Stewart Rosemary A, Ram Bhaskar, Hamilton Garun, Weiner John, Kane Kevin J
Department of Otolaryngology, Royal Victorian Eye & Ear Hospital, Melbourne, Australia.
Otolaryngol Head Neck Surg. 2008 Nov;139(5):682-7. doi: 10.1016/j.otohns.2008.07.010.
To examine the potential of montelukast, a leukotriene receptor antagonist, as an adjunct to oral and inhaled steroid in subjects with chronic nasal polyps.
Prospective, randomized controlled trial.
Thirty-eight consecutive adult patients with bilateral nasal polyps were randomized into two groups. Eighteen subjects were treated with oral prednisolone for 14 days and budenoside nasal spray for 8 weeks. Twenty subjects received similar treatment with additional oral montelukast for 8 weeks. Subjects completed a modified nasal ICSD symptom score at 8 and 12 weeks after beginning treatment and the SF-36 quality of life questionnaire at 12 weeks.
Symptom scores improved in both groups after treatment. Subjects treated with montelukast reported significantly less headache (P = 0.013), facial pain (P = 0.048) and sneezing (P = 0.03) than controls. Four weeks after completing treatment, no significant differences were recorded.
Montelukast therapy may have clinical benefit as an adjunct to oral and inhaled steroid in chronic nasal polyposis, but effects are not maintained after cessation of treatment.
研究白三烯受体拮抗剂孟鲁司特作为口服和吸入类固醇辅助药物治疗慢性鼻息肉患者的潜力。
前瞻性随机对照试验。
38例双侧鼻息肉成年患者连续入选并随机分为两组。18例患者接受口服泼尼松龙14天及布地奈德鼻喷雾剂治疗8周。20例患者在接受类似治疗的基础上，加用口服孟鲁司特治疗8周。患者在治疗开始后8周和12周完成改良鼻ICSD症状评分，并在12周时完成SF-36生活质量问卷。
两组治疗后症状评分均有改善。与对照组相比，孟鲁司特治疗组患者的头痛（P = 0.013）、面部疼痛（P = 0.048）和打喷嚏（P = 0.03）症状明显减轻。治疗结束4周后，未记录到显著差异。
孟鲁司特治疗作为口服和吸入类固醇的辅助治疗可能对慢性鼻息肉有临床益处，但停药后效果不能维持。
