鼻喷激素与白三烯受体拮抗剂治疗儿童腺样体肥大临床观察比较  

Clinical observation on efficacy of nasal spray hormone and leukotriene receptor antagonist in the treatment of adenoidal hypertrophy in children

作　　者：袁轲[1] 白燕[1] 杨大志[1] 

机构地区：[1]重庆医科大学附属儿童医院耳鼻咽喉科,重庆400014

出　　处：《重庆医科大学学报》2015年第1期119-122,共4页Journal of Chongqing Medical University

基　　金：重庆市卫生局课题资助项目(编号:20142042)

摘　　要：目的:探讨并比较儿童腺样体肥大患者使用鼻喷激素或白三烯受体拮抗剂治疗的临床效果。方法:对我院2011年6月至2013年8月收治的160例腺样体肥大患儿,随机分为治疗组和对照组,治疗组分为鼻喷激素治疗组(雷诺考特)、白三烯受体拮抗剂治疗组(孟鲁司特钠)以及雷诺考特与孟鲁司特钠联用治疗组,每组患儿各40例,并观察临床症状指标评分及腺样体厚度/鼻咽腔宽度(Adenoido/Nasopharyngeal比值)的改变。结果:鼻喷激素治疗组患儿临床症状综合评分较对照组明显下降,分别为3.20±0.29、3.27±0.48及3.50±0.17,差异具有统计学意义(2组比较均P=0.000),腺样体厚度/鼻咽腔宽度比降至0.60以下;白三烯受体拮抗剂治疗组患儿临床症状综合评分较对照组明显下降,分别为3.49±0.45、3.61±0.32及3.41±0.39,差异具有统计学意义(两组比较均P=0.000),腺样体厚度/鼻咽腔宽度比降至0.71以下;联合治疗组患儿临床症状综合评分较对照组明显下降,分别为3.02±0.13、3.22±0.41及3.38±0.12,差异具有统计学意义(两组比较均P=0.000),腺样体厚度/鼻咽腔宽度比降至0.60以下;联合治疗组部分临床症状评分优于单独给药组(2组比较均P=0.000);联合治疗组改善腺样体体积疗效优于单独给药组(P分别为0.05、0.001及0.001)。结论:鼻喷激素(雷诺考特)与白三烯受体拮抗剂(孟鲁司特钠)能有效改善儿童腺样体肥大患者的临床症状,且联合治疗组疗效优于单独给药组。Objective：To investigate the efficacy of nasal spray hormone and leukotriene receptor antagonist in the treatment of adenoidal hypertrophy in children. Methods：From June 2011 to August 2013,160 adenoidal hypertrophy children were randomly divided to treatment group and control group. The treatment group was subdivided into nasal spray hormone group,leukotriene receptor antagonist group and combined treatment group. The changes in clinical symptom score and Adenoido/Nasopharyngeal（A/N） ratio were measured. Results：Clinical symptom score was decreased in nasal spray hormone group compared with that in control group,with statistical differences（P=0.000）;A/N ratio in nasal spray hormone group was reduced to lower than 0.60. Clinical symptom score was decreased in leukotriene receptor antagonist group compared with that in control group,with statistical differences（P=0.000）;A/N ratio in nasal spray hormone group was reduced to lower than 0.71. Clinical symptom score was decreased in combined treatment group compared with that in control group,with statistical differences（P=0.000）;A/N ratio in nasal spray hormone group was reduced to lower than 0.60. Clinical symptom score and efficacy was better in combined treatment group than in nasal spray hormone group and leukotriene receptor antagonist group（P=0.05,P=0.001,P=0.001）. Conclusion：Both nasal spray hormone（Rhinocort）and leukotriene receptor antagonist（Montelukast）are effective in improving symptoms in children with adenoid hypertrophy. The clinical efficacy of combined treatment is better than that of single-drug treatment.

关 键 词：儿童腺样体肥大 鼻喷激素 白三烯受体拮抗剂 

分 类 号：R76[医药卫生—耳鼻咽喉科]