小剂量克拉霉素联合鼻内局部给药治疗慢性鼻窦炎临床疗效

Clinical Efficacy of Low-dose Clarithromycin Combined with Local Intranasal Administration in the Treatment of Chronic Sinusitis

目的 :观察采用小剂量克拉霉素联合鼻内局部给药治疗慢性鼻窦炎的临床疗效及药物不良反应,为慢性鼻窦炎的临床治疗方案选择提供参考。方法 :选择2015年1月—2016年1月收治的慢性鼻窦炎患者118例,按照就诊顺序编号,采用随机数字表法分为对照组和研究组,各59例。对照组按照指南推荐方法给予抗炎药物、小剂量克拉霉素及其它对症治疗措施治疗,研究组在对照组基础上予以鼻内局部给药治疗,两组均连续治疗12周。比较两组患者临床症状评分(鼻塞、黏性或脓性鼻涕、头面部胀痛、嗅觉减退)、WHOQOL生活质量评分、主观临床疗效、Lund-MackerCT鼻窦客观临床疗效,以及两组不良反应发生率、处置预后情况。结果 :治疗后,两组临床症状评分(鼻塞、黏性或脓性鼻涕、头面部胀痛、嗅觉减退)、WHOQOL生活质量评分均较治疗前改善,且研究组临床症状评分低于对照组,WHOQOL生活质量评分高于对照组,差异有统计学意义(P <0.05);治疗后,研究组主观临床疗效和Lund-MackerCT客观临床疗效总有效率均高于对照组,差异有统计学意义(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 :小剂量克拉霉素联合鼻内局部给药可有效改善慢性鼻窦炎患者的临床症状,提高疗效,且安全性好,具有较高的临床价值。

Objective:To observe the clinical efficacy and adverse drug reactions of low-dose clarithromycin combined with local intranasal administration in the treatment of chronic sinusitis to provide a reference for the selection of clinical treatment regimens for chronic sinusitis.Methods:118 patients with chronic sinusitis admitted to our hospital from January 2015 to January 2016 were selected and randomly divided into a control group and a study group according to the consultation number,59 cases each.The patients in the control group were given antiinflammatory drugs,low-dose clarithromycin and other symptomatic treatments according to the recommended method of the guidelines,and the patients in the study group were given intranasal local administration treatment on the basis of the treatment in the control group.The patients in the two groups were treated continuously for 12 weeks.The clinical symptom scores(nasal congestion,viscous or purulent nasal discharge,head and face pain,olfactory sensation),WHOQOL quality of life score,subjective clinical efficacy,objective clinical efficacy of Lund-Macker CT sinus,incidence of adverse reactions and disposal of prognosis in the two groups were compared between the two groups.Results:The clinical symptom scores(nasal congestion,viscous or purulent nasal discharge,head and face pain,olfactory loss)and WHOQOL quality of life scores after treatment were improved compared with those before treatment in the two groups,and the clinical symptom scores in the study group were lower than those in the control group,while WHOQOL quality of life scores were higher than those in the control group,with statistically significant differences(P<0.05).After treatment,the subjective clinical efficacy and Lund-Macker CT objective clinical efficacy in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Low-dose clarithromycin combined with local intranasal administration can effectively improve the clinical symptoms of the patients with chronic sinusitis and improve the efficacy,and has good safety and high clinical value.