Hughes K, Glass C, Ripchinski M, Gurevich F, Weaver T E, Lehman E, Fisher L H, Craig T J
College of Medicine, Hershey Medical Center, Hershey, PA, USA.
Allergy. 2003 May;58(5):380-5. doi: 10.1034/j.1398-9995.2003.00093.x.
Improving quality of life is considered to be a major endpoint and motivation for clinical intervention in patients with perennial allergic rhinitis (PAR). In addition to classical symptoms of congestion, pruritus, and rhinorrhea, patients will often complain of not being able to sleep well at night and of feeling fatigued during the day. Like sleep apnea, PAR has also been shown to cause sleep disturbance and consequently worsen daytime fatigue and somnolence.
It is proposed that by decreasing nasal obstruction due to allergic rhinitis by treating with the topical steroid budesonide, symptoms of daytime fatigue and somnolence can be improved.
Twenty-two subjects were enrolled in a double-blind, placebo-controlled, crossover study using Baalam's design. Patients were treated with either budesonide 128 g/day or placebo. Subjective data include the Epworth Sleepiness Scale, Functional Outcomes of Sleep Questionnaire, Rhino-conjunctivitis Quality of Life Questionnaire, and a daily diary recording nasal symptoms, sleep problems, and daytime fatigue.
The results illustrated that the topical nasal corticosteroid significantly improved daytime fatigue (P = 0.03), somnolence (P = 0.02), and quality of sleep (P = 0.05) compared to placebo in patients suffering from PAR.
Budesonide is able to improve congestion, sleep, and daytime somnolence.
改善生活质量被认为是常年性变应性鼻炎（PAR）患者临床干预的主要终点和动力。除了鼻塞、瘙痒和流涕等典型症状外，患者常抱怨夜间睡眠不好以及白天感到疲劳。与睡眠呼吸暂停一样，PAR也已被证明会导致睡眠障碍，进而加重白天的疲劳和嗜睡。
有人提出，通过使用局部类固醇布地奈德治疗来减轻变应性鼻炎引起 的鼻塞，可以改善白天疲劳和嗜睡的症状。
采用Baalam设计，22名受试者参与了一项双盲、安慰剂对照、交叉研究。患者分别接受每天128μg布地奈德或安慰剂治疗。主观数据包括爱泼华嗜睡量表、睡眠问卷功能结果、鼻结膜炎生活质量问卷，以及记录鼻部症状、睡眠问题和白天疲劳情况的每日日记。
结果表明，与安慰剂相比，局部鼻用皮质类固醇显著改善了PAR患者的白天疲劳（P = 0.03）、嗜睡（P = 0.02）和睡眠质量（P = 0.05）。
布地奈德能够改善鼻塞、睡眠和白天嗜睡情况。
