氯雷他定联合氟尼缩松治疗嗜酸性粒细胞增多性非变应性鼻炎（NARES）有效性的对照研究。

A controlled study on the effectiveness of loratadine in combination with flunisolide in the treatment of nonallergic rhinitis with eosinophilia (NARES).

作者信息

Purello-D'Ambrosio F, Isola S, Ricciardi L, Gangemi S, Barresi L, Bagnato G F

机构信息

Scuola di Specializzazione in Allergologia ed Immunologia Clinica, University of Messina, Italy.

出版信息

Clin Exp Allergy. 1999 Aug;29(8):1143-7. doi: 10.1046/j.1365-2222.1999.00598.x.

DOI:10.1046/j.1365-2222.1999.00598.x

PMID:10457120

Abstract

BACKGROUND

Nonallergic rhinitis with eosinophilia (NARES), accounting for some 15% of perennial rhinitis, is a nasal disorder whose main features are eosinophil counts in nasal smear higher than 10% and negative IgE tests. The mainstay of treatment is topical corticosteroids.

OBJECTIVE

To evaluate the adjunctive effect of loratadine, a non-sedating antihistamine with anti-allergic activity, on nasal symptoms and eosinophil counts in nasal secretions in patients with NARES.

METHODS

Thirty patients with NARES were divided in two groups, half receiving flunisolide two 25 microg puffs per nostril morning and night plus loratadine 10 mg u.i.d. and half the same doses of flunisolide plus placebo, according to a double-blind fashion, for 3 weeks. The effectiveness of the treatment in the two groups was evaluated by comparing symptom scores and eosinophil counts, and safety was assessed by comparing the adverse effects.

RESULTS

The loratadine treated group had better results both in nasal symptoms, with a decrease in sneezing (P < 0.000001) and rhinorrhoea (P < 0.006), respectively, corresponding with 73.4% and 66.7% with respect to 46.6% and 26.7% in the control group, and in eosinophil counts which decreased by 20% compared with 14.3% in patients treated with placebo and flunisolide. As to safety, only nasal irritation in two patients, one in each group, was reported.

CONCLUSION

Loratadine improves the effectiveness of flunisolide in treatment of NARES with no change in safety, and with no sedation.

摘要

背景

嗜酸性粒细胞增多性非变应性鼻炎（NARES）约占常年性鼻炎的15%，是一种鼻腔疾病，其主要特征是鼻涂片嗜酸性粒细胞计数高于10%且IgE检测为阴性。治疗的主要方法是局部使用糖皮质激素。

目的

评估氯雷他定（一种具有抗过敏活性的非镇静性抗组胺药）对NARES患者鼻部症状和鼻分泌物中嗜酸性粒细胞计数的辅助作用。

方法

30例NARES患者分为两组，按照双盲方式，一组患者早晚每侧鼻孔各喷入25μg氟尼缩松，同时每日口服10mg氯雷他定；另一组患者给予相同剂量的氟尼缩松加安慰剂，治疗3周。通过比较症状评分和嗜酸性粒细胞计数评估两组治疗的有效性，通过比较不良反应评估安全性。

结果

氯雷他定治疗组在鼻部症状方面有更好的效果，打喷嚏次数减少（P<0.000001），流涕减少（P<0.006），分别为73.4%和66.7%，而对照组分别为46.6%和26.7%；在嗜酸性粒细胞计数方面，与接受安慰剂和氟尼缩松治疗的患者相比，氯雷他定治疗组下降了20%，而对照组下降了14.3%。至于安全性，仅报告两组各有1例患者出现鼻部刺激症状。