泛福舒联合生理海水洗鼻液治疗儿童慢性鼻-鼻窦炎的临床研究  

Clinical study on Broncho-Vaxom combined with physiological seawater nasal wash in treating children with chronic rhinitis-rhinosinusitis

作　　者：王俭 尹希 蒋博 万光平 张慧[1] 李阳[1] 刘丹凤 冯小平 WANG Jian;YIN Xi;JIANG Bo;WAN Guangping;ZHANG Hui;LI Yang;LIU Danfeng;FENG Xiaoping(Department of Pediatrics,Meishan Hospital of West China Hospital of Sichuan University,Meishan,Sichuan,620010;Pharmacy Department,Meishan Hospital of West China Hospital of Sichuan University,Meishan,Sichuan,620010;Department of ENT,Meishan Hospital of West China Hospital of Sichuan University,Meishan,Sichuan,620010)

机构地区：[1]四川大学华西医院眉山医院儿科,四川眉山620010 [2]四川大学华西医院眉山医院药剂科,四川眉山620010 [3]四川大学华西医院眉山医院五官科,四川眉山620010

出　　处：《实用临床医药杂志》2024年第14期72-76,共5页Journal of Clinical Medicine in Practice

基　　金：2023年四川省眉山市指导性科技计划项目(2023KJZD012)。

摘　　要：目的评估泛福舒联合生理海水洗鼻液对儿童慢性鼻-鼻窦炎的疗效。方法选取儿童慢性鼻-鼻窦炎患者179例,随机分成观察组90例和对照组89例。观察组接受泛福舒胶囊口服治疗,每次剂量为3.5 mg,晨起空腹,每天1次,连续使用10 d,停药20 d为1个疗程,总共进行3个疗程;同时,进行生理海水洗鼻液清洗,每天早晚各1次,连续使用10 d,停用20 d为1个疗程,总共3个疗程。对照组进行生理海水洗鼻液清洗,方法同观察组。2组均接受抗过敏等对症治疗,当明显伴有炎症改变时,加用抗生素。治疗结束后,比较2组患儿临床总有效率;比较视觉模拟量表(VAS)和鼻内镜检查Lund-Kenndy量表评分前后变化,血清IgG、IgE和T淋巴亚群的变化,并行半年随访,比较患儿鼻-鼻窦炎的再发生率和平均发生次数(次/例)。结果观察组的临床总有效率为95.56%,高于对照组的86.52%;观察组VAS和Lund-Kenndy量表评分优于对照组;观察组患儿血清IgG增高,且高于对照组;观察组患儿血清IgE下降,且低于对照组;3个疗程后,观察组血CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平升高,CD8^(+)水平降低;治疗完成后的半年随访显示,观察组鼻-鼻窦炎的再发生率为17.05%,平均发生次数为0.28次/例,低于对照组;2组以上指标比较,差异均有统计学意义(P<0.05)。结论泛福舒联合生理海水洗鼻液可有效治疗儿童慢性鼻-鼻窦炎,增高血清IgG水平,降低血清IgE水平,优化T淋巴细胞亚群结构,提高机体抵抗力,改善过敏体质。半年随访结果显示,该治疗方式显著降低了鼻-鼻窦炎的再发生率和平均发生次数。Objective To evaluate the efficacy of Broncho-Vaxom combined with physiological sea water nasal wash in the treatment of chronic rhinitis-rhinosinusitis in children.Methods A total of 179 children with chronic rhinitis-rhinosinusitis were randomly divided into observation group of 90 cases and control group of 89 cases.The observation group received treatment of oral administration of Broncho-Vaxom capsules at a dose of 3.5 mg once daily on an empty stomach in the morning for 10 consecutive days,with a 20-day drug-free period as one course of treatment,for a total of 3 courses.Additionally,they underwent nasal irrigation with physiological sea water twice daily in the morning and evening,for 10 consecutive days,with a 20-day break as one course of treatment,for a total of 3 courses.The control group underwent nasal irrigation with physiological sea water using the same method of the observation group.Both groups received symptomatic treatment such as anti-allergy therapy,and antibiotics were added when there presented obvious inflammatory changes.After treatment,the clinical total effective rate was compared between the two groups.Changes in the scores of Visual Analogue Scale(VAS)and Lund-Kenndy scale for nasal endoscopy,as well as changes in serum IgG,IgE,and T lymphocyte subsets were also compared.A six-month follow-up was conducted to assess the recurrence rate and average number of episodes of rhinosinusitis(times per person).Results The clinical total effective rate in the observation group was significantly higher compared to that in the control group(95.56%versus 86.52%).The scores of VAS and Lund-Kenndy scale in the observation group were significantly better than those in the control group.Serum IgG levels in the observation group were increased and higher than those in the control group,while serum IgE level in the observation group was decreased and lower than that in the control group.After 3 courses of treatment,the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the blood of the observation group w

关 键 词：泛福舒 生理海水洗鼻液 儿童慢性鼻-鼻窦炎 疗效 

分 类 号：R765[医药卫生—耳鼻咽喉科] R720.5[医药卫生—临床医学] R453