长期低剂量克拉霉素联合鼻用激素治疗慢性鼻-鼻窦炎的疗效分析  

Efficacy Analysis of Long-term Low-dose Clarithromycin Joint Nasal Steroid in the Treatment of Chronic Rhino Sinusitis

作　　者：戴润芝[1] 李谨[1] 张群[1] 王丽欣[1] 张远芬[1] 

机构地区：[1]湖北医药学院附属人民医院耳鼻喉科,十堰442000

出　　处：《医学研究杂志》2015年第5期137-140,共4页Journal of Medical Research

摘　　要：目的探讨长期低剂量克拉霉素联合鼻用激素治疗慢性鼻一鼻窦炎的疗效。方法2010年2月～2012年8月笔者医院共收治慢性鼻-鼻窦炎患者112例，随机分为治疗组（联合用药组）与对照组（单纯用药组），其中治疗组65例，对照组47例。治疗组采用低剂量克拉霉素联合鼻用激素及鼻腔冲洗进行治疗，对照组则单纯采用鼻用激素及鼻腔冲洗进行治疗。评估指标包括视觉模拟量表评分（visual analogue scale，VAS）、鼻窦cT评分（Lund Mackay）及临床疗效。采用SPSS16．0软件进行统计学分析。结果治疗组患者鼻塞、流涕、头痛、嗅觉减退VAS评分均明显下降（P〈0．05），对照组患者只有鼻塞VAS评分明显下降（P〈0．05）；治疗组与对照组的总有效率分别为80％和51％，组间对比差异有统计学意义（P〈0．05）；治疗组的鼻窦CT评分较对照组改善，差异有统计学意义（P〈0．05）。结论长期低剂量克拉霉素联合鼻用激素疗效明显优于单用鼻用激素组，且费用经济、用药方便、不良反应发生率低，对慢性鼻一鼻窦炎有重要治疗价值，建议作为一线药物联合应用。Objective To assess the therapy effect of long - term low - dose elarithromyein joint nasal steroid in the treatment of chronic rhino sinusitis. Methods Totally 112 patients with chronic rhino sinusitis who were treated in our hospital from February 2010 to August 2012 were selected and randomly divided into the treatment group （65） and the control group（47）. The patients in the control group were treated by the long - term low - dose clarithromycin joint nasal steroid and nasal irrigation,while the patients in the treatment group were treated by the nasal steroid and nasal irrigation. Then the visual analogue scale, Lund Mackay and the therapeutic effect were evaluated. SPSS 16.0 software was used to analyze the data. Results The results were as follws： （1） The visual analogue scale score of rhinobyon, nasal mucus, headache and hyposmia in the treatment group significantly decreased（ P 〈 O. 05 ） ,while only the visual analogue scale score of rhinobyon in the control group significantly decreased（ P 〈 0.05 ）. （2） The total effective rate in the treatment group （80%） was significantly higher than the control group （51% ）. The difference was statistically significant （ P 〈 O. 05 ）. （ 3 ） About the Lund - Mackey sinus CT score, the treatment group was significantly lower than the control group,and the difference was also statistically signlfi- cant（P 〈 O. 05）. Conclusion The long - term low - dose clarithromycin joint nasal steroid is superior to nasal steroid in the total effec- tive rate in treatments of patients with chronic rhino sinusitis. It had convenient economic costs and low incidence of adverse reactions. Therefore it has great value for ehronic nasal - sinusitis therapy. We recommend it as a first - line drug combination.

关 键 词：慢性鼻-鼻窦炎 克拉霉素 鼻用激素 临床疗效 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]