应用不同的温度行鼻腔冲洗观察变应性鼻炎患者的临床效果

Treatment of allergic rhinitis with normal saline nasal irrigation at different temperature

目的探讨不同鼻腔冲洗温度对变应性鼻炎患者的临床效果。方法采用随机数字法将200例变应性鼻炎患者平均分为A、B和C 3组,分别给予15、25和40℃生理盐水进行鼻腔冲洗。检测鼻腔冲洗液中白三烯C4、组胺、特异性IgE及嗜酸粒细胞阳离子蛋白(ECP)。3个月随访后对患者临床疗效进行比较。结果治疗后C组患者白三烯C4、组胺较治疗前有明显下降(P<0.05),且明显低于A和B两组(P<0.05)。治疗后B组、C组喷嚏、鼻塞症状得分较明显低于治疗前(P<0.05);C组得分均明显低于A和B两组,B组得分低于A组(P<0.05)。3组患者总有效率分别为75.7%、74.6%和95.5%,差异有统计学意义(P<0.05)。结论 40℃生理盐水鼻腔冲洗可以通过降低鼻黏膜炎症因子组胺和白三烯C4水平,有效改善患者打喷嚏及鼻塞症状,是适宜的鼻腔冲洗液温度。

[ Objective] To investigate the influence of normal saline nasal irrigation with different temperature on allergic rhinitis and to confirm the appropriate temperature of nasal irrigation. [Methods] 200 patients with allergic rhinitis were randomly divided into group A, group B and group C, and respectively were given 15℃, 25℃ and 40℃ saline nasal irrigation. The leukotriene C4, histamine, specific IgE and aci- dophilic granulocyte cationic protein （ECP） were tested. The clinical curative effect were compared follow-up 3 months. [Results] The levels of leukotriene C4, histamine in group C were lower after treatment than that before treatment, which were also lower than that in group A and group B （P 〈0.05）. The score of sneezing, stuffy nose symptoms in group C and group B were lower after treatment than that before treatment, which were also lower than that in group A （P 〈0.05）. The score of sneezing, stuffy nose symptoms in group C were lower than that in group B （P〈0.05）. The total effective rate were 75.7%, 74.6%, 95.5% respectively （P〈 0.05）. [Conclusion] 40℃ normal saline nasal irrigation can improve the symptoms of sneezing and nasal ob- struction and can alleviate the local levels of inflammatory factors like histamine and leukotriene C4 in aller- gic rhiniti patients and is the appropriate irrigation temperature.