中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2009年
1期
16-20
,共5页
张华%陈璇%王惠妩%向阳冰
張華%陳璇%王惠嫵%嚮暘冰
장화%진선%왕혜무%향양빙
鼻炎%变应性%季节性%哮喘%糖皮质激素类%投药途径
鼻炎%變應性%季節性%哮喘%糖皮質激素類%投藥途徑
비염%변응성%계절성%효천%당피질격소류%투약도경
Rhinitis%allergic%seasonal%Asthma%Glucocorticoids%Drug administration routes
目的 观察比较局部应用糖皮质激素不同给药方式治疗季节性变应性鼻炎合并轻-中度哮喘患者的临床疗效.方法 分别采用鼻喷、口吸及鼻喷+口吸联合吸入糖皮质激素(布地奈德)治疗90例季节性变应性鼻炎合并轻-中度哮喘患者12周,观察治疗前后血清总IgE、嗜酸性粒细胞阳离子蛋白(eosinophil cationic protein,ECP)、白细胞介素5(interleukin-5,IL-5)水平、肺功能变化及鼻炎、哮喘记分.结果 三组患者治疗后血清总IgE、ECP、IL-5水平和鼻炎、哮喘记分均明显下降,组内治疗前后比较,差异均有统计学意义(P值均<0.05),组间治疗前后比较差异无统计学意义.鼻喷组治疗后肺功能各指标较治疗前虽有改善,但差异均无统计学意义(P值均>0.05).口吸组治疗前后第1秒用力呼气容积(forced expiratory volume in 1 second,FEV1)由(2.04±0.45)L提高到(2.47±0.54)L,FEV1/用力肺活量(forced vital capacity,FVC)比值由(72.73±5.59)%提高到(75.42±5.94)%;FEF25%-75%由1.69±0.52提高到2.06±0.77,差异均有统计学意义(P值均<0.05).联合治疗组治疗前后FEV1由(2.32±0.56)L提高到(2.76±0.58)L;FEV1/FVC由(73.80±4.17)%提高到(76.04±4.49)%;FEF25%-75%由2.09±0.45提高到2.34±0.64,差异均有统计学意义(P<0.05).治疗后三组间肺功能指标比较,FEV1差异有统计学意义(P=0.041),采用SNK-q法进行两两比较.认为鼻喷+口吸联合组治疗后FEV1与鼻喷组、口吸组比较差异有统计学意义(P<0.05).本组共失访9例.结论 局部应用糖皮质激素分别经鼻喷、口吸及鼻喷+口吸联合三种方法 治疗变应性鼻炎合并轻-中度哮喘患者,可以明显缓解鼻炎及哮喘症状,在症状记分和血清学检测方面没有明显差异.
目的 觀察比較跼部應用糖皮質激素不同給藥方式治療季節性變應性鼻炎閤併輕-中度哮喘患者的臨床療效.方法 分彆採用鼻噴、口吸及鼻噴+口吸聯閤吸入糖皮質激素(佈地奈德)治療90例季節性變應性鼻炎閤併輕-中度哮喘患者12週,觀察治療前後血清總IgE、嗜痠性粒細胞暘離子蛋白(eosinophil cationic protein,ECP)、白細胞介素5(interleukin-5,IL-5)水平、肺功能變化及鼻炎、哮喘記分.結果 三組患者治療後血清總IgE、ECP、IL-5水平和鼻炎、哮喘記分均明顯下降,組內治療前後比較,差異均有統計學意義(P值均<0.05),組間治療前後比較差異無統計學意義.鼻噴組治療後肺功能各指標較治療前雖有改善,但差異均無統計學意義(P值均>0.05).口吸組治療前後第1秒用力呼氣容積(forced expiratory volume in 1 second,FEV1)由(2.04±0.45)L提高到(2.47±0.54)L,FEV1/用力肺活量(forced vital capacity,FVC)比值由(72.73±5.59)%提高到(75.42±5.94)%;FEF25%-75%由1.69±0.52提高到2.06±0.77,差異均有統計學意義(P值均<0.05).聯閤治療組治療前後FEV1由(2.32±0.56)L提高到(2.76±0.58)L;FEV1/FVC由(73.80±4.17)%提高到(76.04±4.49)%;FEF25%-75%由2.09±0.45提高到2.34±0.64,差異均有統計學意義(P<0.05).治療後三組間肺功能指標比較,FEV1差異有統計學意義(P=0.041),採用SNK-q法進行兩兩比較.認為鼻噴+口吸聯閤組治療後FEV1與鼻噴組、口吸組比較差異有統計學意義(P<0.05).本組共失訪9例.結論 跼部應用糖皮質激素分彆經鼻噴、口吸及鼻噴+口吸聯閤三種方法 治療變應性鼻炎閤併輕-中度哮喘患者,可以明顯緩解鼻炎及哮喘癥狀,在癥狀記分和血清學檢測方麵沒有明顯差異.
