不同温度生理盐水鼻腔冲洗对变应性鼻炎的治疗作用
불동온도생리염수비강충세대변응성비염적치료작용
Treatment of allergic rhinitis with normal saline nasal irrigation at different temperature
  • 万方数据
    中华耳鼻咽喉头颈外科杂志 중화이비인후두경외과잡지
    CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
    2014年 2期 109-114 ,共6页

    蔺林%严文洪%赵霞

    린림%엄문홍%조하

    温度%氯化钠%等渗溶液%鼻炎,变应性,常年性%鼻炎,变应性,季节性%治疗结果%灌洗 溫度%氯化鈉%等滲溶液%鼻炎,變應性,常年性%鼻炎,變應性,季節性%治療結果%灌洗
    온도%록화납%등삼용액%비염,변응성,상년성%비염,변응성,계절성%치료결과%관세
    Temperature%Sodium chloride%Isotonic%Rhinitis,allergic,perennial%Rhinitis,allergic,seasonal%Treatment outcome%Irrigation
    目的 研究不同温度的生理盐水鼻腔冲洗对变应性鼻炎(allergic rhinitis,AR)的影响,探讨鼻腔冲洗的恰当温度.方法 将AR患者60例,以随机数字表法平均分为3组,分别以15 ℃C、25℃、40℃生理盐水进行鼻腔冲洗,健康对照组20例不予特殊干预.采用视觉模拟量表评分(visualanalogue scale,VAS)评估流涕、打喷嚏、鼻塞、鼻痒等鼻部症状的改变,采用酶联免疫吸附试验检测各组鼻腔冲洗液中组织胺、白三烯C4(leukotriene C4,LTC4)、屋尘螨D1特异性IgE(specific IgE,sIgE)和嗜酸粒细胞阳离子蛋白(eosinophil cationic protein,ECP)含量的改变.以GraphPad Prism 5统计软件进行数据分析.结果 15℃和25℃生理盐水鼻腔冲洗组流涕、打喷嚏、鼻塞、鼻痒等鼻部症状VAS评分、鼻腔冲洗液中组织胺、LTC4、屋尘螨D1 sIgE、ECP含量治疗前后差异无统计学意义(P值均＞0.05).40℃生理盐水鼻腔冲洗组治疗前打喷嚏、鼻塞VAS评分分别为(6.118±0.410)、(5.765±0.442)分,治疗后分别为(3.765±0.291)、(3.529±0.365)分,差异有统计学意义(t=4.678,P＜0.001;t =3.901,P＜O.01);鼻腔冲洗液中组织胺、LTC4含量治疗前分别为(21.78±0.62)、(17.43 0.67) ng/ml,治疗后分别为(18.82 ±0.52)、(13.14±0.59) ng/ml,差异有统计学意义(t =3.632,P＜0.001;t =4.79,P＜0.001);治疗前后流涕(t=2.02,P=0.051)、鼻痒(t=1.984,P=0.056)的VAS评分和鼻腔冲洗液中sIgE(t=1.891,P=0.066)、ECP(t=2.021,P=O.05)含量差异无统计学意义.40℃与25℃生理盐水鼻腔冲洗组相比,打喷嚏、鼻塞VAS评分差异有统计学意义(t=2.060,P=0.048;t=2.053,P=0.048);鼻腔冲洗液中组织胺、LTC4含量差异有统计学意义(t=2.078,P=0.045;t =2.149,P=0.038);而流涕、鼻痒VAS评分和鼻腔冲洗液中sIgE、ECP含量差异均无统计学意义(P值均＞0.05).结论 40℃生理盐水鼻腔冲洗可以明显改善患者打喷嚏和鼻塞症状,可以明显降低患者鼻腔炎性反应因子组织胺和LTC4的含量,是恰当的冲洗温度.
    목적 연구불동온도적생리염수비강충세대변응성비염(allergic rhinitis,AR)적영향,탐토비강충세적흡당온도.방법 장AR환자60례,이수궤수자표법평균분위3조,분별이15 ℃C、25℃、40℃생리염수진행비강충세,건강대조조20례불여특수간예.채용시각모의량표평분(visualanalogue scale,VAS)평고류체、타분체、비새、비양등비부증상적개변,채용매련면역흡부시험검측각조비강충세액중조직알、백삼희C4(leukotriene C4,LTC4)、옥진만D1특이성IgE(specific IgE,sIgE)화기산립세포양리자단백(eosinophil cationic protein,ECP)함량적개변.이GraphPad Prism 5통계연건진행수거분석.결과 15℃화25℃생리염수비강충세조류체、타분체、비새、비양등비부증상VAS평분、비강충세액중조직알、LTC4、옥진만D1 sIgE、ECP함량치료전후차이무통계학의의(P치균＞0.05).40℃생리염수비강충세조치료전타분체、비새VAS평분분별위(6.118±0.410)、(5.765±0.442)분,치료후분별위(3.765±0.291)、(3.529±0.365)분,차이유통계학의의(t=4.678,P＜0.001;t =3.901,P＜O.01);비강충세액중조직알、LTC4함량치료전분별위(21.78±0.62)、(17.43 0.67) ng/ml,치료후분별위(18.82 ±0.52)、(13.14±0.59) ng/ml,차이유통계학의의(t =3.632,P＜0.001;t =4.79,P＜0.001);치료전후류체(t=2.02,P=0.051)、비양(t=1.984,P=0.056)적VAS평분화비강충세액중sIgE(t=1.891,P=0.066)、ECP(t=2.021,P=O.05)함량차이무통계학의의.40℃여25℃생리염수비강충세조상비,타분체、비새VAS평분차이유통계학의의(t=2.060,P=0.048;t=2.053,P=0.048);비강충세액중조직알、LTC4함량차이유통계학의의(t=2.078,P=0.045;t =2.149,P=0.038);이류체、비양VAS평분화비강충세액중sIgE、ECP함량차이균무통계학의의(P치균＞0.05).결론 40℃생리염수비강충세가이명현개선환자타분체화비새증상,가이명현강저환자비강염성반응인자조직알화LTC4적함량,시흡당적충세온도.
