三级预防健康教育管理与生活方式干预在变应性鼻炎治疗中的作用研究  

Study of three-grade preventive health education and lifestyle intervention in the treatment of allergic rhinitis

作　　者：刘晓玲[1] 罗鸿[1] 余晔[1] 刘珺[1] 姜妍[1] 付选香[1] 严能兵[1] 王鹏举[1] 

机构地区：[1]襄阳市中心医院湖北文理学院附属医院耳鼻咽喉科,湖北襄阳441021

出　　处：《临床耳鼻咽喉头颈外科杂志》2012年第17期783-785,788,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：科技部十一五科技支撑计划合作项目(No:2007BAI18B15);湖北省自然科学基金(No:2011CDB320);湖北省卫生厅项目(No:JX5C26)

摘　　要：目的:探讨三级预防健康教育管理和生活方式干预在变应性鼻炎(AR)治疗中的作用。方法:将需要三级预防管理的210例AR患者随机分为A、B、C 3组,每组70例,进行为期3年的随机对照研究。A组:单用布地奈德鼻喷雾剂治疗。B组联合用布地奈德鼻喷雾剂和盐酸左卡巴斯汀鼻喷雾剂治疗。C组在B组联合用药的基础上采取健康教育管理和生活方式干预:每季度进行1次健康知识讲座、问题咨询和教育资料发放,内容主要为健康知识知晓率、健康行为形成率(健康知、信、行)指导;生活方式干预包括平衡饮食、尽量避免生活环境中的变应原、有氧运动(每天0.5～1.0h)。分别于干预前和干预1、3年后进行症状和体征评分,随访比较患者治疗依从性情况。结果:从AR症状和体征的改善情况、鼻内镜和放射学检查的结果进行记分评定疗效:干预3年后3组患者症状、体征评分比较均差异无统计学意义;3组患者干预前和干预1、3年后组内比较AR症状、体征均有不同程度改善,鼻塞、流涕、鼻痒、喷嚏4项症状及体征评分均较干预前显著降低,均差异有统计学意义(均P<0.05)。干预3年后,A组8例(11.43%)、B组6例(8.57%)、C组1例(1.43%)失访,C组患者治疗依从性显著高于A组和B组。结论:AR的三级预防健康教育管理在保持临床治疗有效性的同时,能明显提高AR患者的治疗依从性,是疗效得以保证的重要手段。Objective：Investigate the effect of three-grade preventive health education and lifestyle intervention in the treatment of allergic rhinitis（AR）. Method：Two hundred and ten selected cases needed for triple prevention were randomly divided into three groups, each group included 70 cases were undertaken for a three-year random- ized controlled study. Group A, treated with Budesonide nasal spray. Group B, combined Budesonide nasal spray with Hydrochloric acid left Kabbah Sting nasal spray. Group C, taking health education management and lifestyle intervention on the basis of group B＇s therapy. A health lecture or health problems counseling and the dissemina- tion of health education information were undertaken, quarterly. It was mainly for health knowledge awareness, and healthy behaviors formation rate guidance. Lifestyle intervention included a balanced diet, avoiding the aller gens of living environment and aerobic exercise （daily 0.5--1.0 h）. The score of the signs and symptoms in each group were obtained respectively at the beginning of study, 1 year after intervention and 3 years after intervention, as well as the comparison of patient compliance of follow-up. Result： The improved score of the signs and symp- toms, endoscopy and radiological results were used to evaluate the treatment effect. There was no significant difference among the score of signs and symptoms in three groups. Comparing in group, before intervention, 1 year after intervention and 3 years after intervention, the signs and symptoms of patients in three groups had improve ment at different degree. The score of four symptoms（rhinobyon, rhinorrhoea, rhinocnesmus, sneezing） and signs were significant lower than before the intervention, there were a significant difference（P〈0.05）. There were 8 pa- tients in group A（ll. 43%） ,6 patients in group B （8.57%） and 1 patient in group C（1.43%） lost to follow-up at 3 years after the intervention. The patient compliance Conelusion：Triple prevention health education

关 键 词：鼻炎 变应性 持续性 预防 生活方式 健康管理 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]