聚焦超声配合鼻喷激素治疗变应性鼻炎的疗效观察

Clinical effect of focused ultrasound in combination with nasal spray hormone in treating allergic rhinitis

目的观察聚焦超声配合鼻喷激素治疗变应性鼻炎的疗效。方法将药物治疗效果不理想的持续性中-重度变应性鼻炎患者进行聚焦超声治疗后完全随机分为A、B两组,A组在术后继续使用小剂量鼻喷激素治疗3个月:B组作为对照组在术后不加用鼻喷激素。分别于治疗前和治疗后3个月、1年和2年对患者进行症状VAS评分,比较两组的评分和有效率并观察不良反应情况。结果与治疗前相比,两组术后3个月、1年和2年时的VAS评分均显著下降(P均<0.05),但随着时间延长呈递增趋势,B组每个阶段随访评分的增加均有统计学差异(P<0.05);A组1年内随访评分无明显差异,2年时差异有统计学意义。A、B两组之间术后1年和2年时的评分比较也有差异(P<0.05),A组评分更低,且A组随访2年时的总有效率为71.4%,高于B组的53.1%。结论对药物治疗难以控制的持续性中-重度变应性鼻炎聚焦超声治疗的疗效显著,但是随着时间的延长其疗效有下降趋势。如果术后配合使用小剂量鼻喷激素,则对于该治疗的中远期疗效有明显的提高。

Objective To observe the therapeutic effect of focused ultrasound and nasal spray hormone in treating allergic rhinitis under nasal endoscopy. Methods After focused ultrasound treatment,the patients with allergic rhinitis were randomly divided into A and B two groups. Group A continued to use small dose of nasal spray hormone for 3 months,while group B as the control group without using nasal spray hormone. We interview ed the patients respectively before and at the 3 months,1 year and 2 years after surgery. The visual analogue scale（ VAS） was recorded. Results Compared with baseline,the VAS scores of the two groups were both significantly decreased（ P〈0. 05） at postoperative 3months,1 year and 2 years. but with the time extension,the scores of group B were statistically significantly increased（ P〈0. 05）; No obvious difference was found at group A within 1 year＇s follow-up,the difference was statistically significant at 2 year＇ follow-up. Betw een group A and B there were statistically significant difference scores at postoperative1 year and 2 year＇s follow-up,the score of group A was lower. Conclusion For allergic rhinitis,the efficacy of focused ultrasound is significant,but it is decreased over time. If with postoperative small dose of nasal spray hormone,the long-term treatment effect is significantly improved.