    Objective To investigate the influence of normal saline nasal irrigation with different temperature on allergic rhinitis (AR) and to confirm the appropriate temperature of nasal irrigation.Methods Sixty patients with AR were randomly divided into 3 groups(according to random number table) and received 15 ℃,25 ℃ or 40 ℃ normal saline nasal irrigation respectively,and 20 healthy controls received no treatment.Visual analogue scale (VAS) was used to assess the symptoms among the control group and the various intervention groups and the enzyme linked immunosorbent assay (ELISA) was applied to detect the contents of histamine,leukotriene C4 (LTC4),house dust mite D1 specific IgE (sIgE) and eosinophil cationic protein (ECP) among the control group and the various intervention groups.GraphPad Prism 5 software was used to analyze the data.Results There was no statistical difference between 15 ℃ normal saline nasal irrigation group and 25 ℃ normal saline nasal irrigation group.Pre-intervention and postintervention whether in VAS scores of rhinorrhea,sneezing,nasal obstruction and nasal pruritis or in contents of histamine,LTC4,sIgE and ECP showed no difference (all P ＞ 0.05).However,the symptoms of sneezing (VAS score:6.118 ± 0.410) and nasal obstruction (VAS score:5.765 ± 0.442) were reduced (sneezing VAS score:3.765 ± 0.291 ; nasal obstruction VAS score:3.529 ± 0.365).The difference was significant (t =4.678,P ＜ 0.001 ; t =3.901,P ＜ 0.O1).The contents of histamine [(21.78 ± 0.62) ng/ ml] and LTC4 (17.43 ± 0.67 ng/ml) were also decreased after intervention of 40 ℃C normal saline nasal irrigation [histamine content:(18.82 ± 0.52) ng/ml; LTC4 content:(13.14 ± 0.59) ng/ml].The difference was significant (t =3.632,P ＜ 0.001 ; t =4.79,P ＜ 0.001).Nonetheless,there were no statistical differences in VAS scores of rhinorrhea (t =2.02,P =0.051) and nasal pruritis (t =1.984,P =0.056) and in contents of sIgE (t =1.891,P =0.066) and ECP (t =2.021,P=0.05).There were statistical differences between the 40 ℃ group and the 25 ℃ normal saline nasal irrigation group in symptoms of sneezing (t =2.060,P =0.048) and nasal obstruction (t =2.053,P =0.048) and inflammatory factors of histamine (t =2.078,P =O.045) and LTC4 (t =2.149,P =0.038).In symptoms of rhinorrhea and nasal pruritis and local production of sIgE and ECP,there was no statistical difference (all P ＞ 0.05).Conclusion 40 ℃ normal saline nasal irrigation can improve the symptoms of sneezing and nasal obstruction and can alleviate the local levels of inflammatory factors like histamine and LTC4 in AR patients,and is the appropriate irrigation temperature.
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