CAJ | 학술논문

目的评价克拉霉素联合鼻渊舒口服液治疗慢性鼻-鼻窦炎(CRS)的疗效.方法采用前瞻、随机、对照的临床试验方式将56例不伴鼻息肉CRS患者分为两组.对照组28例给予克拉霉素片0.25 g,次/d,连续口服3个月;治疗组28例在对照组基础上给予鼻渊舒口服液,前1个月10 ml,2次/d,后2个月10 ml,1次/d.两组的每位患者在治疗开始前均给予7～ 10日包括两种抗生素联用的综合强化治疗.采用鼻窦CT(Lund-Mackey)评分和视觉模拟量表(VAS)评分评定疗效.结果 56例患者中5例脱落,均按治疗无效病例处理.治疗组、对照组治疗后鼻窦CT得分分别为(3.28±2.11)分和(3.50±1.95)分,显著低于治疗前的(7.32±1.63)分和(7.07±1.74)分,治疗前后比较差异均有统计学意义(配对t检验,P＜ 0.01),均明显改善.两组鼻窦CT得分组间比较差异无统计学意义(t=0.394,P＞0.05).治疗组、对照组治疗后VAS总体影响得分分别为(2.39±2.13)分和(3.86±1.37)分,显著低于治疗前的(6.21±0.92)分和(6.14±0.85)分,治疗前后比较差异均有统计学意义(配对t检验,P＜ 0.01),均明显改善.两组的单项症状流涕、鼻塞、头面部痛的VAS得分治疗前、后比较差异也都有统计学意义(配对t检验,P＜0.01).组间比较:治疗后除流涕症状VAS得分两组差异无统计学意义外,总体影响及鼻塞、头面部痛VAS得分差异均有统计学意义,治疗组主观症状改善明显好于对照组.结论 3个月小剂量克拉霉素、鼻渊舒口服液联用和单用克拉霉素治疗不伴鼻息肉CRS都有效,但克拉霉素、鼻渊舒口服液联用疗效更好.治疗疗程开始前给予包括两种抗生素联用的短程综合强化措施对CRS抗炎治疗有益.
목적 평개극랍매소연합비연서구복액치료만성비-비두염(CRS)적료효.방법 채용전첨、수궤、대조적림상시험방식장56례불반비식육CRS환자분위량조.대조조28례급여극랍매소편0.25 g,차/d,련속구복3개월;치료조28례재대조조기출상급여비연서구복액,전1개월10 ml,2차/d,후2개월10 ml,1차/d.량조적매위환자재치료개시전균급여7～ 10일포괄량충항생소련용적종합강화치료.채용비두CT(Lund-Mackey)평분화시각모의량표(VAS)평분평정료효.결과 56례환자중5례탈락,균안치료무효병례처리.치료조、대조조치료후비두CT득분분별위(3.28±2.11)분화(3.50±1.95)분,현저저우치료전적(7.32±1.63)분화(7.07±1.74)분,치료전후비교차이균유통계학의의(배대t검험,P＜ 0.01),균명현개선.량조비두CT득분조간비교차이무통계학의의(t=0.394,P＞0.05).치료조、대조조치료후VAS총체영향득분분별위(2.39±2.13)분화(3.86±1.37)분,현저저우치료전적(6.21±0.92)분화(6.14±0.85)분,치료전후비교차이균유통계학의의(배대t검험,P＜ 0.01),균명현개선.량조적단항증상류체、비새、두면부통적VAS득분치료전、후비교차이야도유통계학의의(배대t검험,P＜0.01).조간비교:치료후제류체증상VAS득분량조차이무통계학의의외,총체영향급비새、두면부통VAS득분차이균유통계학의의,치료조주관증상개선명현호우대조조.결론 3개월소제량극랍매소、비연서구복액련용화단용극랍매소치료불반비식육CRS도유효,단극랍매소、비연서구복액련용료효경호.치료료정개시전급여포괄량충항생소련용적단정종합강화조시대CRS항염치료유익.
Objective To observe the clinical treatment effectiveness of clarithromycin combined with Biyuanshu Oral Liquid(BOL) for chronic rhinosinusitis without nasal polyps (CRSsNP).Methods 56 patients with CRSsNP were randomly assigned into two groups:28 patients with CRSsNP into a control group,administered with Clarithromycin 0.25 g once a day for three months,and the other 28 patients with CRSsNP into a treatment group,administered with BOL 10 ml twice a day for first month and once a day for the following two months in addition to the clarithromycin therapeutics.Before the therapeutics,each patient in both groups were administered with colligated strengthen treatment,including two kinds of antibiotics,for 7-10 days.The effects were evaluated by visual analogue scale (VAS) and Lund-Macksy CT mark system.Results Fifty-one patients completed 3-month follow-up but 5 patients withdrew due to different reasons.The treatment group and control group's CT scores after the treatment were (3.28±2.11) and (3.50±1.95) respectively,which were statistically lower than those before the treatment [(7.32±1.63) and (7.07±1.74)],with statistical differences (P＜ 0.01).There was no statistical difference in CT score between these two groups (t =0.394,P＞0.05).After the treatment,the general nasal symptom VAS scores of both groups were (2.39±2.13) and (3.86±1.37),respectively,which were statistically lower than those before the treatment [(6.21±0.92) and (6.14±0.85)],with statistical differences (P＜ 0.01).The VAS scores of individual symptom of rhinorrhea,blocked nose,and front-headache also significantly improved.There were significant differences in the VAS scores of both general nasal symptom and individual symptom of blocked nose and front-headache but rhinorrhea between these two groups.Conclusions Both long-term small dosage of clarithromycin combined with BOL and only clarithromycin for CRSsNP are effective,but clarithromycin combined with BOL is more effective.Besides,before the therapeutics,patients with CRSsNP can benefit from the colligated strengthen treatment,including two kinds of antibiotics,for 7-10 days.