Abstract
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.
Highlights
Allergic rhinitis (AR) is one of the most common diseases in children [1]
Weended excluded article four written in Czech systematic review and meta-analysis
Compared with the control group, the hypertonic saline nasal irritation (HSNI) group had statistically significant better nasal symptom scores (Figure 2A, mean difference (MD), 1.82 points; 95% confidence interval (CI), 0.35–3.30; I2 = 64%; p = 0.02)
Summary
Allergic rhinitis (AR) is one of the most common diseases in children [1]. It affects 10–30% of children and adults in the United States and in other industrialized countries [2,3]. A runny, itchy nose, and sneezing are the cardinal symptoms of AR, and disturbances of sleep and daily functions are common in patients with AR [4,5,6]. Co-existence with other allergic diseases, such as atopic dermatitis and asthma, is common. Common AR complications include impaired quality of sleep, daytime fatigue, otitis media, and sinusitis [6,8].
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