糖皮质激素分别联合氯雷他定与孟鲁司特治疗持续性中重度变应性鼻炎的疗效比较  

Comparison of the efficacy of glucocorticoid combined with loratadine and montelukast respectively in the treatment of persistent moderate to severe allergic rhinitis

作　　者：方忠泓 陈伟龙[1] 陈声伟[1] 陈伟东[1] FANG Zhonghong;CHEN Weilong;CHEN Shengwei;CHEN Weidong(Department of Otolaryngology Head and Neck Surgery,Shantou Chenghai District People′s Hospital,Guangdong Province,Guangdong Province,Shantou 515800,China)

机构地区：[1]广东省汕头市澄海区人民医院耳鼻咽喉头颈外科,515800

出　　处：《临床合理用药杂志》2022年第22期35-38,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的比较糖皮质激素分别联合氯雷他定与孟鲁司特治疗持续性中重度变应性鼻炎的疗效。方法回顾性选取2018年3月—2019年3月在汕头市澄海区人民医院就诊的持续性中重度变应性鼻炎患者100例作为研究对象,按照治疗方法不同分为氯雷他定组(n=50)和孟鲁司特组(n=50)。氯雷他定组采用糖皮质激素联合氯雷他定治疗,孟鲁司特组采用糖皮质激素联合孟鲁司特治疗,2组患者均治疗2周。比较2组患者临床疗效、治疗前后各项症状(鼻阻、鼻痒、流涕、喷嚏)评分、总症状评分、血清特异性抗体IgE、鼻腔分泌物嗜酸粒细胞(EOS)阳性率及不良反应。结果治疗2周后,氯雷他定组与孟鲁司特组患者总有效率比较差异无统计学意义(90.00%vs.98.00%,χ^(2)=1.596,P=0.207);2组患者各项症状评分及总症状评分均较治疗前明显降低(P<0.01);孟鲁司特组患者鼻阻症状评分低于氯雷他定组(P<0.01),鼻痒、喷嚏症状评分高于氯雷他定组(P<0.01);2组患者流涕评分及总症状评分比较差异均无统计学意义(P>0.05);2组患者血清特异性抗体IgE及鼻腔分泌物EOS阳性率均低于治疗前(P<0.01),2组比较差异无统计学意义(P>0.05)。2组患者不良反应总发生率比较差异无统计学意义(2.00%vs.4.00%,χ^(2)=0.345,P=0.558)。结论糖皮质激素分别联合氯雷他定与孟鲁司特治疗持续性中重度变应性鼻炎的疗效均较好,糖皮质激素联合孟鲁司特缓解鼻阻效果略优,糖皮质激素联合氯雷他定更有利于缓解鼻痒及喷嚏症状,两种药物均可有效缓解持续性中重度变应性鼻炎患者的临床症状,降低血清特异性IgE及鼻腔分泌物EOS阳性率,且不良反应较少,应根据患者病情合理选择用药。Objective To compare the efficacy of glucocorticoid combined with loratadine and montelukast respectively in the treatment of persistent moderate to severe allergic rhinitis.Methods A total of 100 patients with persistent moderate to severe allergic rhinitis who were treated in Shantou Chenghai District People′s Hospital from March 2018 to March2019 were retrospectively selected as the research objects,and they were divided into loratadine group(n=50)and montelukast group(n=50)according to different treatment methods.The loratadine group was treated with glucocorticoid combined with loratadine,and the montelukast group was treated with glucocorticoid combined with montelukast,both groups were treated for 2 weeks.The clinical efficacy,symptom scores(nasal obstruction,nasal itching,runny nose,sneezing),total symptom score,serum specific antibody IgE,nasal secretion eosinophil(EOS)positive rate and adverse reactions were compared between the two groups before and after treatment.Results After 2 weeks of treatment,there was no significant difference in the total effective rate between the loratadine group and the montelukast group(90.00%vs.98.00%,χ^(2)=1.596,P=0.207).The symptom scores and total symptom scores of the two groups were lower than those before treatment(P<0.01);The nasal obstruction symptom scores of the montelukast group were lower than those of the loratadine group(P<0.01),the itching and sneezing symptom scores were higher than those in the loratadine group(P<0.01);There were no significant difference in the runny nose score and total symptom score between the two groups(P>0.05).The positive rates of serum specific antibody IgE and nasal secretions EOS in both groups were lower than those before treatment(P<0.01),and there were no significant difference between the two groups(P>0.05).There was no significant difference in the overall incidence of adverse reactions between the two groups(2.00%vs.4.00%,χ^(2)=0.345,P=0.558).Conclusion Glucocorticoids combined with loratadine and montelukast have good

关 键 词：变应性鼻炎 中重度 糖皮质激素 氯雷他定 孟鲁司特 治疗效果 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]