Norès Jean-Marc, Avan Paul, Bonfils Pierre
Department of Otolaryngology, Head and Neck Surgery, European Hospital Georges Pompidou, 25 rue Leblanc, 75015 Paris, France.
Rhinology. 2003 Jun;41(2):97-102.
The management of nasal polyps is undoubtedly a controversial subject. The medical treatment remains the undisputed therapeutic mainstay but most of the publications are aimed at the registration of new molecules from the pharmaceutical industry which explains why they are confined to a single agent.
The aim of this study is focused on the evaluation of a dual modality on a series of 152 subjects treated according to a standardized protocol combining a short-term administration of prednisolone and the daily intranasal spraying of beclomethasone.
Over the follow-up period of one year, this modality proved to be successful in 68.5% of the subjects; only 31.5% had to undergo surgery after its failure. In the former group, after a six months period, the average symptom reduction reached an improvement rate varying from 35 to 80%, according to the symptom type. During the ensuing six months follow-up period, the improvement was maintained. The average utilization of prednisolone and beclomethasone was assessed for each individual patient.
Management of nasal polyps should be primarily medical. Resorting to surgical procedures should not be envisaged before a six months trial of dual steroid therapy under strict compliance to treatment.
鼻息肉的治疗无疑是一个有争议的话题。药物治疗仍然是无可争议的主要治疗方法，但大多数出版物旨在记录制药行业的新分子，这就解释了为什么它们局限于单一药物。
本研究的目的是评估一种双模式疗法，该疗法应用于152名按照标准化方案治疗的受试者，该方案结合了短期服用泼尼松龙和每日鼻内喷洒倍氯米松。
在一年的随访期内，这种疗法在68.5%的受试者中取得了成功；只有31.5%的受试者在治疗失败后不得不接受手术。在前一组中，六个月后，根据症状类型，平均症状减轻率达到35%至80%的改善率。在随后的六个月随访期内，改善情况得以维持。对每位患者的泼尼松龙和倍氯米松的平均使用量进行了评估。
鼻息肉的治疗应以药物治疗为主。在严格遵守治疗的情况下，在进行为期六个月的双激素治疗试验之前，不应考虑采用手术治疗。
