Objective To evaluate the efficacy and safety of traditional Chinese medicine (TCM) in treating Chronic Rhinosinusitis (CRS) after Functional Endoscopic Sinus Surgery (FESS). Methods The following databases and periodicals such as PubMed (Jan. 1980 to Jan. 2009), MEDLINE (1980 to 2009), EBSCOhost (Jan. 1975 to Jan. 2009), CALIS (1984 to 2009), CNKI (1979 to 2007), VIP (1989 to 2009), CBM (1978 to 2009); Chinese Journal of Otorhinolaryngology Head and Neck Surgery (1990 to 2008), Journal of Clinical Otorhinolaryngology Head and Neck Surgery (1988 to 2008), Otorhinolaryngology Head and Neck Surgery (1990 to 2008), and Chinese Journal of Otorhinolaryngology of Integrated Traditional and Western Medicine (1996 to 2008) were searched by computer and handwork for randomized controlled trials (RCTs) about TCM to treat CRS after ESS. The trial screening, quality assessment, and the data extraction of the included trials were conducted before performing statistical analyses by using RevMan 4.2.10 software. Results A total of 32 RCTs in three sub-groups in Chinese literatures were identified with meta-analyses in comparisons of the cure rate (OR=1.99, 95%CI 1.78 to 2.23), total effective rate (OR=2.66, 95%CI 2.20 to 3.22), degree I postoperative improvement rate (OR=2.22, 95%CI 1.60 to 3.06), total postoperative improvement rate (OR=8.77, 95%CI 1.09 to 70.64), postoperative clean time (OR=2.54, 95%CI 1.70 to 3.79), postoperative epithelization time (OR= –29.46, 95%CI –37.73 to –21.18), and mucociliary transport rate (OR=1.14, 95%CI 0.22 to 2.06). A total of 4 RCTs were meta-analyzed to evaluate the safety in comparisons of gastrointestinal reaction (OR=0.25, 95%CI 0.00 to 33.78) and local reaction (OR=0.03, 95%CI 0.01 to 0.12). Conclusion The current evidence shows TCM in treating CRS after ESS tends to improve the clinical efficacy and reduce the cure time without obvious adverse reaction. Due to the low methodological quality of included trials, more RCTs with high quality and large scale are required.
Objective To investigate the potential causal relationship between chronic rhinosinusitis (CRS) and chronic obstructive pulmonary disease (COPD) using a two-sample two-way Mendelian randomization (MR) approach. Methods In the forward study, single nucleotide polymorphisms (SNPs) closely associated with CRS were selected as instrumental variables from publicly available genome-wide association studies datasets, with COPD as the outcome variable; conversely, in the reverse study, SNPs closely associated with COPD were selected as instrumental variables, with CRS as the outcome variable. MR analysis was conducted using three regression models: inverse variance weighted (IVW), MR-Egger regression analysis, and weighted median (WME) to assess the causal relationship between CRS and COPD. Cochran’s Q statistic, MR-Egger intercept, MR-PRESSO, and “leave-one-out” methods were employed to test for heterogeneity and horizontal pleiotropy, thereby evaluating the stability and reliability of the MR results. Results A total of 14 SNPs closely associated with CRS were included in the forward study; the IVW-fixed effects analysis indicated that CRS may increase the risk of developing COPD [odds ratio=1.003, 95% confidence interval (1.002, 1.004), P<0.001], which was confirmed by the WME method, while the MR-Egger regression method did not show a causal link between CRS and COPD. Heterogeneity test (IVW result: Cochran’s Q=7.910, P=0.849; MR-Egger regression result: Cochran’s Q=7.450, P=0.827), MR-Egger intercept method (P=0.510), MR-PRESSO test (P=0.917), and “leave-one-out” method showed that the MR analysis results were reliable. In the reverse study, a total of 12 SNPs related to COPD were included as instrumental variables; MR analysis did not support the notion that COPD would increase the risk of CRS (P>0.05). Heterogeneity test (IVW result: Cochran’s Q=5.947, P=0.877; MR-Egger regression result: Cochran’s Q=5.937, P=0.821), MR-Egger intercept method (P=0.921), MR-PRESSO test (P=0.875), and “leave-one-out” analysis method showed that the MR analysis results were reliable. Conclusions There is a potential causal association between CRS and COPD, and CRS may increase the risk of developing COPD. But there is no evidence to suggest that COPD increases the risk of CRS.