大环内脂类药物联合糖皮质激素治疗慢性鼻窦炎疗效及对患者鼻腔分泌物IL-6、IL-8的影响  

Curative efficacy of macrolides in combination with glucocorticoid in the treatment of chronic sinusitis and its effects on nasal secretion of IL-6,IL-8

作　　者：马新明 

机构地区：[1]湖北省应城市人民医院耳鼻咽喉科,湖北应城432400

出　　处：《临床和实验医学杂志》2015年第6期480-482,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨大环内脂类药物联合糖皮质激素治疗慢性鼻窦炎的疗效及对患者鼻腔分泌物白介素6(IL-6)、白介素8(IL-8)水平的影响。方法 120例符合入选标准的慢性鼻窦炎患者随机分为对照组(n=60)和观察组(n=60)。对照组给予常规治疗,包括滴鼻剂、鼻炎片及抗过敏治疗;观察组给予克拉霉素联合布地奈德治疗。12周疗程结束后,比较组间临床疗效、视觉模拟评分(VAS)评分、Lund-Kennedy评分、鼻腔分泌物IL-6、IL-8水平及不良反应发生情况。结果观察组的治疗总有效为93.3%,明显高于对照组78.3%,差异有统计学意义(P<0.05)。与对照组治疗后相比,观察组VAS、Lund-Kennedy评分,鼻腔分泌物IL-6、IL-8水平均显著下降,差异均有统计学意义(P均<0.05)。治疗过程中,未出现严重不良反应,组间不良反应发生率比较差异无统计学意义(P>0.05)。结论大环内脂类药物联合糖皮质激素治疗慢性鼻窦炎疗效可靠,能够显著提高疗效,改善症状,减轻炎性炎性反应,且不良反应轻微,临床上值得进一步研究。Objective To investigate the clinical effect of treatment of macrolides in combination with glucocorticoid in the treatment of chronic sinusitis and its effects on nasal secretion of IL-6,IL-8. Methods 120 cases of chronic sinusitis meeting the inclusion criteria were divided into two groups equally according to therapeutic schemes. The control group was given routine treatment,including nasal drops,rhinitis tablet and anti-allergic therapy,while the observation group was treated with clarithromycin（ macrolides） and budesonide（ glucocorticoid）. Then,visual analogue scale（ VAS） was applied to assess the severity of the disease and Lund-Kennedy scale was employed to quantitatively appraise the result of the nasal endoscopic examination. After the twelve-week treatment,the curative efficacy,score of VAS,Lund-Kennedy scale,nasal secretion of IL-6,IL-8 and adverse reactions were compared between the two groups. Results The observation group had a therapeutic efficiency ratio of 93. 3%,which was significantly higher than that of 78. 3% in the control group（ P 0. 05）. Compared with the control group,score of VAS,Lund-Kennedy scale and nasal secretion of IL-6,IL-8 were statistically lower in the observation group after the treatment（ all P 0. 05）. During the treatment,there＇s no severe case of adverse reaction,and the occurrence rates of adverse reactions in the two groups were statistically same（ P 0. 05）. Conclusion Combined treatment of macrolides with glucocorticoid was effective for chronic sinusitis,which could significantly increase curative efficacy,improve symptoms and alleviate inflammatory reaction with minor adverse reactions.

关 键 词：慢性鼻窦炎 大环内酯类药物 糖皮质激素 IL - 6 8 

分 类 号：R765.41[医药卫生—耳鼻咽喉科]