克拉霉素治疗慢性鼻-鼻窦炎疗效观察

Clinical observation of clarithromycin in the treatment of chronic sinusitis

目的观察长期低剂量克拉霉素治疗慢性鼻窦炎的疗效。方法将56例慢性鼻-鼻窦炎患者,随机分为两组,治疗组28例,对照组28例,分别口服克拉霉素、阿莫西林克拉维酸钾治疗12周和4周,根据患者症状、体征的改善情况进行疗效评估。结果治疗组患者症状评价为治愈19例(67.8%),有效7例(25%),无效2例(12%);对照组治愈15例(53.3%),有效4例(14.2%),无效9例(32.3%),两组患者整体症状评分、鼻塞、嗅觉障碍、流涕和头痛等观察指标治疗前比较差异无统计学意义,治疗后,整体症状评分治疗组较对照组明显改善(P<0.01),鼻塞、嗅觉障碍、流涕治疗有效(P<0.05)但头痛无明显改善。结论长期低剂量应用克拉霉素对慢性鼻窦炎患者有良好疗效,不良反应更小。

Objective To observe the therapeutic effect of longer course and lower dosage clarithromycin therapy on chronic sinusitis.Methods Fifty-six patients with chronic sinusitis（without nasal polyps）were randomly divided into two groups： treatment group and control group.The 28 pfatients in treatment group were administered with clarithromycin for 12 weeks,but the 28 patients in control group were treated with amoxicillin/clavulanate potassium and the duration was 4 weeks.The VAS scores of subjective symptoms（nasal obstruction,purulent nasal discharge,headache,smell worse） were monitored.Results In the treatment group,19 cases were cured,7 cases improved,2 cases failured.In the control group,15 cases were cured,4 cases improved,9 cases failured.The total effective rates were statistically different between the two group（P0.05）;General symptom score were significantly improved（P0.01）after treatment;nasal obstruction,purulent nasal discharge smell worse in the treatment group were better than those in the control group（P0.05）,but headache in treatment group showed no statistic significance,compared with those in the control group. Conclusion Long-term low dose clarithromycin has curative and safe effect in treating chronic sinusitis.