生理性海水喷雾洗鼻液治疗轻度间歇性变应性鼻炎患儿的疗效

Efficacy of Physiological Seawater Nasal Irrigation in Treatment of Mild Intermittent Allergic Rhinitis in Children

目的观察生理性海水喷雾洗鼻液对儿童轻度间歇性变应性鼻炎(AR)的临床疗效及安全性。方法设计调查问卷,将上海4家医院哮喘及呼吸门诊符合轻度间歇性AR诊断标准的5～12岁患儿纳入研究,随机分为4个研究组,根据治疗方案设计分为生理性海水喷雾洗鼻液组(试验组)、氯雷他定组、联合治疗(生理性海水喷雾洗鼻液+氯雷他定)组及空白对照组,根据AR相关症状及体征评分标准对纳入研究的患儿随访4周,观察其临床疗效。结果共255例患儿完成本项研究,4组患儿入组前AR症状及体征评分差异均无统计学意义(Pa>0.05)。在改善AR症状评分方面,试验组、氯雷他定组分别于第2周、第3周起AR症状评分有明显改善(Pa<0.05),且试验组优于氯雷他定组。联合治疗组药后1周,AR症状评分与其他组比较差异均有统计学意义。在改善AR体征方面,治疗第4周,试验组、氯雷他定组与空白对照组比较差异有统计学意义(P<0.05),且试验组优于氯雷他定组。联合治疗组与其他组比较,在治疗第2周体征评分即有改善。本试验未出现试验药物导致的不良反应。结论生理性海水喷雾洗鼻液辅助治疗轻度间歇性AR可以有效地改善患儿鼻部症状及体征,与抗组胺药物联合使用效果更明显。

Objective To evaluate the clinical effect and safety of physiological seawater nasal irrigation in treating mild intermittent allergic rhinitis（AR）in children. Methods The patients,aged 5-12 years,who were diagnosed as mild intermittent AR in 4 hospitals in Shanghai were randomly divided into 4 groups：nasal irrigation group,loratadine group,combined treatment group and control group.The clinical efficacy of treatment was assessed based on total nasal symptom scores,sign scores and clinical findings in the 4 weeks treatment duration. Results The study population comprised 255 unrelated individuals,whose symptom and sign scores at baseline didn′t be different significantly（Pa〈0.05）.As for the improvement of symptom scores,the nasal irrigation group took effect at the second week,and the loratadine group did at the third week,in both groups the symptom scores greatly improved（Pa〈0.05）,however,the nasal irrigation group was better.The combined treatment group was superior than the other 2 groups,while a statistically significant difference was found since the first week.As for the improvement of the sign scores,in the nasal irrigation group,the loratadine group and the control group showed statistical difference（P〈0.05）,the nasal irrigation group was better than loratadine group at the fourth week.The combined treatment group showed improvement since the second week compared with the other groups.No adverse reaction from the drugs used in the experiment was observed. Conclusions Physiological seawater nasal irrigation is well tolerated and provides clinical benefits for the patient with AR,and the efficacy will be better if it is combined with antihistamine.