非手术药物序贯治疗患儿腺样体肥大伴变应性鼻炎的效果

Effect of Non-surgical Drugs Sequential Therapy in Children with Adenoid Hypertrophy and Allergic Rhinitis

目的:探讨非手术药物序贯治疗患儿腺样体肥大(AH)伴变应性鼻炎(AR)的临床效果。方法:选择2019年7月-2020年11月本院60例AH伴AR的患儿,参照随机数字表分为非手术组(NO组)和手术组(O组)。O组采用腺样体切除+扁桃体切除术,NO组采用非手术药物序贯治疗(强的松+维生素D+左西替利嗪+孟鲁司特钠)。2个月后,比较两组症状评分、炎性反应、免疫功能变化。结果:两组鼻塞、张口呼吸、打鼾、睡眠不安的评分比较差异无统计学意义(P>0.05)。治疗前,两组炎性反应和免疫功能比较差异无统计学意义(P>0.05),治疗后,NO组IL-6、IL-8低于O组(P<0.05),NO组IgA、IgG低于O组(P<0.05),IgM高于O组(P<0.05)。结论:非手术药物序贯治疗改善AH伴AR患儿的临床症状与手术相似,但可减轻炎性反应,提高免疫功能。

Objective:To investigate the clinical effect of non-surgical drugs sequential therapy in children with adenoid hypertrophy(AH)and allergic rhinitis(AR).Method:A total of 60 children with AH and AR in our hospital selected from July 2019 to November 2020,were divided into non operation group(group NO)and operation group(group O)according to random number table.Group O was treated with adenoidectomy and tonsillectomy,and group NO was treated with non-surgical drugs sequential therapy(Prednisone+Vitamin D+Levocetirizine+Montelukast).After 2 months,the symptom scores,inflammatory reaction and immune function were compared between the two groups.Result:There were no significant differences in the scores of nasal obstruction,mouth breathing,snoring and sleep disturbance in the two groups(P>0.05).Before treatment,there were no significant differences in inflammatory reaction and immune function in the two groups(P>0.05).After treatment,IL-6 and IL-8 levels in group NO were lower than those in group O(P<0.05),IgA,IgG levels in group NO were lower than those in group O(P<0.05),IgM level in group NO was higher than that in group O(P<0.05).Conclusion:Non-surgical drugs sequential therapy can improve the clinical symptoms of children with AH and AR,which was similar to operation,but can reduce inflammatory reaction and improve immune function.