目的 系統(tǒng)評(píng)價(jià)大環(huán)內(nèi)酯類(lèi)藥物治療慢性鼻竇炎的療效及安全性。方法 計(jì)算機(jī)檢索自建庫(kù)至2018年3月25日Pubmed、Embase、Cochrane Library、中國(guó)學(xué)術(shù)期刊全文數(shù)據(jù)庫(kù)（CNKI）、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)（CBM）和萬(wàn)方數(shù)據(jù)庫(kù)等中英文數(shù)據(jù)庫(kù)，篩選符合納入標(biāo)準(zhǔn)的隨機(jī)對(duì)照試驗(yàn)（RCT）。提取資料，并采用RevMan 5.0和Stata 12.0軟件進(jìn)行Meta-分析。結(jié)果 共納入25項(xiàng)RCT，包括2 106例患者。結(jié)果顯示，兩組患者有效率[OR=5.33，95% CI（4.03，7.04），P=0.000]、顯效率[OR=2.65，95% CI（2.20，3.20），P=0.000]等指標(biāo)比較具有統(tǒng)計(jì)學(xué)意義。兩組患者Lund-Kennedy評(píng)分[SMD=-2.18，95% CI（-5.61，1.26），P=0.214]、不良反應(yīng)發(fā)生率[OR=0.81，95% CI（0.40，1.65），P=0.569]等比較無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 大環(huán)內(nèi)酯類(lèi)藥物治療慢性鼻竇炎具有較好的療效，能夠顯著提高慢性鼻竇炎患者生活質(zhì)量，提高纖毛清除功能，降低炎性細(xì)胞因子水平，減少?gòu)?fù)發(fā)，且具有較好的安全性。

Objective To systematically analyze the efficacy and safety of macrolides in the treatment of the chronic rhinosinusitis. Methods Randomized controlled trials of related articles from inception to March 25, 2018 were searched from Pubmed、Embase、Cochrane Library, CNKI, CBM and Wanfang data by computer. Meta-analysis were performed using RevMan 5.0 and Stata 12.0 software after data extraction. Results A total of 25 RCTs were included, involving 2106 patients. The results of Meta-analysis showed that the effective rate[OR=5.33, 95% CI(4.03, 7.04), P=0.000], marked effective rate[OR=2.65, 95% CI(2.20, 3.20), P=0.000] and other indicators were statistically significant between the two groups of patients. There were no significant differences in the Lund-Kennedy score[SMD=-2.18, 95% CI(-5.61, 1.26), P=0.214] and incidence of adverse reactions[OR=0.81, 95% CI(0.40, 1.65), P=0.569].Conclusion Macrolides have good efficacy in treating chronic rhinosinusitis, which can significantly improve the quality of life of patients with chronic rhinosinusitis and the function of ciliary clearance, reduce the level of inflammatory cytokines and recurrence, and have good security.

中國(guó)健康促進(jìn)基金會(huì)醫(yī)藥知識(shí)管理專(zhuān)項(xiàng)基金"300種常見(jiàn)疾病藥學(xué)服務(wù)標(biāo)準(zhǔn)與路徑"（JJYX-ZX-1800）