丙酸氟替卡松气雾剂对过敏性鼻炎患儿的临床研究  

Clinical trial of fluticasone propionate on children with allergic rhinitis

作　　者：谭君武[1] 廖勇[1] 彭洪[1] 李良波[1] 孙书菊[2] 於席芳 

机构地区：[1]湖北民族学院附属民大医院耳鼻咽喉头颈外科,湖北恩施445000 [2]湖北民族学院附属民大医院超声影像科,湖北恩施445000 [3]黄石市第一医院管理科,湖北黄石435001

出　　处：《中国临床药理学杂志》2017年第6期561-564,共4页The Chinese Journal of Clinical Pharmacology

基　　金：湖北省卫生厅科研一般基金资助项目(JX6B104)

摘　　要：目的观察丙酸氟替卡松气雾剂对过敏性鼻炎患儿的临床疗效及其对骨桥蛋白(OPN)、白细胞介素-4(IL-4)及白细胞介素-5(IL-5)表达的影响。方法将60例过敏性鼻炎患儿随机分为对照组和试验组,每组30例。对照组给予酮替芬1 mg,每天2次,口服;试验组给予丙酸氟替卡松气雾剂治疗,每次100μg,每天2次,2组均3个月为1个疗程,共治疗2个疗程。比较2组患儿的临床疗效,观察2组的白细胞介素(IL)-4、IL-5水平及OPN的免疫组化阳性染色的积分光密度值(IOD),并记录试验组治疗后的第1,3,6个月外周血中嗜酸性粒细胞,中性粒细胞,淋巴细胞计数。结果治疗后,试验组IL-4,IL-5,OPN水平分别为(66.31±18.00)ng·mL^(-1),(62.12±0.33)ng·mL^(-1),5589.71±267.00,对照组分别为(85.32±12.34)ng·mL^(-1),(30.24±0.30)ng·mL^(-1),(15.00±0.26)×10~3(P<0.05)。试验组治疗后的第6个月外周血中嗜酸性粒细胞、中性粒细胞和淋巴细胞计数分别为(0.21±0.01)×10~9/L、(0.10±0.01)×10~9/L、(0.14±0.01)×10~9/L。对照组治疗后第6个月外周血中嗜酸性粒细胞、中性粒细胞和淋巴细胞计数分别为(0.21±0.02)×10~9/L、(0.10±0.01)×10~9/L、(0.14±0.01)×10~9/L。与治疗后1个月相比,差异均有统计学意义(P<0.05),但2组差异无统计学意义(P>0.05)。试验组总有效率为93.33%(28/30例),对照组为36.67%(11/30例),差异有统计学意义(P<0.05)。试验组发生1例皮肤过敏,药物不良反应发生率为3.33%(1/30例);对照组发生皮肤过敏4例,鹅口疮3例,支气管痉挛伴哮喘3例,药物不良反应发生率为33.33%(10/30例,P<0.05)。结论丙酸氟替卡松气雾剂治疗儿童过敏性鼻炎有较显著的临床疗效。Objective To observe the clinical efficacy of fluticasone propionate aerosol in children with allergic rhinitis and its effect on osteopontin（OPN）,interleukin-4（IL-4） and interleukin-5（IL-5）expression.Methods Sixty children with allergic rhinitis were randomly divided into control group and treatment group,30 cases in each group.Control group was treated with ketotifen 1 mg,twice daily.The treatment group was treated with fluticasone propionate aerosol,100 μg each time,twice a day for 2 months.The levels of interleukin（IL）-4,IL-5 and integral optical density（IOD） of immunohistochemical staining of osteopontin in two groups were observed.The clinical effect and the number of eosinophils,neutrophils and lymphocytes in peripheral blood of 1,3,6 months after operation were observed.Results After treatment,the levels of IL-4,IL-5 and OPN in treatment group were（66.31 ± 18.00） ng · mL^-1,（62.12 ± 0.33）ng · mL^-1,5589.71 ± 267.00,had significant difference with those in control group,which were（85.32 ± 12.34）ng · mL^-1,（30.24 ± 0.30） ng · mL^-1 and（15.00 ±0.26） × 10^3（P〈0.05）.The number of eosinophils,neutrophils and lymphocytes in 6 month after treatment in treatment group were（0.21 ±0.01） × 10^9/L,（0.10 ±0.01） × 10^9/L,（0.14 ±0.01） × 10^9/L.The number of eosinophils,neutrophils and lymphocytes in control group at 6 months after treatment were（0.21 ±0.02） × 10^9/L,（0.10 ± 0.01） × 10^9/L,（0.14 ±0.01） × 10^9/L respectively,all had significant difference with those in 1 month after treatment（P〈0.05）,with no significant between the two groups（P〉0.05）.The total effective rate was 93.33%（28/30 cases） in treatment group and 36.67%（11/30 cases） in control group（P〈0.05）.The incidence of adverse drug reaction in treatment group was 3.33%（1/30 cases）.In control group,there were 4 cases of skin allergy,3 cases of thrush,3 cases of bronchospasm with asthma,the incidence of adverse drug reactions was 33.33%（1

关 键 词：丙酸氟替卡松气雾剂 过敏性鼻炎 骨桥蛋白 白细胞介素-4 白细胞介素-5 

分 类 号：R974[医药卫生—药品]