克拉霉素强化治疗用于慢性鼻窦炎患者的临床观察  

Clinical Observation of Clarithromycin Intensive Therapy for Patients with Chronic Rhinosinusitis

作　　者：李震[1] 张瑞桐[1] 苏光春 王莹 周成[1] 刘永刚[2] LI Zhen ZHANG Ruitong SU Guangchun WANG Ying ZHOU Cheng LIU Yonggang(PIVAS, Nanyang Central Hospital, Henan Nanyang 473000, China Dept. of E.N.T, Nanyang Central Hospital, Henan Nanyang 473000, China)

机构地区：[1]南阳市中心医院静脉用药调配中心,河南南阳473000 [2]南阳市中心医院耳鼻喉科,河南南阳473000

出　　处：《中国药房》2017年第30期4212-4215,共4页China Pharmacy

摘　　要：目的:探讨克拉霉素强化治疗用于慢性鼻窦炎患者的疗效、安全性及对血清炎性细胞因子的影响。方法:186例慢性鼻窦炎患者随机分为对照1组(62例)、对照2组(62例)和观察组(62例)。对照1组患者口服阿莫西林克拉维酸钾片(7∶1)0.457 g,每日3次;对照2组患者口服克拉霉素分散片0.25 g,每日1次;观察组患者口服克拉霉素分散片第1周0.5 g,每日2次,第2周0.25g,每日2次。各组患者疗程均为2周。观察各组患者的临床疗效和治疗前后各临床症状评分、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、超敏C反应蛋白(hs-CRP)水平及不良反应发生情况。结果:总有效率观察组(93.55%)>对照2组(80.65%)>对照1组(65.51%),差异均有统计学意义(P<0.05)。治疗前,各组患者各临床症状评分、TNF-α、IL-6、hs-CRP水平比较,差异均无统计学意义(P>0.05);治疗后,各组患者各临床症状评分、TNF-α、IL-6、hs-CRP水平均显著低于同组治疗前,且观察组<对照2组<对照1组,差异均有统计学意义(P<0.05)。观察组、对照2组患者不良反应发生率均显著低于对照1组,差异均有统计学意义(P<0.05),但观察组与对照2组间比较,差异无统计学意义(P>0.05)。结论:克拉霉素强化治疗用于慢性鼻窦炎的疗效显著,可改善患者的临床症状,降低血清炎性细胞因子水平,且未增加不良反应的发生。OBJECTIVE： To investigate therapeutic efficacy and safety of clarithromycin intensive therapy on patients with chronic rhinosinusitis and its effects on serum inflammatory cytokines. METHODS： A total of 186 patients with chronic rhinosinusitis were randomly divided into control group 1 （62 cases）, control group 2 （62 cases） and observation group （62 cases）. Control group 1 was given Amoxicillin and clavulanate potassium tablet （7：1 ） 0.457 g, 3 times a day. Control group 2 was given Clarithro- mycin dispersible tablet 0.25 g orally, once a day. Observation group was given Clarithromycin dispersible tablet 0.5 g orally on the first week, twice a day, 0.25 g at the second week, twice a day. Both groups were treated for 2 weeks. Clinical efficacies of 3 groups were observed. Clinical symptom score, TNF-α, IL-6 and hs-CRP before and after treatment as well as the occurrence of ADR were observed. RESULTS： Total response rate was in descending order： observation group （93.55%）〉control group 2 （80.65%） 〉control group 1 （65.51%）, with statistical significance （P〈0.05）. Before treatment, there was no statistical significance in clinical symptom score, the levels of TNF-α, IL-6 and hs-CRP among 3 groups （P〉0.05）. After treatment, clinical symptom score, the levels of TNF-α, IL-6 and hs-CRP were significantly lower than before treatment; those indexes of 3 groups were in ascending order： observation group〈control group 2〈control group 1, with statistical significance （P〈0.05）. The incidence of ADR in observation group and control groups were significantly lower than control group 1, with statistical significance （P〈0.05）. There was no statistical significance between observation group and control group 2 （P〉0.05）. CONCLUSIONS： Clarithromycin intensive therapy shows significant therapeutic efficacy for chronic rhinosinusitis, improves clinical symptoms of patients and reduces the level of serum inflammatory factor without increasing the occurr

关 键 词：慢性鼻窦炎 克拉霉素 强化治疗 炎性细胞因子 疗效 安全性 

分 类 号：R765.41[医药卫生—耳鼻咽喉科]