咪唑斯汀常规剂量联合糠酸莫米松治疗变应性鼻炎疗效观察

Effect of mizoiastine conventional dose combined with momestasone furoate in the treatment of allergic rhinitis caused by pollen allergy

目的比较咪唑斯汀强化剂量与咪唑斯汀常规剂量联合糠酸莫米松方案对花粉过敏所致变应性鼻炎患者症状评分及实验室指标的影响:方法选取台州市第一人民医院2016年6月至2018年1月收治的花粉过敏所致变应性鼻炎患者共150例,采用随机数字表法分为A组(75例)和B组(75例),分别采用咪唑斯汀强化剂量与咪唑斯汀常规剂量+糠酸莫米松方案治疗,比较两组患者近期疗效,治疗前后鼻炎症状评分、组胺、白三烯C4、白细胞介素6(IL-6)、白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α)水平及不良反应发生率、日均治疗费用。结果B组近期疗效显著优于A组(93.33%比81.33%(χ^2=9.15,P<0.05);B组治疗后鼻炎症状评分[(0.49±0.19)分、(1.02±0.20)分、(0.95±0.28)分、(0.84±0.20)分]显著低于A组[(0.87±0.21)分、(1.40±0.24)分、(1.63±0.36)分、(1.19±0.27)分]、治疗前[(3.13±1.06)分、(2.88±0.57)分.(2.81±0.79)分、(2.85±0.61)分](t=2.45、2.71、2.66、2.89、3.78、3 75、3.44、4.53,均P<0.05);B组治疗后组胺、白三烯C4、IL-6、IL-8及TNF-α水平[(15.76±3.54)mg/L、12.17±3.58)mg/L,(1.23±0.19)mg/L、(3.27±0.62)mg/L、(3.96±1.05)mg/L]均显著低于A组[(19.58±5.25)mg/L、(15.44±4.14)mg/L、(1.96±0.33)mg/L、(5.40±0.88)mg/L.(5.01±1.40)mg/L]、治疗前[(24.57±7.67)mg/L、18.90±6.33)mg/L、(2.58±0.54)mg/L.(7.66±1.17)mg/L.(6.81±1.67)mg/L](t=2.31、2.50、2.53、2.39、3.05、3.60、3.10、3.57、3.90,均P<0.05);两组不良反应发生率差异无统计学意义(P>0.05);B组日均治疗费用显著低于A组[(7.56±1.02)元比(6.88±0.80)元,t=3.12,P<0.05]。结论相较于咪唑斯汀强化剂量方案,咪唑斯汀常规剂量+糠酸莫米松方案治疗花粉过敏所致变应性鼻炎能够显著减轻鼻部症状,下调组胺、白三烯C4及炎性细胞因子水平,降低治疗费用,且安全性值得认可。

Objective To compare the effects of mizoiastine intensive dose and mizoiastine conventional dose + momestasone furoate on symptom score and laboratory index of patients with allergic rhinitis caused by pollen allergy. Methods From June 2016 to January 2018, one hundred and fifty allergic rhinitis patients caused by pollen allergy were chosen in the First People's Hospital of Taizhou anc! randomly divided into two groups according to the digital table,with 75 patients in each group. A group was treated with mizoiastine intensive dose scheme,and B group was treated with mizoiastine conventional dose + momestasone furoate. The short - term efficacy, rhinitis symptoms score,the levels of histamine,leukotrienes C4,IL -6,IL-8 and TNF - α before and after treatment,the incidence of adverse reactions and daily treatment cost of the two groups were compared. Results The short - term efficacy of B group was significantly better than that of A group(93. 33% vs. 81.33%,χ^2=9. 15 ,p< 0. 05 ). The rhinitis symptoms scores of B group[(0. 49 ±0. 19) points,( 1.02 ± 0. 20) points,(0. 95 ± 0. 28) points,(0. 84 ± 0. 20) points] after treatment were significantly lower than those of A group [( 0. 87 ± 0. 21 ) points,( 1.40 ± 0. 24 ) points,( 1. 63 ± 0. 36) points,( 1. 19 ± 0. 27 ) points] and before treatment [(3. 13 ± 1.06 ) points,(2. 88 ± 0. 57 ) points,(2.81 ±0. 79)points,(2. 85 ±0. 61)points](t=2.45,2. 71 ,2. 66,2. 89,3. 78,3. 75,3. 44,4. 53,all P <0.05). The levels of histamine, leukotrienes C4, IL - 6, IL - 8 and TNF - α of B group ( 15.76 ± 3. 54 ) mg/L,( 12. 17 ± 3. 58 ) mg/L,(1.23 ± 0. 19) mg/L,(3. 27 ±0. 62) mg/L,(3. 96 ± 1.()5 ) mg/L] after treatment were significantly lower than those of A group [(19.58 ±5.25)mg/L,( 15.44 ±4. 14) mg/L,(1.96 ±0. 33) mg/L,(5. 40 ± 0. 88) mg/L,(5. 01 ± 1.40) mg/L ] and before treatment [(24. 57 ± 7. 67 ) mg/L,( 18. 90 ± 6. 33 ) mg/L,( 2. 58 ± 0. 54 ) mg/L,( 7. 66 ± 1. 17)mg/L,(6.81 ±1.67)mg/L](t=2.31 ,2.50,2.53,2.39,3.05,3.60,3. 10,3. 57,3. 90, all P < 0. 05 ). There was no statistically significant difference in the incidence rate of adverse reactions between the two groups ( P > 0. 05 ). The daily treatment cost of B group after Ireatment was significantly less than that of A group and before treatment[(7.56 ± 1.02) CNY vs.( 6. 88 ± 0. 80) CNY ,t=3. 12 ,p< 0. 05 ]. Conclusion Compared with mizolastine intensive close scheme, mizokistine conventional dose + niomestasonr furoate in the treatment of patients with allergic rhinitis caused by pollen allergy can efficiently relieve the nasiil symptoms, down - regukite the levels of histamine, leukotiirne C4 and inflammatory cytokines, reduce the treatnirnt i*ost and has the approved safetv.