Andrews Charles P, Martin Bruce G, Jacobs Robert L, Mohar Dale E, Diaz Joseph D, Amar Niran J, Kaiser Harold B, Vandewalker Mark L, Bernstein Jonathan, Toler William T, Prillaman Barbara A, Dalal Anand A, Lee Laurie A, Philpot Edward E
Diagnostics Research Group, San Antonio, Texas, USA.
Allergy Asthma Proc. 2009 Mar-Apr;30(2):128-38. doi: 10.2500/aap.2009.30.3204.
Nasal symptoms of allergic rhinitis are an important cause of sleep disturbance. Reduction of nasal symptoms, particularly nasal obstruction, has been linked to improvements in self-reported sleep quality. The enhanced-affinity intranasal corticosteroid fluticasone furoate and the oral antihistamine fexofenadine were compared with respect to nighttime symptoms of seasonal allergic rhinitis. In two randomized, double-blind, double-dummy, parallel-group studies, patients received fluticasone furoate nasal spray (FFNS),110 microg (study 1, n = 312; study 2, n = 224); fexofenadine, 180 mg (study 1, n = 311; study 2, n = 227); or placebo (study 1, n = 313; study 2, n = 229) once daily for 2 weeks. Fluticasone furoate was more effective (p < 0.001) than fexofenadine and placebo in both studies with respect to the mean changes from baseline over the treatment period in the nighttime symptoms score, nighttime reflective total nasal symptom score, predose instantaneous nasal symptom score, and morning peak nasal inspiratory flow. Fluticasone furoate was more effective than placebo (p <or= 0.001) in study 1 and more effective than both placebo and fexofenadine (p <or= 0.034) in study 2 with respect to the mean changes from baseline in the nighttime reflective total ocular symptom score and predose instantaneous total ocular symptom score. In these double-dummy studies, fexofenadine did not separate from placebo in comparisons of the nighttime symptoms score or the nighttime nasal or ocular symptom measures. The incidence of adverse events was similar among groups. FFNS once daily was more effective than fexofenadine and placebo with respect to nighttime sleep disturbance caused by seasonal allergy symptoms.
过敏性鼻炎的鼻部症状是睡眠障碍的一个重要原因。鼻部症状的减轻,尤其是鼻塞的减轻,与自我报告的睡眠质量改善有关。对增强亲和力的鼻用皮质类固醇糠酸氟替卡松和口服抗组胺药非索非那定在季节性过敏性鼻炎夜间症状方面进行了比较。在两项随机、双盲、双模拟、平行组研究中,患者接受糠酸氟替卡松鼻喷雾剂(FFNS),110微克(研究1,n = 312;研究2,n = 224);非索非那定,180毫克(研究1,n = 311;研究2,n = 227);或安慰剂(研究1,n = 313;研究2,n = 229),每日一次,共2周。在两项研究中,糠酸氟替卡松在治疗期间夜间症状评分、夜间反射性总鼻部症状评分、给药前即时鼻部症状评分和早晨最大鼻吸气流量方面相对于基线的平均变化上比非索非那定和安慰剂更有效(p < 0.001)。在夜间反射性总眼部症状评分和给药前即时总眼部症状评分相对于基线的平均变化方面,糠酸氟替卡松在研究1中比安慰剂更有效(p≤0.001),在研究2中比安慰剂和非索非那定都更有效(p≤0.034)。在这些双模拟研究中,在夜间症状评分或夜间鼻部或眼部症状测量的比较中,非索非那定与安慰剂没有差异。各组不良事件的发生率相似。每日一次的FFNS在由季节性过敏症状引起的夜间睡眠障碍方面比非索非那定和安慰剂更有效。