难治性变应性鼻炎68例疗效探讨

Therapeutic effect of 68 cases of refractory allergic rhinitis

目的通过比较2种不同方案治疗难治性变应性鼻炎的疗效分析,为临床诊疗提供较优治疗方案的经验。方法病例选取新疆医科大学第一附属医院门诊收治难治性变应性鼻炎68例,采用随机数字表法随机分为A、B2组,充分治疗1个月后疗效评估;A组方案:鼻腔冲洗+糠酸莫米松2喷/鼻1次/d+地氯雷他定5mg口服1次/d;B组方案:鼻腔冲洗+糠酸莫米松2喷/鼻1次/d+依巴斯汀10mg口服2次/d治疗。结果 2组患者均获得不同程度症状好转,A组方案痊愈率优于B组,B组方案显效率优于A组,差异有统计学意义(P<0.05)。针对鼻痒症状,B组方案优于A组,在比较成本-效果分析中B组方案优于A组,用药风险评估方面,B组不良反应发生率低。结论难治性变应性鼻炎对单一药物疗效较差,一般需要联合用药,2种抗组胺药均取得良好疗效,但也各有特点,坚持使用安全范围内较大剂量药物可以在短期内达到鼻炎控制目的,大部分难治性变应性鼻炎在长期规范用药治疗后可以达到控制目标。

Objective To compare the efficacy of two different regimens in the treatment of refractory allergic rhinitis,and to provide experience in clinical treatment for better treatment effects.Methods Sixtyeight patients with refractory allergic rhinitis diagnosed in the otolaryngology clinic of the First Affiliated Hospital of Xinjiang Medical University were randomly divided into two groups according to the random number table method.Group A regimen：nasal irrigation＋mometasone furoate 2 spray/Nasal Qd plus desloratadine 5 mg Qd;and Group B regimen：nasal irrigation＋mometasone furoate 2 spray/nasal Qd＋Ebastine 10 mg oral Bid for treatment.The curative effect of all cases was evaluated,after 1 month adequate treatment.Results Patients of both groups were improved.The recovery rate of group A was better than that of group B.The effective rate of group B was better than that of group A.The difference was statistically significant（P ≤0.05）.For the symptoms of nasal itching,group B regimen was better than group A.In comparison cost-effectiveness analysis,group B regimen was superior to group A.In terms of drug risk assessment,the incidence of adverse reactions in group B was low.Conclusion A single drug has poor curative effect on refractory allergic rhinitis and generally requires a combination of drugs.Both antihistamines have achieved good results,but also have their own characteristics.The goal of rhinitis controlled can be achieved by adherence to and consistent use of safe range of a large dose of drug,in short-term.Most of the refractory allergic rhinitis could be cured by long-term standardized drug treatment.