mucociliary transport and alleviating subjective symptoms, with significantly higher treatment effectiveness. However, comparisons of topical herbal therapy combined with pharmacotherapy versus pharmacotherapy alone showed high heterogeneity. For chronic rhinosinusitis, topical herbal therapy showed significant improvement in subjective discomfort. Nevertheless, high heterogeneity was also observed in studies comparing topical herbal therapy with conventional treatments. Conclusion: This study synthesized evidence on the efficacy and safety of topical herbal therapy, identifying its potential as an alternative to nasal steroids or as an adjunct to conventional treatments. The findings provide a foundation for the clinical application of topical herbal therapy and the development of treatment guidelines. Further well-designed studies using more standardized and objective methodologies are required.