Relation between chronic rhinosinusitis and gastroesophageal reflux in adults: systematic review

Abstract Introduction: The relationship between gastroesophageal reflux disease (GERD) and chronic rhinosinusitis (CRS) is still a controversial issue in literature. Objective: A systematic review of the association between these two diseases in adult patients. Methods: Systematic review in PubMed and Cochrane Database with articles published between 1951 and 2015. We included all articles that specifically studied the relationship between CRS and GERD. Results: Of the 436 articles found, only 12 met the inclusion criteria. Eight cross-sectional articles suggest a relation between CRS and GERD, especially on CRS that is refractory to clinical or surgical treatment. However, the groups are small and methodologies are different. Four other longitudinal studies have assessed the effect of treatment with proton pump inhibitors (PPIs) on the improvement of symptoms of CRS, but the results were conflicting. Conclusions: There seems to be relative prevalence of reflux with intractable CRS. There is still a lack of controlled studies with a significant number of patients to confirm this hypothesis. Few studies specifically assess the impact of treatment of reflux on symptom improvement in patients with CRS.

研究背景：胃食管反流病（gastroesophageal reflux disease, GERD）与慢性鼻-鼻窦炎（chronic rhinosinusitis, CRS）之间的关联在现有学术文献中仍存在争议。
研究目的：针对成人患者中两种疾病的相关性开展系统综述。
研究方法：检索PubMed及考克兰数据库中1951年至2015年发表的相关文献，纳入所有专门探讨CRS与GERD关联的研究。
研究结果：共检索到436篇文献，仅12篇符合纳入标准。其中8项横断面研究提示CRS与GERD存在关联，尤其针对临床或手术治疗难治性CRS患者。但此类研究样本量较小且研究方法各异。另有4项纵向研究评估了质子泵抑制剂（proton pump inhibitors, PPIs）治疗对CRS症状改善的效果，但其结果存在矛盾。
研究结论：难治性CRS患者的反流患病率相对较高，但目前仍缺乏大样本对照研究以验证这一假说；同时，专门探讨反流治疗对CRS患者症状改善影响的研究仍较为匮乏。