小儿变应性鼻炎173例疗效分析及随访  

A study on treatment for children with allergic rhinitis and the follow-up

作　　者：蔡幸生[1] 朱勇斌[1] 张淳[1] 纪细芳[1] 林舜红[1] 徐海玲[1] 林锡平[1] 

机构地区：[1]广东省揭阳市人民医院儿科,广东揭阳522000

出　　处：《中国实用儿科杂志》2008年第5期365-367,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨小儿变应性鼻炎(AR)的疗法与疗效、预后的关系。方法2001—2006年将广东省揭阳市人民医院收治的173例AR患儿随机分成对照组,吸入糖皮质激素组(IC组),口服孟鲁司特钠组(MT组),吸入糖皮质激素加孟鲁司特钠组(I-M组)。对照组予口服酮替芬<3岁每次0.5mg,每日2次,≥3岁每次1mg,每日1～2次。IC组在对照组治疗基础上,吸入丙酸氟替卡松定量气雾剂,每次125μg,每日1次,采用带有活瓣的储雾罐辅助吸入,若患儿能够配合,嘱其闭口,用鼻呼吸,充分吸入罐内药雾。MT组在对照组治疗基础上,口服孟鲁司特钠每天1次,每次5mg。I-M组为IC组与MT组治疗的组合。疗程均为3个月。分别于治疗2周、3个月后评价疗效。疗程结束后1年比较各组AR复发率及哮喘发生率。结果治疗2周后,4组总有效率差异无统计学意义(P>0.05)。治疗3个月后,总有效率I-M组高于IC组和MT组(P均<0.05),显著高于对照组(P<0.01);IC组和MT组高于对照组(P均<0.05),而IC组与MT组之间差别无统计学意义(P>0.05)。治疗结束1年后AR加重或复发及哮喘发生率I-M组低于IC组及MT组(P<0.05),显著低于对照组(P<0.01),IC组和MT组低于对照组(P<0.05),而IC组与MT组之间差异无统计学意义(P>0.05)。四组副反应发生率差异无统计学意义(P>0.05)。结论酮替芬在短期内控制AR症状有良效,但2周后如果疗效不佳应考虑加用其它药物。联合用药有协同效果。使用带有活瓣的储雾罐用鼻吸入丙酸氟替卡松加服孟鲁司特钠和酮替芬疗效最佳,且可减少AR复发及发生哮喘。Abstract Objective To investigate the relationship between therapy and curative effect and prognosis in children with allergic rhinitis （ AR）. Methods A total of 173 cases with AR were randomly divided into control group,inhalant corticosteroid group （ IC group ） , oral montelukast group （ MT group ） and inhalant corticosteroid plus oral montelukast group （ I- M group）. The control group was treated by oral kotetifen. The dose was 0. 5mg,twice a day,in patients＇ages 〈3yrs,lmg 1 ～ 2 times daily in patients＇ ages ≥ 3yrs. IC group was adminstered by inhalation of fluticasone propionate with 125ug once a day on the therapy of control group. Fluticasone was inhaled with a spacer. The patients were told to close their mouth and to breathe through their nose if they are able to cooperate. MT group was adminstered by oral montelukast with 5mg once a day on the therapy of control group. I-M group consisted of IC and MT groups. Each course of treatment was 3 months in all groups. The curative effect was evaluated after 2 weeks and 3 months of administration. After one year of treatment, the recurrent or aggravating rates of AR and occurence of asthma were compared in all groups. Results After 4 weeks of administration,the total effective rates hadnt significant difference in all groups （ P 〉 0. 05）. After 3 months of administration,the total effective rate was higher in I-M group than that of IC and MT groups （ P 〈 0. 05, respectively） , and was significantly higher in I-M group than control group（ P 〈0. 01 ） ;that of IC and MT groups was higher than con- trol group（ P 〈0.05,respectively）. There wasn＇t difference in total effective rate between IC and MT groups（ P 〉0. 05 ）. After one year of treatment, the recurrent or aggravating rates of AR and occurence of asthma were lower in I-M group than that of IC and MT groups （ P 〈 0. 05, respectively ）, and was significantly lower in I-M group than control group （ P 〈0. 01 ） ;it was lower in IC and MT groups t

关 键 词：变应性鼻炎 疗法 预后 

分 类 号：R72[医药卫生—儿科]