难治性变应性鼻炎患者血清维生素D水平及应用维生素D钙咀嚼片治疗的价值  

Refractory allergic rhinitis serum levels of vitamin D and vitamin D calcium chewable therapeutic value

作　　者：陈斌[1] 刘业海[1] 里晓红[1] 马燕[1] 吴静[1] 李亦凡[1] 张亮[1] 杨清[1] 姚长玉[1] 

机构地区：[1]安徽医科大学第一附属医院耳鼻咽喉头颈外科变态反应科,合肥230022

出　　处：《临床耳鼻咽喉头颈外科杂志》2016年第17期1397-1401,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：2014年高等教育振兴计划人才项目基金

摘　　要：目的:了解成人难治性变应性鼻炎(AR)血清1,25-二羟维生素D3的水平,观察维生素D钙咀嚼片在该类患者应用过程中的临床疗效。方法:以2014-05-2015-11期间收治的60例成人难治性中重度AR患者为实验组,所有患者在治疗前皆检测血清1,25-二羟维生素D3的含量,随机分为实验组和对照组,每组各30例;同时选取60例健康人作为健康对照组。对照组联合使用丙酸氟替卡松鼻喷雾剂和左西替利嗪;实验组在对照组的基础上加用维生素D钙咀嚼片,分别于治疗前及治疗2周、4周后用视觉模拟量表(VAS)对总体症状及鼻部分类症状进行临床疗效评定。结果:血清1,25-二羟维生素D3的含量60例AR患者为(17.46±4.94)μg/L,健康对照组为(21.70±7.32)μg/L,2组比较差异有统计学意义(P<0.05)。与治疗前相比,实验组及对照组VAS评分均呈明显下降趋势,均差异有统计学意义(P<0.05)。治疗后第4周,实验组各项VAS评分均低于对照组,均差异有统计学意义(P<0.05)。结论:血清1,25-二羟维生素D3缺乏是难治性AR患者中普遍存在的现象,维生素D钙咀嚼片是辅助治疗AR安全、有效、简便的方法之一,应大力推广。Objective：To survey clinical efficacy of vitamin D calcium chewable tablets in the treatment of adults with refractory allergic rhinitis and investigate the level of 1,25-dihydroxyvitamin D3 in the patients＇serum. Method ： Sixty cases who were dignosed with adult refractory moderate to severe allergic in our hospital outpatient were admitted in our study from May 2014 to November 2015. Sixty cases of healthy people in our hospital medical center were selected as the control group, serum 1,25-dihydroxyvitamin D3 were detected in all patients and normal controls before the treatment. The control group were treated using fluticasone propionate nasal spray and left cetirizine while the experimental group were added with vitamin D calcium chewable tablets on the basis of the control group. Before treatment and after 2 or4 weeks of treatment, a visual analog scale of the overall classification of nasal symptoms were used of and clinical symptoms evaluation. Result： Compared with healthy controls, the incidence of serum 1, 25-dihydroxy vitamin D3 content is： （17.46±4.94）μg/L and the difference was statistically significant（P〈0.05）. The symptom scores of the treatment group and control group were significantly decreased before treatment and the difference had statistical signifieance（P〈0.05）. After four weeks of treatment, the experimental group of the symptom scores were lower than that of control group. The differences were statistically significant（P^0.05）. Conclusion：Serum 1, 25-dihydroxyvitamin D3 deficiency is a widespread phenonmenon in refractory allergic rhinitis . Vitamin D calcium chewable tables adjuvant treatment of allergic rhinitis is one of methods with safe , effective, and simple treatment.

关 键 词：维生素D 鼻炎 变应性 药物治疗 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]