地塞米松联合布地奈德双途径治疗嗜酸性中耳炎的疗效观察

Efficacy Observation of Dexamethasone Plus Budesonide Double-Route Treatment of Eosinophilic Otitis Media

目的:评估地塞米松经咽鼓管注射联合布地奈德雾化吸入双途径治疗嗜酸性中耳炎(EOM)的疗效,以及对EOM患者白细胞介素-6(IL-6)、白细胞介素-17A(IL-17A)水平及近远期疗效的影响。方法:选取2017年1月-2019年2月南华大学附属长沙中心医院收治的EOM患者120例作为观察对象,按随机数字表法分为观察组和对照组,各60例,两组患者均采用布地奈德雾化治疗,观察组在此治疗基础上予以耳内镜下,地塞米松经咽鼓管鼓室口注射治疗,两组均治疗2周。观察并比较两组患者的近期疗效、骨导阈值、IL-6、IL-17A水平以及远期复发率、鼓室积液发生率。结果:观察组患者的治疗总有效率明显高于对照组,差异有统计学意义(P<0.05);两组患者的1、2、4、8 kHz的骨导阈值均下降,且观察组患者的1、2、4、8 kHz的骨导阈值低于对照组,差异有统计学意义(P<0.05);观察组患者的IL-6、IL-17A水平低于对照组,差异有统计学意义(P<0.05);观察组患者的复发率、鼓室积液发生率低于对照组,差异有统计学意义(P<0.05);两组患者的不良反应比较,差异无统计学意义(P>0.05)。结论:地塞米松经咽鼓管注射联合布地奈德雾化吸入双途径对EOM的治疗后,患者的IL-6、IL-17A水平显著下降,患者的近期疗效以及远期复发情况显著改善。

Objective:To evaluate the efficacy of dexamethasone via eustachian tube injection combined with budesonide nebulized inhalation in the treatment of eosinophilic otitis media(EOM),and the effect on interleukin-6(IL-6)level,interleukin-17A(IL-17A)level,short-term efficacy and long-term efficacy of EOM patients.Methods:From January 2017 to February 2019,120 EOM patients who were admitted to Changsha Central Hospital Affiliated to University of South China were selected as the observation objects,and divided into an observation group and a control group according to the random number table method,with 60 cases in each group.Budesonide nebulization treatment was given in two groups.On the basis of this treatment,the observation group was treated with dexamethasone injection through the eustachian tube tympanic opening under ear endoscopy.Both groups were treated for 2 weeks.The short-term efficacy,bone conduction threshold,IL-6 level,IL-17A level,long-term recurrence rate and tympanic effusion incidence were observed and compared between the two groups.Results:The total effective rate of treatment in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).The bone conduction thresholds of 1,2,4,and 8 kHz in two groups were decreased,and those in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The levels of IL-6 and IL-17A in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05);the recurrence rate and the incidence of tympanic effusion in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05);there was no significant difference in the adverse reactions between the two groups(P>0.05).Conclusion:After dexamethasone injection through eustachian tube combined with budesonide nebulized inhalation double-route treatment for EOM,the levels of IL-6 and IL-17A in patients are significantly decreased,and the short-term efficacy and long-term recurrence of patients are significantly improved.