微量元素锌辅助治疗变应性鼻炎临床疗效观察

发布时间：2018-01-15 06:27

本文关键词：微量元素锌辅助治疗变应性鼻炎临床疗效观察　出处：《宁夏医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的观察微量元素锌辅助治疗变应性鼻炎的临床疗效,从而为变应性鼻炎的治疗和预防提供新的方案。方法收集2010年1～12月在宁夏医科大学总医院变态反应性疾病诊疗中心就诊的资料完整的变应性鼻炎且合并微量元素锌缺乏患者90例，随机分为三组，每组各为30例，实验组:给予丙酸氟替卡松鼻喷剂（葛兰素史克公司）喷鼻+锌咀嚼片（汤臣倍健股份有限公司）口服;对照组①:给予丙酸氟替卡松鼻喷剂喷鼻;对照组②:给予丙酸氟替卡松鼻喷剂喷鼻+盐酸氮卓斯汀片（贵州云峰药业)口服。三组疗程均为一月。于治疗前、后分次抽取各组研究对象静脉血3ml-5ml⑴采用电感耦合等离子体原子发射光谱（ICP-AES）法测定治疗前、后各组血清中微量元素Zn、Cu、Ni、Se含量，利用配对样本t检验比较各组治疗前后微量元素含量有无差别⑵采用欧蒙印迹法检测治疗前、后各组血清常见变应原特异性IgE种类及分级变化情况,利用卡方检验对各组结果进行比较。采用症状体征计分标准对各组治疗前后疗效进行评定，同时对各组治疗后不良反应进行评估。所有数据均应用软件SPSS16.0进行统计分析。结果1.实验组、对照组①及对照组②治疗后总有效率分别为93%、60%、96%。实验组与对照组②疗效显著，两者之间无统计学差异。实验组与对照组①疗效比较有显著性差异。在鼻塞、鼻痒、每日擤鼻次数、喷嚏及体征改善方面，实验组与对照组②效果基本等同，且明显优于对照组①，P＜0.05，表明微量元素锌结合鼻用糖皮质激素能明显改善AR的症状及体征，临床疗效显著。2.治疗后实验组、对照组①及对照组②在鼻出血、鼻腔干燥、胃肠道不适等不良反应方面无显著性差异（P＞0.05）,实验组、对照组①分别与对照组②比较在嗜睡、口干方面存在显著性差异（P＜0.05），表明微量元素锌辅助治疗AR安全性较高。3.治疗前、后三组常见变应原（如树组合2、艾蒿、尘螨组合、淡水鱼组合1）血清中特异性IgE分级及种类，，实验组与对照组②有明显统计学差异（P＜0.05），实验组与对照组①比较无统计学差异（P＞0.05）表明实验组与对照组②能明显降低血清特异性IgE种类及分级。4.治疗前三组血清中Zn、Cu、Ni、Se含量无统计学差异（P＞0.05），治疗后三组血清中Zn含量有不同程度升高，且以实验组升高最为显著，治疗后三组血清Cu含量有不同程度下降，具有统计学差异（P＜0.05）表明血清锌含量升高与AR疗效改善密切相关。结论1.本课题通过对比研究证实微量元素锌辅助治疗变应性鼻炎疗效明显，并且不良反应少，安全性较高，值得在临床推广。2.微量元素锌辅助治疗变应性鼻炎能明显减低血清特异性IgE分级及种类，且血锌含量升高与AR疗效改善密切相关。3.微量元素锌辅助治疗变应性鼻炎，疗效判定与患者年龄、民族、性别、分类无关，与是否合并哮喘关系不甚清楚，今后需进一步开展此方面的研究。
[Abstract]:Objective to observe the clinical efficacy of trace element zinc in the treatment of allergic rhinitis and to provide a new scheme for the treatment and prevention of allergic rhinitis. Methods 90 patients with allergic rhinitis and trace element zinc deficiency were collected from 2010 to December in the diagnosis and treatment center of allergic diseases in the General Hospital of Ningxia Medical University. Three groups were randomly divided into three groups, 30 cases in each group. The experimental group was given fluticasone propionate nasal spray (GlaxoSmithKline) orally; Control group 1: fluticasone propionate nasal spray; Control group 2: fluticasone propionate nasal spray was administered orally with azoxetine hydrochloride tablets (Guizhou Yunfeng Pharmaceutical Industry). The course of treatment in the three groups was January. The venous blood levels of 3ml-5ml1 were measured by ICP-AESS-ICP-AESmethod before and after treatment. The content of NiSe was compared by paired t-test before and after treatment. 2 before and after treatment, the content of trace elements was detected by OMBI. After the serum allergen specific IgE types and grading changes, chi-square test was used to compare the results of each group. The symptoms and signs of scoring criteria were used to evaluate the efficacy of each group before and after treatment. At the same time, the adverse reactions of each group were evaluated. All the data were analyzed by software SPSS16.0. Results 1. The total effective rate of experimental group, control group 1 and control group 2 after treatment was 930.60 and 96, respectively. The effect of experimental group and control group 2 was significant. 2. There was no statistical difference between the two groups. There was a significant difference between the experimental group and the control group. The effect of the experimental group and the control group 2 was basically the same as that of the control group in the aspects of nasal congestion, nasal itching, number of times of blowing nose daily, sneezing and improvement of physical signs. The results showed that the trace element zinc combined with nasal glucocorticoid could significantly improve the symptoms and signs of AR. Control group 1 and control group 2 had no significant difference in adverse reactions such as epistaxis, dry nasal cavity and gastrointestinal discomfort (P > 0.05). There was significant difference in dry mouth (P < 0.05), indicating that the safety of trace element zinc in the treatment of AR was higher. 3. Before treatment, common allergens (such as tree combination 2, Artemisia argyi, dust mite) were found in the latter three groups. There was significant difference between the experimental group and the control group (P < 0.05). There was no significant difference (P > 0.05) between the experimental group and the control group (P > 0.05). The results showed that the type and grading of serum specific IgE in the experimental group and the control group were significantly decreased. There was no statistical difference in the content of nitianse (P > 0.05). After treatment, the serum Zn content in the three groups increased to some extent, especially in the experimental group. After treatment, the serum Cu content in the three groups decreased to some extent, with statistical difference (P < 0.05). The results showed that the increase of serum zinc content was closely related to the improvement of AR curative effect. This subject through comparative study confirmed that trace element zinc adjuvant treatment of allergic rhinitis curative effect is obvious, and the adverse reaction is less, the safety is higher. 2. It is worth popularizing in clinic. The trace element zinc adjuvant treatment of allergic rhinitis can obviously reduce the serum specific IgE grade and type. The increase of blood zinc content is closely related to the improvement of AR curative effect .3.Trace element zinc adjuvant therapy for allergic rhinitis, the curative effect is not related to the age, nationality, sex and classification of the patients. The relationship between asthma and asthma is unclear, and further research is needed in the future.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R765.21

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