Nielsen Lars P, Dahl Ronald
Department of Clinical Pharmacology, University of Aarhus, Aarhus, Denmark.
Am J Respir Med. 2003;2(1):55-65. doi: 10.1007/BF03256639.
For several years there has been discussion of whether first-line pharmacological treatment of allergic rhinitis should be antihistamines or intranasal corticosteroids. No well documented, clinically relevant differences seem to exist for individual nonsedating antihistamines in the treatment of allergic rhinitis. Likewise, the current body of literature does not seem to favor any specific intranasal corticosteroid. When comparing efficacy of antihistamines and intranasal corticosteroids in allergic rhinitis, present data favor intranasal corticosteroids. Interestingly, data do not support antihistamines as superior in treating conjunctivitis associated with allergic rhinitis. Safety data from comparative studies in allergic rhinitis do not indicate differences between antihistamines and intranasal corticosteroids. Combining antihistamines and intranasal corticosteroids in the treatment of allergic rhinitis does not provide additional beneficial effects to intranasal corticosteroids alone. Considering present data, intranasal corticosteroids seem to offer superior relief in allergic rhinitis, when compared with antihistamines.
关于过敏性鼻炎的一线药物治疗应该是使用抗组胺药还是鼻内用糖皮质激素，已经讨论了数年。对于各种非镇静性抗组胺药在治疗过敏性鼻炎方面，似乎不存在充分记录的、临床相关的差异。同样，目前的文献资料似乎也不支持任何一种特定的鼻内用糖皮质激素。在比较抗组胺药和鼻内用糖皮质激素对过敏性鼻炎的疗效时，现有数据支持鼻内用糖皮质激素。有趣的是，数据并不支持抗组胺药在治疗与过敏性鼻炎相关的结膜炎方面更具优势。过敏性鼻炎比较研究的安全性数据并未表明抗组胺药和鼻内用糖皮质激素之间存在差异。在过敏性鼻炎治疗中联合使用抗组胺药和鼻内用糖皮质激素，相较于单独使用鼻内用糖皮质激素，并不会带来额外的益处。考虑到现有数据，与抗组胺药相比，鼻内用糖皮质激素似乎能在过敏性鼻炎中提供更有效的缓解。
