酪酸梭菌二联活菌胶囊辅助治疗变应性鼻炎的疗效观察  

Observation of the auxiliary curative effect of combined clostridium and bifidobacterium capsules,live in the treatment of allergic rhinitis

作　　者：乔燕[1] 刘涛[1] 张克军[1] 冯彦[1] 刘瑛[1] 李科婷 

机构地区：[1]山西医科大学第一医院耳鼻咽喉头颈外科,太原030001

出　　处：《临床耳鼻咽喉头颈外科杂志》2017年第17期1315-1321,共7页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:对比应用酪酸梭菌二联活菌胶囊(常乐康)等药物前后变应性鼻炎(AR)患者血清中IL-10、转化生长因子-β1(TGF-β1)、视觉模拟量表(VAS)评分及鼻结膜炎生活质量调查问卷(RQLQ)评分的变化,观察常乐康辅助治疗AR的疗效。方法:招募到符合条件的季节性中-重度AR患者,研究组20例,对照组20例;另取10例健康者为正常组。研究组给予常乐康加枸地氯雷他定片加糠酸莫米松鼻喷剂治疗(疗程2周),然后继续给予常乐康维持治疗6周,而停用其他2种药物。对照组给予枸地氯雷他定片加糠酸莫米松鼻喷剂治疗2周后退出临床实验。统计分析在治疗过程中患者症状评分、RQLQ评分及血清IL-10、TGF-β1的变化。结果:(1)治疗前正常组、研究组、对照组血清TGF-β1和IL-10水平总体差异有统计学意义(P<0.001),且研究组、对照组均显著低于正常组;(2)随着治疗时间的增加,研究组血清IL-10、TGF-β1水平逐渐升高,四分法眼部症状评分、VAS眼部症状评分、RQLQ总分逐渐降低;(3)对照组患者治疗2周后血清IL-10、TGF-β1均高于治疗前(P<0.001),症状评分、RQLQ总评分均低于治疗前(P<0.001);(4)治疗2周后研究组患者血清IL-10高于对照组(P<0.001);(5)治疗前AR患者血清IL-10、TGF-β1与各项症状评分、RQLQ总分之间无线性相关关系(P>0.05)。结论:(1)IL-10、TGF-β1可能参与了AR的发病;(2)常乐康可能对AR患者血清IL-10、TGF-β1的产生起促进作用;(3)AR患者在枸地氯雷他定和糠酸莫米松鼻喷剂治疗的基础上加用常乐康可能比常规的二者联合治疗更能促进血清IL-10的产生,但在症状及患者生活质量方面没有更明显的改善;(4)常乐康可能对AR患者眼部症状、总生活质量的改善有一定作用;(5)AR患者治疗前血清IL-10、TGF-β1水平可能与其症状、生活质量关联性较小,暂不能用血清IL-10、TGF-β1水平的高低来评估AR患者病情的严重程度。Objective：To observe the auxiliary curative effect of combined clostridium and bifidobacterium cap- sules, live（also called Changlekang） in the treatment of allergic rhinitis by comparing IL-10, transforming growth factor- β1 （TGF- β1）, the quality of life score and symptom score before and after oral Changlekang. Method： Twenty qualified patients in the study group and 20 qualified patients in the control group were enrolled. The study group was given changlekang, desloratadine citrate disodium tablets and mometasone furoate nasal spray for treat- ment. After 2 weeks of treatment, Changlekang was still given for maintenance therapy for 6 weeks, and no other two kinds of drugs. The control group was given the desloratadine citrate disodium tablets and mometasone furoate nasal spray for 2 weeks and then quited the clinical trials. The changes of symptom score, quality of life score, ser- um IL-10, serum TGF- β1 would be statistically analyzed during the treatment. Result： ①Before treatment, serum TGF-β1 and IL-10 of normal group was significantly different from the study group and the control group （P〈0. 001）, and the study group and the control group＇s were significantly lower than the normal group. ②With the in- crease of treatment time, serum IL-10, TGF-β1 levels of patients in the study group increased gradually. Four point method ocular symptoms score, VAS ocular symptoms score and total score of RQLQ decreased gradually;③ patients in the control group after 2 weeks＇treatment, serum IL-10, TGF-β1 was higher than that before treat- ment （P〈0. 001）, at the same time all symptom scores, total score of RQLQ were lower than those before treat- ment（P〈0. 001）. ④After 2 weeks＇treatment, patients in the study group, the serum IL-10 is higher than that of control group （P〈0. 001） ;⑤Before treatment serum IL-10, TGF-β1 of AR patients might have little correlation with symptom scores, total score of RQLQ on linear （P〈0.05）. Conclusion： ①serum IL-10,

关 键 词：鼻炎 变应性 益生菌 酪酸梭菌 白介素-10 转化生长因子-Β1 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]