阶梯式抗组胺药物在变应性鼻炎治疗中的临床观察

Clinical observation of stepwise antihistamine in the treatment of allergic rhinitis

目的探究变应性鼻炎应用阶梯式抗组胺药物治疗的临床效果。方法90例变应性鼻炎患者按照BSACI治疗指南中的升阶梯方法治疗效果,分为第一治疗组(给予盐酸西替利嗪+地氯雷他定)、第二治疗组(给予盐酸西替利嗪+地氯雷他定治疗+马来酸氯苯那敏)、第三级治疗组(给予盐酸西替利嗪+地氯雷他定治疗+孟鲁司特),各30例。并对应其相应阶梯组别使用抗组胺药物。比较三组患者治疗效果和不良反应发生情况。结果治疗后,第三级治疗组的显效率为80.00%高于第一级治疗组的53.33%和第二级治疗组的36.67%,差异有统计学意义(P<0.05)。第一级治疗组总显效率高于第二级治疗组,差异有统计学意义(P<0.05)。第二级治疗组的不良反应发生率为3.33%高于第一级治疗组的10.00%和第三级治疗组的10.00%,差异有统计学意义(P<0.05)。第一级治疗组和第三级治疗组不良反应发生率比较,差异无统计学意义(P>0.05)。结论变应性鼻炎治疗首选第三代抗组胺药物联用,对于治疗效果不佳的患者可在此治疗基础上,加用孟鲁司特等白三烯受体拮抗剂治疗,以增强临床治疗效果,减少患者不良反应发生。

Objective To investigate the clinical effect of stepwise antihistamine in the treatment of allergic rhinitis.Methods A total of 90 patients with allergic rhinitis were divided into first-step treatment group(cetirizine hydrochloride+desloratadine),second-step treatment group(cetirizine hydrochloride+desloratadine+chlorphenamine maleate)and third-step treatment group(cetirizine hydrochloride+desloratadine+montelukast)according to the step-up method in the BSACI treatment guidelines,with 30 cases in each group.All three groups used antihistamines according to the corresponding step group.The therapeutic effect and occurrence of adverse reactions of the three groups were compared.Results After treatment,the effective rate of third-step treatment group was 80.00%,which was higher than 53.33%of first-step treatment and 36.67%of second-step treatment,and the difference was statistically significant(P<0.05).The total effective rate of first-step treatment group was higher than that of second-step treatment group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions of second-step treatment group was 3.33%,which was higher than 10.00%of firststep treatment,and 10.00%of third-step treatment group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in incidence of adverse reactions between first-step treatment group and third-step treatment group(P>0.05).Conclusion The third generation antihistamines are the first choice in the treatment of allergic rhinitis.On the basis of this treatment,leukotriene receptor antagonists such as montelukast can be added to patients with poor therapeutic effect,so as to enhance the clinical effect and reduce the occurrence of adverse reactions.