克拉霉素胶囊联合布地奈德混悬液治疗慢性鼻窦炎合并支气管哮喘鼻内镜术后患者的效果

Effects of Clarithromycin capsules combined with Budesonide suspension in treatment of patients with chronic sinusitis complicated with bronchial asthma after nasal endoscopy

目的:观察克拉霉素胶囊联合布地奈德混悬液治疗慢性鼻窦炎(CRS)合并支气管哮喘(BA)鼻内镜术后患者的效果。方法:选取2018年4月至2023年4月该院收治的180例经鼻内镜Messerklinger术治疗后的CRS合并BA患者进行前瞻性研究,按照随机数字表法分为观察组与对照组各90例。对照组采用经鼻雾化吸入布地奈德混悬液治疗,观察组在对照组基础上联合克拉霉素胶囊口服治疗,比较两组治疗总有效率、气道阻力水平、血清炎性指标[白细胞介素-4(IL-4)、可溶性白细胞介素-2受体(sIL-2R)、环氧化酶-2(COX-2)]水平、鼻腔鼻窦结局测试20(SNOT-20)评分、哮喘控制测试(ACT)评分和不良反应发生率。结果:观察组治疗总有效率为93.33%,明显高于对照组的83.33%,差异有统计学意义(P<0.05);治疗后,两组SNOT-20评分、气道阻力水平和血清IL-4、COX-2、sIL-2R水平低于治疗前,且观察组低于对照组,两组ACT评分高于治疗前,且观察组高于对照组,差异均有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:克拉霉素胶囊联合布地奈德混悬液治疗CRS合并BA鼻内镜术后患者可提高治疗总有效率和ACT评分,降低气道阻力水平、SNOT-20评分和血清炎性指标水平,效果优于单纯布地奈德混悬液治疗。

Objective:To observe effects of Clarithromycin capsules combined with Budesonide suspension in treatment of patients with chronic sinusitis(CRS)complicated with bronchial asthma(BA)after nasal endoscopy.Methods:A prospective study was conducted on 180 patients with CRS combined with BA who were treated with endoscopic Messerklinger surgery from April 2018 to April 2023.According to the random number table method,they were divided into observation group and control group,90 cases in each group.The control group was treated with Budesonide suspension by atomization inhalation,while the observation group was treated with Clarithromycin capsules orally on the basis of that of the control group.The total effective rate,the airway resistance level,the serum inflammatory indexes[interleukin-4(IL-4),soluble interleukin-2 receptor(sIL-2R),cyclooxygenase-2(COX-2)]levels,the nasal sinus outcome test 20(SNOT-20)score,the asthma control test(ACT)score,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 93.33%,which was significantly higher than 83.33%of the control group,and the difference was statistically significant(P<0.05).After the treatment,the SNOT-20 score,the airway resistance level and the serum IL-4,COX-2 and sIL-2R levels in the two groups were lower than those before the treatment,and those in the observation group were lower than those in the control group;the ACT scores of the two groups were higher than those before the treatment,and that in the observation group was higher than that in the control group;and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Clarithromycin capsules combined with Budesonide suspension can improve the total effective rate and the ACT scores,and reduce the levels of airway resistance,the SNOT-20 scores and the serum inflammatory index levels in the patients with CRS and BA after nasal endoscopy.Moreover,it is superior to single Budesonide suspension treatment.