糠酸氟替卡松鼻用喷雾剂联合孟鲁司特治疗变应性鼻炎的临床研究

Clinical research of fluticasone furoate nasal spray combined with montelukast in treating allergic rhinitis

目的:探讨糠酸氟替卡松鼻用喷雾剂联合孟鲁司特治疗变应性鼻炎的疗效及对血清白细胞介素IL-4和IL-6水平的影响。方法:筛选应性鼻炎患者112例,按数字表发随机分为对照组(56例)和观察组(56例)。对照组予糠酸氟替卡松鼻喷雾剂喷鼻,第1～2周每侧鼻腔2喷,每日2次;第3～4周每侧鼻腔1喷,每日1次。观察组在对照组基础上予孟鲁司特钠片,每日1次,每次10 mg。2组连续治疗4周。比较2组临床症状评分、临床症状消失时间及临床疗效。检测2组血清IL-4、IL-6水平。结果:治疗后,观察组患者的临床症状(喷嚏、鼻痒、鼻塞、流清涕)评分显著低于对照组(P<0.01)。观察组患者临床症状消失时间明显低于对照组(P<0.01)。观察组患者总有效率为94.64%,显著高于对照组(80.36%)(χ~2=4.000, P=0.046)。与对照组比较,观察组治疗后血清IL-4和IL-6水平下降更明显(P<0.01)。结论:糠酸氟替卡松鼻用喷雾剂联合孟普司特可进一步改善变应性鼻炎患者的临床症状,提高临床疗效,下调IL-4和IL-6水平可能是其疗效途径之一。

Objective To investigate the efficacy of fluticasone furoate nasal spray combined with montelukast in treating allergic rhinitis and its influence on serum levels of interleukin IL-4 and IL-6.Methods A total of 112 cases with allergic rhinitis were selected and randomly divided into control group（56 cases） and observation group（56 cases）.Cases of control group were given with fluticasone furoate nasal spray（2 sprays the first and second week for each side of the nasal cavity and sooner or later,1 spray at the third and fourth week for each side of the nasal cavity,qd）. Based on control group,cases of observation group were given with montelukast（10 mg,qd）.Both groups were treated for four weeks.Scores of symptoms,symptom disappearance time,and the efficacy were compared in both groups.Serum levels of IL-4 and IL-6 were detected in two groups.Results After treatment,scores of symptoms（sneezing,itchy nose,stuffy nose,and runny nose） of observation group were evidently lower than those of control group（ P〈0.01）.Symptom disappearance time of observation group was obviously shorter than that of control group（ P〈0.01）. Total effective rate for observation group was 94.64% superior to control group 80.36%（ χ2=4.000,P=0.046）.After treatment,serum levels of IL-4 and IL-6 of observation group were remarkably lower than control group（ P〈0.01）.Conclusion Fluticasone furoate nasal spray combined with montelukast in treating allergic rhinitis can improve symptoms and increase the efficacy,and down-regulation of serum levels of IL-4 and IL-6 may be one of effective ways.