锌补充剂对嗅觉障碍的影响：一项系统评价与荟萃分析

文献信息

中文摘要

目的： 本系统评价旨在评估锌补充剂治疗成人嗅觉障碍（包括定量和定性症状）的疗效。
方法： 我们全面检索了Cochrane对照试验中心注册库、PubMed、Embase及其他相关数据库，纳入评估锌补充剂治疗嗅觉障碍的随机对照试验（RCT）和观察性研究。纳入截至2025年4月发表的研究。采用经验证的嗅觉测试或主观问卷评估嗅觉功能的改善。评估了定性症状（嗅觉倒错、幻嗅）、不良反应、患者报告结局以及通过问卷测量的生活质量。
结果： 本评价共纳入6项研究，包括3项RCT和3项观察性研究。样本量在25至606名参与者之间，随访时间为1至15个月。荟萃分析显示，锌治疗组与对照组在嗅觉功能改善方面无显著差异（OR=1.78；95%CI 0.63-5.03；p=0.28）。此外，对主观改善感知的分析也未显示出统计学显著效应（OR=0.69；95%CI 0.25-1.93；p=0.48）。然而，一项个体研究报告了特定亚组的改善，例如创伤后嗅觉丧失者。不良事件通常较轻，主要为胃肠道反应。
结论： 当前证据不支持锌补充剂对嗅觉障碍具有明确获益。需要进一步的高质量RCT来确定其潜在作用，特别是在目标亚组中。

英文摘要

OBJECTIVES: This systematic review aimed to evaluate the efficacy of zinc supplementation for treating olfactory disorders, including quantitative and qualitative symptoms, in adults.
METHODS: We conducted a comprehensive search of the Cochrane Central Register of Controlled Trials, Pubmed, Embase, and other relevant databases for Randomized Controlled Trials (RCTs) and observational studies evaluating zinc supplementation for olfactory dysfunction. Studies published up to April 2025 were included. Improvement in olfactory function was assessed with validated olfactory tests or subjective questionnaires. Qualitative symptoms (parosmia, phantosmia), adverse effects, patient-reported outcomes, and quality of life measured by questionnaires were evaluated.
RESULTS: A total of 6 studies, including 3 RCTs and 3 observational studies, were included in the review. Sample sizes varied between 25 and 606 participants, with follow-up durations ranging from 1 to 15 months. The meta-analysis showed no significant difference in olfactory function improvement between the zinc-treated group and the control group (OR = 1.78; 95% CI 0.63-5.03; p = 0.28). In addition, the analysis of subjective perception of improvement, also did not demonstrate a statistically significant effect (OR = 0.69; 95% CI 0.25-1.93; p = 0.48). However, an individual study reported improvement in specific subgroups, such as those with posttraumatic anosmia. Adverse events were generally mild and primarily gastrointestinal.
CONCLUSION: Current evidence does not support a clear benefit of zinc supplementation for olfactory disorders. Further high-quality RCTs are necessary to determine its potential role, particularly in targeted subgroups.
LEVEL OF EVIDENCE: Level 2a.