甲泼尼龙治疗分泌性中耳炎33例

Methylprednisolone in treatment of 33 patients with secretory otitis media

目的：评价甲泼尼龙治疗分泌性中耳炎的临床疗效和安全性。方法：65例(74耳)分泌性中耳炎的病人分为2组。试验组33例(37耳),其中男性17例,女性16例,年龄(36±s 5)a,应用甲泼尼龙16 mg,po,qd×3 d,3 d后改为8 mg,po,qd×3 d；3 d后改为4 mg,po,qd×3 d。对照组32例(37耳),男性15例,女性17例,年龄(35±4)a,应用地塞米松0.75 mg,po,tid×9 d。观察2组治疗后9 d和随访3 mo时的疗效和安全性。结果：治疗后9 d和随访3 mo时,2组气导平均听阈值和鼓室导抗图峰压值均下降,与治疗前比较差异非常显著(P＜0.01),其中试验组下降幅度大于对照组(P＜0.01)。试验组有效率分别为97%和91%,对照组的有效率分别为84%和72%,2组疗效比较差异显著,试验组优于对照组(P＜0.05)。试验组不良反应发生率9%,低于对照组的22%,但差异无显著意义(P＞0.05)。结论：甲泼尼龙治疗分泌性中耳炎有效、安全。

AIM： To evaluate the clinical effect and safety of methylprednisolone in the treatment of secretory otitis media （SOM）. METHODS： Sixty-five patients （74 ears） with SOM were divided into two groups. Thirty-three patients （M 17, F 16, age （36 ±s 5） a, 37 ears） in the trial group were treated with methylprednisolone 16 mg,po,qd× 3 d; 3 d later changed to 8 mg,po,qd ×3 d;still 3 d later for 4 mg,po,qd × 3 d. Thirty-two patients in the control group （M 15,F 17,age（35 ±4） a, 37 ears） were treated with dexamethasone 0.75 mg, po, tid ×9 d. The clinical efficacies and safeties were observed at 9 d after treatment and 3 mo of follow up for all the two groups. RESULTS： At 9 d after treatment and 3 mo of follow up, the hearing level and peak pressure value decreased with significant difference in comparing with those before the treatment （P 〈 0.01） in both groups. The decreased level in the trial group was higher than that in the control group（P 〈 0.01 ）. According to the hearing, tinnitus and sense of block, the pressure value of peak point and the total clinical effective rates were 97 % and 91% of the trial group at 9 d after treatment and 3 mo of follow up, those of the control group were 84 % and 72 %,respectively. The clinical efficacy of the trial group was superior to that of the control group （P 〈 0.05）.The adverse reaction rates were 9 % of the trial group and 22 % for the control group （P 〉 0.05）,without serve ones. CONCLUSION： Methylprednisolone is a safe and effective drug in treating SOM .