本文關(guān)鍵詞： 變應(yīng)性鼻炎 兒童 鼻內(nèi)激素 白三烯受體拮抗劑 抗組胺藥　出處：《實(shí)用醫(yī)學(xué)雜志》2014年02期 　論文類型：期刊論文

【摘要】：目的:比較鼻內(nèi)糖皮質(zhì)激素、白三烯受體拮抗劑和第2代口服抗組胺藥對(duì)兒童變應(yīng)性鼻炎(AR)癥狀評(píng)分和生活質(zhì)量評(píng)分的改善作用,探討鼻炎的個(gè)體化藥物治療方案。方法:將186例年齡6~14歲的中、重度持續(xù)性AR患兒,隨機(jī)分入布地奈德(BUD)組、孟魯司特(MON)組和氯雷他定(LORA)組。BUD組使用布地奈德鼻噴劑256μg/d,MON組每晚口服孟魯司特5 mg,LORA組每日口服氯雷他定片5 mg或10 mg。進(jìn)行鼻炎癥狀評(píng)分和鼻結(jié)膜炎生命質(zhì)量問卷(RQLQ)評(píng)分,評(píng)分越低癥狀越輕。結(jié)果:治療4周,三組比較鼻炎癥狀總評(píng)分在BUD組最低(F=2.977,P0.05)。鼻塞癥狀評(píng)分BUD組改善最顯著(χ2=6.488,P0.01),而MON組鼻塞評(píng)分亦顯著低于LORA組(P0.01)。流涕和噴嚏評(píng)分在LORA組和BUD組改善明顯,三組比較差異有統(tǒng)計(jì)學(xué)意義(χ2=4.176和5.806,P0.01)。咽癢評(píng)分在MON組和BUD組顯著低于LORA組(P0.01)。同時(shí)BUD組RQLQ總分和RQLQ鼻部癥狀評(píng)分顯著低于其他兩組(P0.05)。MON組眼癢癥狀評(píng)分和RQLQ眼部癥狀評(píng)分,數(shù)值上均低于其他兩組,但差異均未達(dá)顯著界值(P0.05)。結(jié)論:布地奈德對(duì)鼻炎的總體癥狀和鼻塞改善更具優(yōu)勢(shì);氯雷他定對(duì)噴嚏和流涕效果突出,但對(duì)鼻塞效果差;而孟魯司特對(duì)咽癢和鼻塞的效果優(yōu)于氯雷他定,對(duì)眼部癥狀亦有一定的優(yōu)勢(shì)。
[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 鹵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.
【作者單位】： 廣州醫(yī)科大學(xué)附屬第一醫(yī)院
【基金】：廣東省科技廳資助項(xiàng)目(編號(hào):2010B031600149)
【分類號(hào)】：R765.21

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