14元环大环内酯类抗生素对功能性鼻窦内窥镜术后鼻腔粘膜炎症转归的影响

发布时间：2018-05-13 03:12

本文选题：14元环大环内酯类抗生素 + 功能性鼻窦内窥镜术　；参考：《广州医学院》2011年硕士论文

【摘要】：目的了解14元环大环内酯类抗生素对慢性鼻窦炎鼻息肉患者术后鼻腔粘膜炎症转归中的影响,寻找鼻内镜术后有可能替代或减少皮质类固醇激素用量的辅助用药。方法选取慢性鼻窦炎鼻息肉患者共60例。术后将鼻窦炎鼻息肉患者随机分为2组:罗红霉素组(14元环大环内酯类抗生素)按常规一般处理加用口服罗红霉素,150mg,1次/日,持续3个月;对照组在一般处理的基础上口服乙酰螺旋霉素(16元环大环内酯类抗生素),200mg,3次/日,持续3个月。对两组患者分别通过症状、生活质量评分及术腔粘膜转归的表面特征判定进行疗效评估;并分别收集术中及术后3个月鼻粘膜标本,应用双抗体夹心ABC-ELISA法分别检测IL-4含量,对以上两组资料及数据进行统计学分析、讨论。结果治疗组治愈率为92.86%,对照组治愈率为72.41%,两者差异有统计学意义。治疗组术腔清洁时间平均为(2.1±0.24)周,对照组术腔清洁时间平均为(2.4±0.21)周。1-4周内每周两组术腔完全清洁病例所占百分比差异有显著性意义。二组术腔完全上皮化时间在12周以内比较无显著差异,但是罗红霉素组术腔完全上皮化时间与对照组在6周以内比较差异有统计学意义。治疗后症状严重程度视觉模拟量表,治疗组与对照组评分平均分别为(5.72±5.36)、(8.76±6.16),有统计学差异。治疗后SNOT-20鼻腔鼻窦结果测量20条表治疗组与对照组评分分别为(11.06+7.73)、(16.13+7.63),两组间五大条目得分(5.37+2.92)、(7.12+3.01),两组治疗前后比较,治疗后总分及五大条目评分皆有统计学差异。治疗后两组鼻粘膜组织中IL-4含量分别为(62.56±22.16ng/ml)、(89.01±27.43ng/ml),有显著性差异。结论口服罗红霉素抗炎作用显著,副作用小,可长期低剂量使用,可作为鼻内镜术后辅助用药。
[Abstract]:Purpose To investigate the effect of 14 yuan ring macrolide antibiotics on the outcome of nasal mucosal inflammation in patients with chronic sinusitis and nasal polyps, and to find out the adjuvant drugs which may replace or reduce the dosage of corticosteroids after nasal endoscopy. Method A total of 60 patients with chronic sinusitis and nasal polyps were selected. Patients with sinusitis and nasal polyps were randomly divided into two groups after operation: roxithromycin group (n = 14) was treated with roxithromycin 150 mg / d for 3 months. The control group was treated with acetylspiramycin on the basis of general treatment. The control group received oral administration of acylspiramycin 16-component macrolide antibiotics 200 mg / d for 3 months. The two groups of patients were evaluated by symptom, quality of life score and surface features of the outcome of the operation, and the nasal mucosa samples were collected during operation and 3 months after operation respectively. The content of IL-4 was detected by double antibody sandwich ABC-ELISA method. The above two groups of data and data were statistically analyzed and discussed. Result The cure rate was 92.86 in the treatment group and 72.41 in the control group. The average cleaning time was 2.1 卤0.24 weeks in the treatment group and 2.4 卤0.21 weeks in the control group. There was no significant difference in the time of complete epithelization between the two groups within 12 weeks, but the time of complete epithelization in the roxithromycin group was significantly different from that in the control group within 6 weeks. After treatment, the scores of 20 tables of nasal cavity and paranasal sinus measured by SNOT-20 in the treatment group and the control group were 11.06 7.73 and 16.13 7.63, respectively. The scores of the five items in the two groups were 5.37 2.92 and 7.123.01, respectively. There were significant differences between the two groups before and after treatment in the total score and the five major items. After treatment, the content of IL-4 in nasal mucosa of the two groups was 62.56 卤22.16 ng / ml and 89.01 卤27.43 ng / ml / ml, respectively. Conclusion The oral roxithromycin has obvious anti-inflammatory effect and low side effect. It can be used as a adjuvant after nasal endoscopy.
【学位授予单位】：广州医学院
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R765

【相似文献】