鼻用糖皮质激素治疗积液性中耳炎的疗效观察

Clinical observation of nasal steroids in the treatment of otitis media with effusion

目的探讨鼻用糖皮质激素喷雾治疗中耳炎积液临床疗效。方法选取2014年1月~2015年6月期间我院收治的180例积液性中耳炎患者,随机将其分成A组、B组和C组,每组各60例患者。其中A组患者给予糠酸莫米松鼻喷雾剂治疗,B组患者给予口服强的松治疗,C组患者给予生理盐水鼻喷雾治疗,治疗结束后比较三组患者的耳镜检查结果,鼓室功能曲线类型以及听力改善情况。结果 A组和B组患者治疗后鼓膜回缩以及失去光泽发生率均低于C组,正常鼓膜比例高于C组（P〈0.05）,A组和B组患者耳镜检查结果数据比较差异无统计学意义（P〉0.05）;三组患者鼓室功能曲线类型数据比较差异有统计学意义（P〈0.05）,A组和B组患者膜曲线类型数据比较差异无统计学意义（P〉0.05）;三组患者治疗后听力数据均优于治疗前（P〈0.05）;A组和B组患者治疗后听力改善数据（18.3±4.8 VS 18.9±4.9d B HL）比较差异无统计学意义（P〉0.05）。结论鼻类固醇激素与全身激素给药治疗积液性中耳炎临床疗效无差异,可作为治疗积液性中耳炎的一种有效方案。

Objective To explore the clinical curative effect of nasal steroid spray in the treatment of middle ear inflammation effusion. Methods From January 2014 to June 2015 in our hospital, 180 cases of patients with effusion of middle ear inflammation were randomly divided into group A, group B and group C, and there were 60 cases in each group. The patients in group A were treated with mometasone furoate nasal spray in the treatment, the patients in group B were treated with oral prednisone therapy, the patients in group C were treated with saline nasal spray treatment. After the end of treatment, to compare otoscopic examination results, tympanometry curve type classification and the hearing improvement of the three groups. Results The incidence of tympanic membrane retraction and gloss loss in group A and group B patients after treatment was lower than that in group C, the proportion of normal tympanic membrane is higher than that of group C（P〈0.05）, there was no significant difference of otoscopic examination results between the group A and B patients（P〈0.05）; The difference in tympanometry curve data type among three groups was statistically significant（P〈0.05）, the difference in membrane type curve data between group A and group B patients was no statistical significant（P 0.05）. After treatment, the data on hearing of patients in the three groups were better than those before treatment（P 0.05）; the differences of the patients in group A and group B after treatment in hearing improvement（18.3 ±4.8 vs 18.9 ±4.9 d B HL） had no statistical significance（P〈0.05）. Conclusion There is no difference in the clinical curative effect between the nasal steroid hormones and systemic hormone drug for the treatment of otitis media with effusion, which can be used as an effective treatment of treatment for otitis media with effusion.