过敏原阻隔剂联合糠酸莫米松鼻喷雾剂治疗变应性鼻炎对患者鼻腔生理功能和趋化因子的影响

EFFECT OF ALLERGEN BLOCKER AND MOMETHASONE FUROATE NASAL SPRAY ON NASAL PHYSIOLOGICAL FUNCTION AND CHEMOKINES OF PATIENTS WITH ALLERGIC RHINITIS

目的观察过敏原阻隔剂联合糠酸莫米松鼻喷雾剂治疗变应性鼻炎对患者鼻腔生理功能和趋化因子的影响,为临床治疗提供参考。方法回顾性选取山东省立第三医院2018年1月—2020年3月收治的变应性鼻炎患者126例,根据治疗方法分为二组,每组63例。对照组给予糠酸莫米松鼻喷雾剂治疗,观察组给予过敏原阻隔剂联合糠酸莫米松鼻喷雾剂治疗。记录二组治疗前后临床症状评分、鼻腔生理功能、趋化因子、炎症因子、免疫球蛋白E(IgE)、嗜酸粒细胞阳离子蛋白(ECP)水平变化,并统计二组临床治疗总有效率和不良反应发生率。结果观察组总有效率(90.48%)高于对照组(76.19%),差异有统计学意义(χ^(2)=4.629,P=0.031)。与治疗前比较,二组患者鼻痒、鼻塞、喷嚏、流清涕评分较治疗前下降,治疗后,观察组患者临床症状评分低于对照组(P<0.05)。与治疗前比较,二组患者鼻黏膜纤毛传输时间(MTT)、鼻黏膜纤毛清除率(MCR)、鼻腔阻力(NR)水平较治疗前下降,治疗后,观察组患者鼻腔生理功能指标优于对照组(P<0.05)。与治疗前比较,二组患者血清CC趋化因子配体17(CCL17)、CC趋化因子配体22(CCL22)、肿瘤坏死因子-α(TNF-α)、白细胞介素-5(IL-5)、白细胞介素-13(IL-13)、白细胞介素-25(IL-25)、IgE、ECP水平较治疗前下降,治疗后,观察组患者趋化因子、炎症因子、IgE、ECP水平低于对照组(P<0.05),以上差异均有统计学意义。观察组不良反应发生率(11.11%)与对照组(7.94%)比较,差异无统计学意义(χ^(2)=0.368,P=0.544)。结论过敏原阻隔剂联合糠酸莫米松鼻喷雾剂治疗变应性鼻炎可有效改善鼻腔生理功能,降低血清趋化因子、IgE、ECP的表达,减轻炎症反应,且不增加不良反应。

Objective To observe the effect of allergen barrier agent combined with momethasone furoate nasal spray on nasal physiological function and chemokines in allergic rhinitis,and to provide reference for clinical treatment.Methods January 2018—March 2020,one hundred and twenty six patients with allergic rhinitis admitted to the third Hospital of Shandong Province,were retrospectively selected.According to the treatment method,they were divided into two groups,63 cases in each group.The control group was treated with momethasone furoate nasal spray,and the observation group was treated with allergen barrier agent combined with momethasone furoate nasal spray.The clinical symptom score,nasal physiological function,chemokines,inflammatory factors,immunoglobulin E(Ig E),eosinophil cationic protein(ECP)levels were recorded before and after treatment in the two groups,and the total effective rate and adverse reaction rate of the two groups were counted.Results The total effective rate in the observation group(90.48%)was higher than that in the control group(76.19%),and the difference was statistically significant(χ^(2)=4.629,P=0.031).Compared with before treatment,the scores of nasal itching,nasal congestion,sneezing and runny nose in group 2 were lower than those before treatment.After treatment,the scores of clinical symptoms in the observation group were lower than those in the control group(P<0.05).The levels of nasal mucosal cilia transmission time(MTT),nasal mucosal cilia clearance rate(MCR)and nasal resistance(NR)decreased compared with before treatment in group 2.after treatment,the nasal physiological function index of the observation group was better than that of the control group(P<0.05).Serum CC chemokine ligand 17(CCL17),CC chemokine ligand22(CCL22),tumor necrosis factor-α(TNF-α),interleukin-5(IL-5),interleukin-13(IL-13),interleukin-25(IL-25),ige,ecp levels decreased compared to pre-treatment levels in the two groups,The levels of chemokines,inflammatory factors and IgE、ECP in the observation group were lower than those in the control group(P<0.05),the above differences were statistically significant.The adverse reaction rate(11.11%)in the observation group was not statistically significant compared with the control group(7.94%)(χ^(2)=0.368,P=0.544).Conclusion Allergen barrier combined with momethasone furoate nasal spray for allergic rhinitis can effectively improve nasal physiological function,reduce the expression of serum chemokines and IgE、ECP,reduce inflammatory response,and do not increase adverse reactions.