Saengpanich Supinda, deTineo Marcy, Naclerio Robert M, Baroody Fuad M
Section of Otolaryngology--Head and Neck Surgery, The Pritzker School of Medicine, The University of Chicago, Chicago, Ill, USA.
Arch Otolaryngol Head Neck Surg. 2003 May;129(5):557-62. doi: 10.1001/archotol.129.5.557.
To compare the effectiveness of an intranasal steroid treatment with that of the combination of a histamine1 receptor antagonist and a leukotriene D receptor antagonist in the treatment of seasonal allergic rhinitis.
A 2-week, parallel, randomized, double-blind, double-dummy study with rolling enrollment.
Tertiary care medical center. Subjects A total of 63 adults with a 2-year history of ragweed sensitivity in the Chicago, Ill, area and a positive skin-prick reaction to ragweed pollen. Intervention Subjects were randomized to receive either 100 micro g of fluticasone propionate aqueous nasal spray in each nostril or 10 mg of loratadine and 10 mg of montelukast sodium by mouth once daily in the evening for 2 weeks. At visits 1 and 2, subjects completed a quality-of-life questionnaire and underwent nasal lavage to determine total eosinophil count and eosinophil cationic protein (ECP) measurements. Daily symptom diaries were kept for 2 weeks.
Questionnaire answers, daily nasal symptom scores, eosinophil counts, and ECP levels.
Median total nasal symptom scores were lower in the fluticasone group (4.5 vs 6), but the difference was not statistically significant. The questionnaire answers showed dramatic improvement in overall and individual domains for both groups (P<.01 vs visit 1) with significantly greater reduction in nasal symptoms in the fluticasone group (P<.05). Eosinophil counts and ECP levels were significantly reduced in the fluticasone group.
Both treatments provided clinically meaningful responses, but the overall results favored fluticasone propionate.
比较鼻用类固醇治疗与组胺1受体拮抗剂和白三烯D受体拮抗剂联合治疗季节性变应性鼻炎的疗效。
一项为期2周的平行、随机、双盲、双模拟滚动入组研究。
三级医疗中心。
共有63名成年人，在伊利诺伊州芝加哥地区有2年豚草过敏史，且对豚草花粉皮肤点刺试验呈阳性。
受试者被随机分为两组，一组每天晚上每侧鼻孔使用100μg丙酸氟替卡松鼻喷雾剂，另一组每天晚上口服10mg氯雷他定和10mg孟鲁司特钠，为期2周。在第1次和第2次访视时，受试者完成生活质量问卷，并进行鼻腔灌洗以测定总嗜酸性粒细胞计数和嗜酸性粒细胞阳离子蛋白（ECP）水平。记录2周的每日症状日记。
问卷答案、每日鼻部症状评分、嗜酸性粒细胞计数和ECP水平。
氟替卡松组的鼻部症状总评分中位数较低（4.5对6），但差异无统计学意义。问卷答案显示两组在总体和各个领域均有显著改善（与第1次访视相比P<0.01），氟替卡松组的鼻部症状减轻更为显著（P<0.05）。氟替卡松组的嗜酸性粒细胞计数和ECP水平显著降低。
两种治疗方法均产生了具有临床意义的反应，但总体结果更倾向于丙酸氟替卡松。
