To Evaluate The Clinical Efficacy And Safety Of Biyuanshu Oral Solution Taken In Perioperative FESS On Patients With CRS: A System Review

BackgroundChronic rhinosinusitis which encompasses a group of disorders characterized by inflammation of the mucosa of nose and sinuses and lasts at least 12 weeks is one of the most common otolaryngologic diseases and a major cause of the upper and lower respiratory complaints and chronic cough. Chronic rhinosinusitis infects about 31 million people in the United States and the incidence is increasing every year. Because of the Symptoms including headache,nasal obstruction,purulent discharge, The chronic rhinosinusitis is similar to "biyuan" in Chinese medicine.Functional endoscopic sinus surgery (FESS) is a commonly used therapy for chronic rhinosinusitis and nasal polyps. The sequelas of FESS such as sinus mucosa swelling, ciliary motility disorder, increased discharge, infection and allergy affect the restoration of sinus mucosa. Therefore, proper use of drugs such as biyuanshu oral solution to promote mucosal restoration arouses wide concern. According to the resent reports in the literature, the Effect and Safety of Biyuanshu Oral Solution in the perioperative period of chronic rhinosinusitis is good but there was no systematic review providing high strength evidence to validate its efficacy and safety.Objective1.To assess the efficacy and safety of Biyuanshu oral solution in the perioperative period of chronic rhinosinusitis.2.To provide certain reference for the use and the research of the Biyuanshu oral solution.Methods1.We performed an electronic search and performed a manual searching for collecting data. We included randomized controlled trials which met the inclusion and exclusion criteria and evaluated the quality of those trials and performed the meta-analysis by RevMan 4.2.10。2. We analyzed the statistical results data, described the meaning and suggestion of the research situation objectively.Evaluate the clinical efficacy and safety of the Biyuanshu oral solution. Then provide certain reference for the future scientific research through analysis the shortage of the present research.Results1. Ten trials were included involving 2175 patients. However, only one of them is high quality; the others were of poor quality.2. Using Biyuanshu at before and after the FESS:tow studies show the total efficiency rate of the treatment group is higher the control group. One study shows the recovery rate of the treatment group is higher the control group. The others show no significant difference between treatment group and control group. Using Biyuanshu at after the FESS:one Meta analysis shows the total efficiency rate of the treatment group is higher the control group.1 Meta analysis and 2 studies shows the recovery rate of the treatment group is higher the control group.1 meta analysis shows the remove rate of the headache,nasal obstruction,hyposmia of the treatment group is higher the control group.All studies show the remove rate of purulent discharge of the treatment group is higher the control group and no significant difference between treatment group and control group in the remove rate of chronic cough.3. There are 3 studies mention the adverse reactions, 2 of them show no adverse reactions and the rest describe the adverse reactions relating the biyuanshu unclearly.ConclusionsBased on the data Collected inadequate evidence shows that the effect and safety of Biyuanshu oral solution in the perioperative period of Chronic rhinosinusitis are marked, due to the poor quantity, poor literature quality and the publish bias of the included trials. High quality RCTs based on the CONSORT is our focus in the future research to provide solid evidence for the clinic.