CAJ | 학술논문

目的观察单独应用局部糖皮质激素治疗中国人慢性鼻-鼻窦炎(chronic rhinosinusitis,CRS)的疗效.方法随机选取2010年11月至2011年12月就诊于中山大学附属第一医院耳鼻咽喉科,未经治疗的CRS伴或不伴鼻息肉患者34例.使用鼻腔局部喷布地奈德规律治疗3个月.以视觉模拟量表(visual analogue scale,VAS)评估治疗前及治疗后第1、2、3个月鼻部症状评分;以鼻腔鼻窦结局测试-20(sino-nasal outcome test-20,SNOT-20)评估治疗前后患者的生活质量;以Lund-Mackay CT评分评估治疗前后影像学的改变.采用SPSS 16.0软件进行统计学分析.结果 34例患者中,脱落4例.患者治疗前鼻塞、鼻漏、头痛、面部压迫感、总体症状的VAS评分分别为(4.84±3.15)、(6.03±2.93)、(1.68±2.66)、(2.04±2.97)、(6.00±2.75)分,治疗后第3个月分别为(2.26±2.27)、(1.96±2.23)、(0.42±0.95)、(0.58±1.42)、(2.71±1.90)分,差异有统计学意义(t值分别为4.386、6.740、2.445、2.980、6.989,P值均＜0.05);嗅觉下降或障碍治疗前后差异无统计学意义(t=0.902、P＞0.05).治疗后第1个月鼻塞、鼻漏、总体症状的VAS评分较治疗前差异有统计学意义(P值均＜0.05);而治疗后第1、2、3个月之间各种鼻部症状的VAS评分差异无统计学意义(P值均＞0.05).治疗后SNOT-20得分较治疗前差异有统计学意义(t=3.687,P＜0.01).从CT表现上评估总体治愈率为22.2％.结论局部糖皮质激素治疗中国人CRS有明确疗效,22.2％的患者能达到CT的痊愈,症状改善出现在第1个月.
목적 관찰단독응용국부당피질격소치료중국인만성비-비두염(chronic rhinosinusitis,CRS)적료효.방법 수궤선취2010년11월지2011년12월취진우중산대학부속제일의원이비인후과,미경치료적CRS반혹불반비식육환자34례.사용비강국부분포지내덕규률치료3개월.이시각모의량표(visual analogue scale,VAS)평고치료전급치료후제1、2、3개월비부증상평분;이비강비두결국측시-20(sino-nasal outcome test-20,SNOT-20)평고치료전후환자적생활질량;이Lund-Mackay CT평분평고치료전후영상학적개변.채용SPSS 16.0연건진행통계학분석.결과 34례환자중,탈락4례.환자치료전비새、비루、두통、면부압박감、총체증상적VAS평분분별위(4.84±3.15)、(6.03±2.93)、(1.68±2.66)、(2.04±2.97)、(6.00±2.75)분,치료후제3개월분별위(2.26±2.27)、(1.96±2.23)、(0.42±0.95)、(0.58±1.42)、(2.71±1.90)분,차이유통계학의의(t치분별위4.386、6.740、2.445、2.980、6.989,P치균＜0.05);후각하강혹장애치료전후차이무통계학의의(t=0.902、P＞0.05).치료후제1개월비새、비루、총체증상적VAS평분교치료전차이유통계학의의(P치균＜0.05);이치료후제1、2、3개월지간각충비부증상적VAS평분차이무통계학의의(P치균＞0.05).치료후SNOT-20득분교치료전차이유통계학의의(t=3.687,P＜0.01).종CT표현상평고총체치유솔위22.2％.결론 국부당피질격소치료중국인CRS유명학료효,22.2％적환자능체도CT적전유,증상개선출현재제1개월.
Objective This study was focused on the clinical effects of topical steroid for chronic rhinosinusitis (CRS) in Chinese adults.Methods The CRS patients were randomly selected in the department of otorhinolaryngology,first affiliated hospital of Sun Yat-sen university between november 2010 and December 2011.Thirty-four CRS patients with polyps (CRSwNP) or CRS without polyps (CRSsNP),no prior surgeries were included.These patients were prescribed to use budesonide nasal spay for three months.Evaluation included visual analog score (VAS),sino-nasal outcome test-20(SNOT-20),CT scan (Lund-Mackay score).SPSS 16.0 software was used to analyze the data.Results Four patients were lost to follow up,while the other 30 patients finished the 3-months' follow up.Except for smelling disturbance which was not statistically changed (t =0.902,P＞0.05),VAS for nasal blockage(baseline:4.84 ±3.15,after treatment:2.26 ± 2.27),rhinorrhea (baseline:6.03 ± 2.93,after treatment:1.96 ± 2.23),headache(baseline:1.68 ± 2.66,after treatment:0.42±0.95),facial pressure (baseline:2.04 ± 2.97,after treatment:0.58 ± 1.42) and general symptom(baseline:6.00 ±2.75,after treatment:2.71 ± 1.90)were statistically decreased(t value was 4.386,6.740,2.445,2.980,6.989,respectively,all P＜0.05).VAS of nasal blockage,rhinorrhea and general symptom were statistically decreased after one-month's treatment(all P ＜0.05),but no statistical improvements were observed between first,second and the third month(all P＞0.05).SNOT-20 was significantly decreased after treatment (t=3.687,P ＜ 0.01).22.2％patients were cured on CT scan.Conclusions Topical steroid improves objective symptoms and quality of life in CRS patients.Some of the patients can be cured in CT scores.The symptoms improvements begin from the first month,but do not change during the latter two months.