鼻用激素与孟鲁司特钠治疗中重度持续性变应性鼻炎的随机对照研究

Randomized controlled clinical trial comparing Budesonide plus Montelukast and Loratadine plus Montelukast for treatment of moderate and severe persistent allergic rhinitis

目的比较布地奈德联合孟鲁司特钠与氯雷他定联合孟鲁司特钠治疗中重度持续性变应性鼻炎的疗效。方法 40例患者随机分配至2个治疗组。分别于治疗前、治疗2周后、治疗4周后对鼻部症状进行评估。并于治疗前和治疗4周后对生活质量进行评估。结果治疗2周后2组鼻部症状均较治疗前明显下降。治疗4周与治疗2周相比,布地奈德联合孟鲁司特钠组各症状评分差异有统计学意义;氯雷他定联合孟鲁司特钠组除鼻阻外其余症状评分差异有统计学意义。治疗4周后,布地奈德联合孟鲁司特钠组鼻阻评分低于氯雷他定联合孟鲁司特钠组。2组生活质量均较治疗前明显提高,差异无统计学意义。结论 2种联合治疗均可取得良好效果。4周疗程较2周疗程效果更好。对于鼻阻症状明显的患者,选择布地奈德联合孟鲁司特钠治疗能够取得更好的疗效。

OBJECTIVE To evaluate the effect of Budesonide plus Montelukast and Loratadine plus Montelukast for treatment of moderate and severe persistent allergic rhinitis.METHODS Forty patients symptoms were evaluated at baseline,2 weeks and 4 weeks after treatment.Quality of life was evaluated before and 4 weeks after treatment.RESULTS After 2 weeks treatment,the symptomatic score decreased compared with baseline in both groups.After 4 weeks,all nasal symptom scores decreased compared with 2 weeks in the Budesonide plus Montelukast group.While in the Loratadine plus Montelukast group,the decrease of nasal blockage score had no statistical difference,which made the nasal blockage score of Loratadine plus Montelukast group higher than another group after 4 weeks.The quality of life at 4 weeks improvd compared with baseline in two groups and there was no difference of the change of the score in two groups.CONCLUSION The two kinds of combined therapies are both effective for the treatment of allergic rhinitis.Four weeks treatment period is better than 2 weeks.For the patients who have severe nasal blockage,Budesonide plus Montelukast may offer substantial advantage.