治疗儿童变应性鼻炎对支气管哮喘控制的影响

Effects of Treatment of Allergic Rhinitis on the Control of Bronchial Asthma

目的观察治疗儿童变应性鼻炎（allergic rhinitis，AR）对支气管哮喘（bronchial asthma，BA）控制的影响。方法2009年1月至2010年5月将65例在本院耳鼻咽喉科确诊为支气管哮喘伴变应性鼻炎患儿，将其随机分为观察组（n=35）及对照组（n=30）。两组患儿年龄、性别、治疗前支气管哮喘严重程度分级、肺功能[最大呼气流量（peak expiratory flow，PEF）预计值]等比较，差异无显著意义（P〉0．05）（本研究遵循的程序符合本院人体试验委员会制定的伦理学标准，得到该委员会批准，分组征得受试对象监护人的知情同意，并与其签署临床研究知情同意书）。两组均按照支气管哮喘严重程度，采取常规吸入丙酸氟替卡松气雾剂[（100～500）μg／d]，2～4次／d治疗，观察组同时联合布地奈德鼻喷剂治疗，第1个月为两侧鼻孔各一喷（64μg／喷），2次／d；第2个月改为1次／d；第3个月隔日1次，连续治疗3个月。治疗期间每个月门诊随访2次，共随访6个月，观察两组临床疗效及肺功能改善情况。结果观察组经联合治疗的总有效率为94．2％（33／35），对照组为73．3％（22／30），两组疗效比较，差异有显著意义（P〈0．05）。观察组和对照组治疗后肺功能改善情况（最大呼气流量预计值）比较[（85．73±5．42）％vs．（81．95±4．31）％]，差异有显著意义（P〈0．05）。结论对于支气管哮喘伴变应性鼻炎患儿，积极治疗变应性鼻炎对控制其支气管哮喘有积极作用。

Objective To observe the effect of treatment of allergic rhinitis（AR） on the control of bronchial asthma（BA）. Methods From January 2009 to May 2010, 65 infantile bronchial asthma and allergic rhinitis were randomly divided into observation group （n = 35） and control group（n： 30）. There had no Significant difference of age, gender, degree of bronchial asthma severity before treatment, lung function [-peak expiratory flow （PEF）] between two groups （P〉0.05）. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Centre for Ya＇an People＇s Hospital of Sichuan Province. Informed consent was obtained from all participants. Both groups received regular use of inhaled with flutieasone propionate aerosol （100-500） μg/d according to degrees of bronchial asthma severity. Observation group simultaneously with budesonide nasal spray on both sides of the nose, each one gush （64μg/spray） for the first month, twice a day. In the second month, both sides of the nose, a spray once a day, and in the third month every other day on both sides of the nose. The treatment lasted for 3 months. After treatment for 6 months, clinical curative effects and pulmonary function changing of two groups were observed. Results Total effectiveness was 94.2%（33/35） for observation group and 73.3% （22/30） for control group with a significant difference （P〈0.05）. Lung function improvement （peak expiratory flow） after the treatment between observation group [-（85.73 ± 5.42）%]and control group E （81- 95 ± 4.31 ）% had a statistically significant difference （P〈0.05）. Conclusion Children with bronchial asthma and allergic rhinitis should receive active treatment to control bronchial asthma.