基层医院治疗变应性鼻炎规范化治疗方案的临床应用研究

Clinical observation on standardized diagnosis and therapeutic approach in patients with allergic rhinitis in grassroots hospital

目的探讨适合基层医院治疗变应性鼻炎(AR)的规范化治疗方案。方法选择AR患者120例,使用盐酸非索非那丁和布地奈德进行规范化治疗,比较治疗前后症状、体征记分的变化及治疗前后患者对变应性鼻炎相关知识的得分情况。结果 AR患者治疗前后症状、体征总记分差异有统计学意义。其中间歇组(8.23±1.24,2.11±1.18,P<0.001);显效27例,有效9例,无效3例,有效率92.31%(36/39);持续组(10.67±1.06,3.58±1.23,P<0.001);显效51例,有效23例,无效7例,有效率91.36%(74/81),120例患者治疗的总有效率为91.67%(110/120)。治疗后患者对变应性鼻炎一般知识、药物治疗和个人防护相关知识的得分情况较治疗前明显增高,差异均有统计学意义(P<0.001)。结论规范化方案治疗AR疗效显著,符合基层医院的特点,能显著提高AR患者的依从性,具有临床应用价值,值得在基层医院推广。今后在控制AR最轻持续炎症反应的药物治疗和患者的宣教方面应投入更多精力,从而能更好地控制AR的症状。

[ Objective ] To detect the effect and technique of a standardized diagnosis and therapeutic approach for allergic rhinitis （AR） in grass-roots hospital. [Methods] 120 patients with AR were selected to receive a standardized diagnosis and therapeutic approach which including using the Fexofenadine Hydroehloride Tablets alone and the combing using of the Fexofenadine Hydroehloride Tablets and Budesonide Nasal Spray, the scores of changing nasal symptom and physical examination were evaluated and compared, as the same time, the mean scores of knowledge with AR were compared after the treatment. [Results] The mean nasal symptom and physical examination scores were significantly higher than there of after the treatment （the scores of the intermittent group is 8.23±1.24, 2.11±1.18, P〈0.001; the scores of the persistent group is 10.67±1.06, 3.58±1.23, P〈0.001）; the overall effective rate was 91.67% （110/120）. The mean scores of knowledge with AR were significantly higher than there of after the treatment. [ Conclusion] The standardized diagnosis and thera- peutic approach is highly effective for treating patients with AR in grass-roots hospital, we should do more in controlling minimal persistent inflammation （MPI） of AR, and we should do active propaganda and education among the patients with AR. Only in this way, can we control the symptoms of AR better.