抗过敏药物联合鼻腔局部应用糖皮质激素治疗慢性鼻-鼻窦炎的疗效观察

Clinical observation of allergy combined with corticosteroids treatment for chronic rhinosinusitis

目的观察小剂量长期使用抗过敏药物联合鼻腔局部应用糖皮质激素治疗无局部解剖结构异常的慢性鼻-鼻窦炎(CRS)的临床效果。方法 CRS患者146例,按照就诊顺序随机分成对照组和观察组各73例。对照组单纯给予抗组胺药地氯雷他定治疗,观察组地氯雷他定和鼻内糖皮质激素联合治疗,比较2组患者的临床疗效、鼻窦CT评分。结果治疗前后,观察组Lund鼻窦CT平均评分由(7.16±2.11)降至(2.61±1.57)分(P<0.05),对照组由(6.42±1.94)降至(2.34±1.72)分(P<0.05);治疗后,观察组疗效优于对照组(P<0.05)。观察组在治疗后12个月内复发率明显低于对照组(P<0.05);2组患者治疗前后主观自评疗效结果与Lund鼻窦CT评分相似。结论抗过敏药物联合鼻腔局部应用糖皮质激素治疗CRS,可以提高临床疗效,改善预后。

Objective To explore the clinical efficacy of allergy combined with corticosteroids in treatment of chronic rhinosinusitis. Methods This was a retrospective analysis of the clinical records of patients with chronic rhinosinusitis in the hospital from June2010 to May 2013. By order of admission,146 cases of patients with chronic rhinosinusitis were divided into the observation group and the control group( n = 73). The control group was treated with allergy. On the basis of the above treatment,the observation group was given corticosteroids. The clinical indicators between two groups were compared including efficiency and recurrence rate. Results The score of CT scan decreased to 2. 83 ± 1. 86 in the observation group and to 2. 43 ± 1. 91( P < 0. 05) in the control group after treatment. The recovery rate of observation group was 90. 41% and the control group was 69. 86% with CT images( P < 0. 05). The self assessment of treatment efficiency was coincident with CT image in the two groups. The observation group was better than that in the control group in clinical indicators including efficiency and recurrence rate. Conclusion Allergy combined with corticosteroids in treatment of chronic sinusitis and nasal polyps may improve the clinical efficacy and prognosis.