异丁司特治疗类固醇抵抗性变应性鼻炎的临床研究

Clinical research of Ibudilast on treating the steroid resistant allergic rhinitis

目的:采用随机、对照方法,比较组胺H1受体拮抗剂氯雷他定和白三烯受体拮抗剂异丁司特治疗类固醇抵抗性变应性鼻炎的疗效和安全性。方法:异丁司特组35例,氯雷他定组34例,采用记分方法比较2种药物对临床症状和体征的缓解。结果:异丁司特对临床症状总积分和体征总积分的改善程度显著优于氯雷他定(P<0.05);单因素方差分析:异丁司特组治疗后3、7、14 d的症状和体征的记分显著低于治疗前(P<0.01),且无明显不良反应。结论:异丁司特能有效缓解类固醇抵抗性变应性鼻炎的临床症状和体征,有可靠的疗效和安全性,对类固醇抵抗性变应性鼻炎患者不能采取加大类固醇剂量或延长疗程的方法,可采用白三稀受体拮抗剂——异丁司特治疗。

Objective：To compare the efficacy and safety of histamine H1 receptor antagonist loratadine with Leukotriene receptor antagonist Ibudilast in steroid resistant allergic rhinitis in a randomized controlled clinical trial. Method： Thirty five cases were treated by Ibudilast,and 34 cases by loratadine. Score system was used to compare the therapeutic effect of these two drugs on clinical symptoms and signs . Result： Ibudilast shows a better curative effect than loratadine in the improvement of the total scores on clinical symptom and signs（P〈0.05）. Scores of symptoms and signs in Ibudilast group after 3,7,14 days decreased significantly by means of square analysis of single factor （P〈0.01） . No complication was observed. Conclusion： Ibudilast can effectively alleviate the clinical symptoms and signs of steroid resistant allergic rhinitis with confirmed efficacy and safety, thus is recommended in steroid resistant allergic rhinitis. Increased doses or prolonged treatment of steroid is inappropriate.