목적 관찰비교국부응용당피질격소불동급약방식치료계절성변응성비염합병경-중도효천환자적림상료효.방법 분별채용비분、구흡급비분+구흡연합흡입당피질격소(포지내덕)치료90례계절성변응성비염합병경-중도효천환자12주,관찰치료전후혈청총IgE、기산성립세포양리자단백(eosinophil cationic protein,ECP)、백세포개소5(interleukin-5,IL-5)수평、폐공능변화급비염、효천기분.결과 삼조환자치료후혈청총IgE、ECP、IL-5수평화비염、효천기분균명현하강,조내치료전후비교,차이균유통계학의의(P치균<0.05),조간치료전후비교차이무통계학의의.비분조치료후폐공능각지표교치료전수유개선,단차이균무통계학의의(P치균>0.05).구흡조치료전후제1초용력호기용적(forced expiratory volume in 1 second,FEV1)유(2.04±0.45)L제고도(2.47±0.54)L,FEV1/용력폐활량(forced vital capacity,FVC)비치유(72.73±5.59)%제고도(75.42±5.94)%;FEF25%-75%유1.69±0.52제고도2.06±0.77,차이균유통계학의의(P치균<0.05).연합치료조치료전후FEV1유(2.32±0.56)L제고도(2.76±0.58)L;FEV1/FVC유(73.80±4.17)%제고도(76.04±4.49)%;FEF25%-75%유2.09±0.45제고도2.34±0.64,차이균유통계학의의(P<0.05).치료후삼조간폐공능지표비교,FEV1차이유통계학의의(P=0.041),채용SNK-q법진행량량비교.인위비분+구흡연합조치료후FEV1여비분조、구흡조비교차이유통계학의의(P<0.05).본조공실방9례.결론 국부응용당피질격소분별경비분、구흡급비분+구흡연합삼충방법 치료변응성비염합병경-중도효천환자,가이명현완해비염급효천증상,재증상기분화혈청학검측방면몰유명현차이.
Objective To observe the therapeutical effect on allergic rhinitis with asthma by different ways of inhaling orticosteroids. Methods Ninety patients suffering from allergic rhinitis with asthma were classified into three groups in random and treated with budesonide (BUD) by nasal spay, inhaling and nasal spay-inhaling combined administration for 12 weeks, respectively. The concentration of serum total IgE, osinophil cationic protein(ECP) and IL-5, pulmonary functions were examined before and after treatment. Results The provement of symptom scores of rhinitis and asthma in three groups were significant (P<0.05). The concentration of serum total IgE, ECP and IL-5 in three groups decreased greatly after treatment (P<0.05). There were significant improvement in FEV1, FEV1/FVC and FEF25%-75% in inhaling group before and after treatment (P<0.05): FEV1 from (2.04±0.45) L to (2.47±0.54)L, FEV1/FVC from (72.73±5.59)% to (75.42±5.94)% and FEF25%-75% from 1.69± 0.52 to 2.06±0.77. There was also significant improvement in nasal spay-inhaling combined groups before and after treatment (P<0.05): FEV1 from (2.32±0.56) L to (2.76±0.58) L, FEV1/FVC from (73.80±4.17)% to (76.04±4.49)% and FEF25%-75% from 2.09±0.45 to 2.34±0.64. The significant difference of FEV1 among the three treatment groups was observed (P=0.041). Conclusions The symptoms of rhinitis and asthma in three groups by three ways of inhaling BUD were greatly mproved, no significant difference in symptom scores and serum parameters was found.
