等离子体低温射频消融术治疗常年性变应性鼻炎

Coblation plasma surgery system in the treatment of perennial allergic rhinitis

目的对比观察等离子体低温射频消融术与丙酸倍氯米松鼻喷雾剂在治疗常年性变应性鼻炎中的疗效和安全性。方法将符合纳入标准的102例患者按鼻甲是否肿胀分组,然后将组内患者随机分为手术组与药物组。手术组予等离子体低温射频消融术;药物组予丙酸倍氯米松鼻喷雾剂,2次/天,2喷/侧/次,观察期3个月。记录症状体征评分、患者自评变化及不良反应情况。结果两种治疗方法在观察结束时均对症状有明显的改善,其中鼻甲肿胀组患者治疗14天、28天、3个月时的疗效,手术组优于药物组;在非鼻甲肿胀组患者中,药物组7天与3个月时的评分低于手术组,但差异均无统计学意义。结论两种治疗方法应用于常年性变应性鼻炎均有较好的疗效,但对于鼻甲肿胀患者,等离子体低温射频消融术效果更好。

OBJECTIVE To compare the effect and safety of coblation plasma surgery and beclomethasone dipropionate nasal spray in the treatment of perennial allergic rhinitis. METHODS A stratified,randomized,controlled trial of surgery and medicament was performed in the treatment of perennial allergic rhinitis. A total number of 102 patients were involved in the trial,including 56 cases with swelling of inferior turbinate,28 cases in surgery group,28 cases in medicament group; and 46 cases without swelling of inferior turbinate, 23 cases in surgery group, 23 cases in medicament group. Coblation plasma surgery was performed in all surgery groups. Each patient was given 50×4×2 μg/d of beclomethasone dipropionate nasal spray in all medicament groups, Treatment time was 3 months. The symptom scores （SS） and visual analogue scale （VAS） were recorded. RESULTS Effect assessment showed that both methods had significant repressive effect on allergic symptoms, the effect of surgery group was better than that of medicament group at the 14th day, 28th day and 3th month in cases with swelling of inferior turbinate. Difference between the surgery group and medicament group in cases without swelling of inferior turbinate had no statistic significance. CONCLUSION Both coblation plasma surgery and beclomethasone dipropionate nasal spray are effective to treat perennial allergic rhinitis. But coblation plasma surgery is better than medicament in cases with swelling of inferior turbinate.