| Objective1. To search and evaluate the quality of the treatment of allergic rhinitis by the method of reinforcing qi and warming Yang, and to provide more in-depth methodological guidance for clinical research.2. To systematically evaluate or to make meta-analysis on the outcome and safety of the treatment of allergic rhinitis by the method of reinforcing qi and warming Yang, so that it can provide evidence based on the efficacy and safety of the treatment of allergic rhinitis with the method of reinforcing qi and warming YangMethodsSearch PUBMED, EMbase, Cochrane library, Chinese biomedical literature database, CNKI database, VIP database and Wanfang database, and screen studies concerning RCT of treating methods and principles of reinforcing qi warming yang and promoting surface for Allergic Rhinitis according to the inclusion and exclusion criteria. Extract information and evaluate the quality of the included studies, meta-analysis the outcome data by using REVMAN5.3 software.Results1. Bias risk assessmentSingle study evaluation:In the 13 study,1 study is assessed more than 5 low risk of bias,2 of uncertainty. There are 3 studies that are 4 low risk, 1 high risk of bias, and 2 risk of uncertainty.1 study is assessed risk of 3 low bias,1 high risk of bias, and 3 risk of uncertainty, there are 7 studies with 2 low risk,4 risk of uncertainty, and 1 high risk of bias.1 study is the 1 low risk,4 risk of uncertainty, and 2 high risk of bias. In all all, 4 studies are considerated low risk of bias, while the rest of the studies are more likely to bias the risk of bias.Bias risk summary assessment:low bias risk account for 38%. high bias risk account for 14%. bias risk uncertainty account for 47%. Therefore, the overall risk of bias in the 13 studies is not determined.2. Meta-analysis of the outcome dataThe main outcome:12 studies use clinical efficiency as outcome measures, Divided into 3 subgroups,1010 cases, Using RR as an effect index in which Meta analysis among the subgroups is RR=1.26,95%CI[1.12,1.42], and the difference is statistically significant (P<0.001).The secondary outcome:Recurrence rate:4 studies use the recurrence rate as the outcome measure,, totally 267 cases. The fixed effect model is used to deal with the combination of statistics RR=0.35 and 95% CI[0.25,0.51], the difference is statistically significant (P<0.00001)Improvement of symptoms:3 studies use nasal symptoms and signs score as the outcome measure, a total of 166 cases. With the mean difference (MD) as indicators of effect. Using random effects model, the combined effects of MD=1.58,95%CI[1.31,1.85], the difference was statistically significant (P<0.0001).In the 6 study, the nasal obstruction score is used as the outcome measure, totally 422 cases. Using the fixed effect model, the combined effect of MD=0.34 and 95%CI[0.25,0.43], the difference is statistically significant (P<0.00001).The 5 study use a sneeze integral as outcome measure, a total of 340 cases, using fixed effect model, the combined effect of the amount of MD=0.33, 95%CI[0.24,0.43], the difference is statistically significant (P<0.00001)The 5 study use a runny nose integral as outcome measure, a total of 340 cases. Using the fixed effect model, the combined effect of the amount of MD=0.40,95%CI[0.30,0.50], the difference is statistically significant (P<0.00001).In the 5 study, the nasal itch score is used as the outcome measure, a total of 340 cases. Using the fixed effect model, the combined effect of MD=0.21, 95%CI[0.11,0.32], the difference is statistically significant (P<0.0001).The 5 study use nasal symptom integral as an outcome measure, a total of 294 cases. Using the fixed effect model, the combined effect of MD=0.23, 95%CI[0.15,0.31], the difference statistically significant (P<0.0001)3. Safety Report:Only 1 study carry out safety report. Patients with adverse reactions can continue to complete the test after treatment. No cases exit or change the test program due to adverse reactions or adverse events. The remaining 12 studies do not report any adverse reactions or adverse events, and have no security of description.ConclusionEffect of Yiqi Wenyang Gubiao method in treatment of allergic rhinitis is effective, it can effectively improve the nasal symptoms and signs, with low recurrence rate, and has no obvious adverse reaction. But because of methodological methods of quality uneven, there is heterogeneity among the studies, the risk of bias cannot be determined, reducing the credibility of the conclusion. It is still needed a large sample volume and high methodological quality of clinical trials to confirm the efficacy and safety of Yiqi wenyang Gubiao method in the treatment of allergic rhinitis. |
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