比较3种不同类药物对儿童持续性变应性鼻炎症状评分的改善作用

发布时间：2018-02-21 09:12

本文关键词： 变应性鼻炎儿童鼻内激素白三烯受体拮抗剂抗组胺药　出处：《实用医学杂志》2014年02期 　论文类型：期刊论文

【摘要】：目的:比较鼻内糖皮质激素、白三烯受体拮抗剂和第2代口服抗组胺药对儿童变应性鼻炎(AR)症状评分和生活质量评分的改善作用,探讨鼻炎的个体化药物治疗方案。方法:将186例年龄6~14岁的中、重度持续性AR患儿,随机分入布地奈德(BUD)组、孟鲁司特(MON)组和氯雷他定(LORA)组。BUD组使用布地奈德鼻喷剂256μg/d,MON组每晚口服孟鲁司特5 mg,LORA组每日口服氯雷他定片5 mg或10 mg。进行鼻炎症状评分和鼻结膜炎生命质量问卷(RQLQ)评分,评分越低症状越轻。结果:治疗4周,三组比较鼻炎症状总评分在BUD组最低(F=2.977,P0.05)。鼻塞症状评分BUD组改善最显著(χ2=6.488,P0.01),而MON组鼻塞评分亦显著低于LORA组(P0.01)。流涕和喷嚏评分在LORA组和BUD组改善明显,三组比较差异有统计学意义(χ2=4.176和5.806,P0.01)。咽痒评分在MON组和BUD组显著低于LORA组(P0.01)。同时BUD组RQLQ总分和RQLQ鼻部症状评分显著低于其他两组(P0.05)。MON组眼痒症状评分和RQLQ眼部症状评分,数值上均低于其他两组,但差异均未达显著界值(P0.05)。结论:布地奈德对鼻炎的总体症状和鼻塞改善更具优势;氯雷他定对喷嚏和流涕效果突出,但对鼻塞效果差;而孟鲁司特对咽痒和鼻塞的效果优于氯雷他定,对眼部症状亦有一定的优势。
[Abstract]:Objective: to compare the effects of nasal glucocorticoid, leukotriene receptor antagonist and second generation oral antihistamine on symptom score and quality of life score in children with allergic rhinitis. Methods: 186 children with moderate or severe persistent AR aged 6 to 14 years were randomly divided into budesonide bud group. The BUD group was given budesonide nasal spray 256 渭 g / d Mon group orally every night, the montelukast 5 mg / L ORA group was given clloratadine tablets 5 mg or 10 mg daily. The rhinitis symptom score and RQLQ score were evaluated. The lower the score, the lighter the symptom. Results: after 4 weeks of treatment, The total score of rhinitis symptoms in the three groups was the lowest in the BUD group (P 0.05). The nasal congestion symptom score in the BUD group was the most significant (蠂 2 + 6.488 卤P 0.01), and the nasal congestion score in the MON group was significantly lower than that in the LORA group (P 0.01). The scores of runny and sneezing were significantly improved in the LORA group and the BUD group. There were significant differences among the three groups (蠂 24.176 and 5.806 P 0.01). The pharyngeal itch score in MON group and BUD group was significantly lower than that in LORA group (P 0.01). At the same time, the total RQLQ score and RQLQ nasal symptom score in BUD group were significantly lower than those in the other two groups (P0.05 + .MON group). The values were lower than those of the other two groups, but the difference was not significant (P 0.05). Conclusion: budesonide has more advantages in improving the overall symptoms and nasal congestion of rhinitis, loratadine is more effective in sneezing and runny, but not in nasal obstruction. Montelukast is superior to loratadine in the treatment of pharynx itching and nasal obstruction, and has an advantage in ocular symptoms.
【作者单位】：广州医科大学附属第一医院
【基金】：广东省科技厅资助项目(编号:2010B031600149)
【分类号】：R765.21

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