鼻用激素联合氯雷他定或孟鲁司特钠治疗变应性鼻炎的疗效分析

发布时间：2019-01-29 05:03

【摘要】：目的:观察鼻用激素联合二代抗组胺药或白三烯受体拮抗剂对中-重度变应性鼻炎患者的临床疗效,探讨变应性鼻炎患者个性化治疗的优选方案。方法:将57例持续性中-重度变应性鼻炎患者随机分为3组,分别用糠酸莫米松鼻喷剂(MOM组)、糠酸莫米松鼻喷剂联合氯雷他定(MOM+L组)、糠酸莫米松鼻喷剂联合孟鲁司特钠(MOM+M组)连续治疗4周,采用"症状分级评分法"对治疗前和治疗后1、2、4周时鼻塞、鼻痒、喷嚏和流涕4项临床症状进行评分,并进行统计学分析。结果:治疗后各组患者鼻部症状总分均呈持续性下降趋势,且不同时间点之间均差异有统计学意义(P0.05)。对于鼻塞症状,MOM+M组在治疗后2、4周时的症状评分显著低于MOM组和MOM+L组。对于喷嚏、鼻痒症状,在治疗后1、2和4周时MOM+L组评分均最低,且与MOM组相比均差异有统计学意义(P0.05),而MOM组和MOM+M组间均差异无统计学意义(P0.05)。对于流涕症状,治疗后各组流涕症状评分均呈下降趋势,而MOM+L组和MOM+M组评分下降的更为明显;其中,治疗后1、2周时MOM+L组的评分显著低于MOM组(P0.05),治疗后2、4周时MOM+M组的评分显著低于MOM组(P0.05),而MOM+L组和MOM+M组之间均差异无统计学意义(P0.05)。结论:鼻喷激素单用或联合二代抗组胺药、白三烯受体拮抗剂均能有效控制中-重度变应性鼻炎患者的鼻部症状,联合用药效果更佳。对于缓解鼻塞症状,鼻用激素联合白三烯受体拮抗剂更具优势;对于缓解鼻痒、喷嚏症状,鼻用激素联合二代抗组胺药效果更佳;对于流涕症状,鼻用激素联合二代抗组胺药或白三烯受体拮抗剂效果相当,相对而言联合二代抗组胺药起效较快,联合白三烯受体拮抗剂起效较慢。
[Abstract]:Objective: to observe the clinical effect of nasal hormone combined with second generation antihistamine or leukotriene receptor antagonist in patients with moderate to severe allergic rhinitis, and to explore the optimal scheme for individualized treatment of allergic rhinitis. Methods: Fifty-seven patients with persistent moderate to severe allergic rhinitis were randomly divided into three groups: MOM group, MOM group and (MOM L group. The patients were treated with momethasone furoate nasal spray combined with montelukast sodium (MOM M group for 4 weeks. The clinical symptoms of nasal obstruction, itching, sneezing and runny were evaluated by "symptom grading method" before and after treatment. Statistical analysis was carried out. Results: after treatment, the total scores of nasal symptoms of each group showed a continuous downward trend, and the differences between different time points were statistically significant (P0.05). The score of nasal congestion in, MOM M group was significantly lower than that in MOM group and MOM L group 2 weeks after treatment. For sneezing and nasal itch symptoms, the scores of MOM L group were the lowest at 2 and 4 weeks after treatment, and there was significant difference compared with MOM group (P0.05), but there was no significant difference between MOM group and MOM M group (P0.05). For the symptoms of snot, the scores of snot in each group showed a downward trend after treatment, but the scores of MOM L and MOM M decreased more obviously. One week after treatment, the score of MOM L group was significantly lower than that of MOM group (P0.05), the score of MOM M group was significantly lower than that of MOM group at 2 weeks after treatment (P0.05), but there was no significant difference between MOM L group and MOM M group (P0.05). Conclusion: the nasal symptoms of patients with moderate to severe allergic rhinitis can be effectively controlled by nasal spray alone or combined with second generation antihistamines and leukotriene receptor antagonists. For relieving nasal congestion symptoms nasal hormone combined with leukotriene receptor antagonist is more advantageous for relieving nasal itching sneezing symptoms nasal hormone combined with second-generation antihistamine. The effects of nasal hormone combined with second generation antihistamines or leukotrienes receptor antagonists were similar to those of second generation antihistamine drugs, but the effects of combination of second generation antihistamine drugs and leukotriene receptor antagonists were relatively fast.
【作者单位】：温州医科大学附属第一医院耳鼻咽喉科;
【基金】：浙江省自然科学基金一般项目(No:LY17H130002) 温州市科技局公益性科技计划项目(No:Y20150270)
【分类号】：R765.21

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