氮卓斯汀联合氟替卡松治疗变应性鼻炎的临床观察
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篇名: | 氮卓斯汀联合氟替卡松治疗变应性鼻炎的临床观察 |
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摘要: | 目的:观察氮卓斯汀联合氟替卡松治疗变应性鼻炎(AR)的有效性及安全性。方法:选择2015年1月-2016年7月笔者所在3家医院中的AR患者135例作为研究对象,按随机数字表法分为氮卓斯汀组、氟替卡松组和联合用药组,各45例。在给予减充血剂盐酸羟甲唑啉喷雾剂的基础上,氮卓斯汀组患者给予盐酸氮卓斯汀鼻喷剂,每个鼻孔1喷,早晚各1次;氟替卡松组患者给予丙酸氟替卡松鼻喷雾剂,每个鼻孔1喷,早晚各1次;联合用药组患者给予盐酸氮卓斯汀鼻喷剂联合丙酸氟替卡松鼻喷雾剂,用法用量同前。3组患者均持续用药30 d。比较3组患者的鼻部症状总评分(TNSS)和眼部症状总评分(TOSS)下降指数、鼻腔最小横截面积(NMCA)、鼻腔总阻力(TNR),以及不良反应发生情况。结果:试验过程中因不同原因脱落,剩余127例患者进入全分析数据集、130例患者进入安全数据集。治疗后,联合用药组患者的TNSS下降指数明显高于氮卓斯汀组和氟替卡松组,差异均有统计学意义(P<0.05);氮卓斯汀组与氟替卡松组患者的TNSS下降指数,以及3组患者的TOSS下降指数比较,差异均无统计学意义(P>0.05)。治疗前,3组患者均有不同程度的鼻通气障碍,但TNR和NMCA比较差异均无统计学意义(P>0.05);治疗后,3组患者的NMCA以及在75、150 Pa下的TNR均明显小于治疗前,且联合用药组的TNR明显小于氮卓斯汀组和氟替卡松组,差异均有统计学意义(P<0.05);但3组患者间NMCA比较,差异无统计学意义(P>0.05)。3组患者总不良反应发生率比较,差异无统计学意义(P>0.05)。结论:氮卓斯汀和氟替卡松均可有效缓解AR患者的鼻部症状,改善鼻通气障碍;联合用药的疗效优于单一用药方案,而且并未增加不良反应的发生概率。 |
ABSTRACT: | OBJECTIVE: To observe the effectiveness and safety of azelastine combined with fluticasone in the treatment of allergic rhinitis (AR). METHODS: A total of 135 AR patients were selected from 3 hospitals during Jan. 2015-Jul. 2016, and divided into azelastine group, fluticasone group and drug combination group according to random number table, with 45 cases in each group. On the basis of decongestant Oxymetazoline hydrochloride spray, azelastine group was given Azelastine hydrochloride nasal spray, 1 spray each nostril, morning and night; fluticasone group was given Fluticasone propionate nasal spray, 1 spray each nostril, morning and night; drug combination was given Azelastine hydrochloride nasal spray combined with Fluticasone propionate nasal spray, with the same usage and dose. Three groups were treated for consecutive 30 d. Total nasal symptom score (TNSS) and total ocular symptom score (TOSS) decline indexes, nasal minimal cross-sectional area (NMCA), total nasal resistance (TNR) and the occurrence of ADR were compared among 3 groups. RESULTS: Some patients were withdrawal from the trial; finally, 127 patients were included in full analysis set, and 130 patients were included in safety set. After treatment, TNSS decline index of drug combination group was significantly higher than azelastine group and fluticasone group, with statistical significance (P<0.05). There was no statistical significance in TNSS decline indexes between azelastine group and fluticasone group, as well as TOSS decline indexes among 3 groups (P>0.05). Before treatment, 3 groups suffered from nasal ventilation disorder to different extents, but there was no statistical significance in TNR or NMCA among 3 groups (P>0.05). After treatment, NMCA and TNR at 75, 150 Pa of 3 groups were significantly lower than before, and TNR of drug combination group was significantly lower than azelastine group and fluticasone group, with statistical significance (P<0.05). There was no statistical significance in NMCA among 3 groups (P>0.05). There was no statistical significance in the incidence of ADR among 3 groups (P>0.05). CONCLUSIONS: Both azelastine and fluticasone can effectively relieve nasal symptom as well as improve nasal ventilation disorder in AR patients; therapeutic efficacy of drug combination is better than single drug, and it doesn’t increase the incidence of ADR. |
期刊: | 2017年第28卷第23期 |
作者: | 毛昳楠,蔡丽,杨莉萍,胡晓敏 |
AUTHORS: | MAO Yinan,CAI Li,YANG Liping,HU Xiaomin |
关键字: | 变应性鼻炎;氮卓斯汀;氟替卡松;鼻通气障碍 |
KEYWORDS: | Allergic rhinitis; Azelastine; Fluticasone; Nasal ventilation disorder |
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