本文關(guān)鍵詞： 變應(yīng)性鼻炎 氮卓斯汀 氟替卡松 鼻通氣障礙　出處：《中國藥房》2017年23期 　論文類型：期刊論文

【摘要】：目的:觀察氮卓斯汀聯(lián)合氟替卡松治療變應(yīng)性鼻炎(AR)的有效性及安全性。方法:選擇2015年1月-2016年7月筆者所在3家醫(yī)院中的AR患者135例作為研究對象,按隨機數(shù)字表法分為氮卓斯汀組、氟替卡松組和聯(lián)合用藥組,各45例。在給予減充血劑鹽酸羥甲唑啉噴霧劑的基礎(chǔ)上,氮卓斯汀組患者給予鹽酸氮卓斯汀鼻噴劑,每個鼻孔1噴,早晚各1次;氟替卡松組患者給予丙酸氟替卡松鼻噴霧劑,每個鼻孔1噴,早晚各1次;聯(lián)合用藥組患者給予鹽酸氮卓斯汀鼻噴劑聯(lián)合丙酸氟替卡松鼻噴霧劑,用法用量同前。3組患者均持續(xù)用藥30 d。比較3組患者的鼻部癥狀總評分(TNSS)和眼部癥狀總評分(TOSS)下降指數(shù)、鼻腔最小橫截面積(NMCA)、鼻腔總阻力(TNR),以及不良反應(yīng)發(fā)生情況。結(jié)果:試驗過程中因不同原因脫落,剩余127例患者進(jìn)入全分析數(shù)據(jù)集、130例患者進(jìn)入安全數(shù)據(jù)集。治療后,聯(lián)合用藥組患者的TNSS下降指數(shù)明顯高于氮卓斯汀組和氟替卡松組,差異均有統(tǒng)計學(xué)意義(P0.05);氮卓斯汀組與氟替卡松組患者的TNSS下降指數(shù),以及3組患者的TOSS下降指數(shù)比較,差異均無統(tǒng)計學(xué)意義(P0.05)。治療前,3組患者均有不同程度的鼻通氣障礙,但TNR和NMCA比較差異均無統(tǒng)計學(xué)意義(P0.05);治療后,3組患者的NMCA以及在75、150 Pa下的TNR均明顯小于治療前,且聯(lián)合用藥組的TNR明顯小于氮卓斯汀組和氟替卡松組,差異均有統(tǒng)計學(xué)意義(P0.05);但3組患者間NMCA比較,差異無統(tǒng)計學(xué)意義(P0.05)。3組患者總不良反應(yīng)發(fā)生率比較,差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:氮卓斯汀和氟替卡松均可有效緩解AR患者的鼻部癥狀,改善鼻通氣障礙;聯(lián)合用藥的療效優(yōu)于單一用藥方案,而且并未增加不良反應(yīng)的發(fā)生概率。
[Abstract]:Objective: to observe the effect of azostostine combined with fluticasone in the treatment of allergic rhinitis. Methods: from January 2015 to July 2016, 135 AR patients in 3 hospitals were selected as the study objects. According to the random digital table method, the patients were divided into three groups: azostostine group, fluticasone group and combined treatment group, each with 45 cases. The patients in the azostostine group were given azostostine hydrochloride nasal spray, 1 spray in each nostril, 1 time in the morning and evening. Patients in fluticasone group were given fluticasone propionate nasal spray, 1 spray per nostril, 1 time in the morning and evening. The patients in the combined treatment group were given azostostine hydrochloride nasal spray combined with fluticasone propionate nasal spray. The total nasal symptom score (TNSS) and the total ocular symptom score (TOSS) of the three groups were compared with those of the former group (30 days), and the decrease index of the total nasal symptom score (TNSS) and the total ocular symptom score (TOSS) were compared. The minimal cross sectional area of nasal cavity (NMCAA), total nasal resistance (TNRN), and adverse reactions occurred. Results: in the course of the trial, the remaining 127 patients were included in the total analysis data set due to different reasons. After treatment, the decrease index of TNSS in the combined treatment group was significantly higher than that in the azostostine group and fluticasone group, and the difference was statistically significant (P 0.05). Compared with fluticasone group and azostetin group, the decrease index of TNSS and TOSS of the three groups were not significantly different before treatment (P0. 05%, P 0. 05%, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P < 0. 05). The three groups had different degree of nasal ventilation disorder, but the difference of TNR and NMCA was not statistically significant (P 0.05). After treatment, the NMCA and TNR at 75,150 Pa in the three groups were significantly lower than those before treatment, and the TNR in the combined treatment group was significantly lower than that in the azoxetine group and fluticasone group. The difference was statistically significant (P 0.05). However, there was no significant difference in NMCA among the three groups. Conclusion: azosteine and fluticasone can effectively relieve nasal symptoms and improve nasal ventilation disorders in AR patients. The efficacy of combined therapy was better than that of single regimen, and the probability of adverse reactions was not increased.
【作者單位】： 河北醫(yī)科大學(xué)第二醫(yī)院耳鼻咽喉二科;石家莊市第一醫(yī)院耳鼻喉科;石家莊市鹿泉人民醫(yī)院兒科;
【分類號】：R765.21
【正文快照】： 變應(yīng)性鼻炎(Allergic rhinitis,AR)是一種由免疫球蛋白E(Immunoglobulin E,Ig E)介導(dǎo)的炎癥性疾病,以鼻塞、流涕、噴嚏、鼻癢等為主要癥狀[1]。臨床對AR的治療以糖皮質(zhì)激素和抗組胺藥物為主,其中抗組胺藥物被推薦為治療輕度AR的首選藥物;而對于中、重度AR,臨床常以糖皮質(zhì)激素

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