Eyibilen Ahmet, Aladağ Ibrahim, Güven Mehmet, Koç Sema, Gürbüzler Levent
Department of Otolaryngology, Medicine Faculty of Gaziosmanpaşa University, Tokat, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2009 Nov-Dec;19(6):289-93.
The aim of this study was to evaluate the effectiveness of nasal decongestants, oral decongestants and oral decongestant-antihistamines in the treatment of acute otitis media and resolution of the middle ear effusion in children.
355 ears of 318 children [160 boys (179 ears) and 158 girls (176 ears)] who were diagnosed to have acute otitis media and treated for it with different drug regimens were evaluated retrospectively regarding resolution of the middle ear fluid. 151 ears were treated with antibiotics and analgesics (group 1), 64 with antibiotics, topical decongestants and analgesics (group 2), 81 with antibiotics, oral decongestants and analgesics (group 3), and 59 with antibiotics, oral decongestant-antihistamine combinations and analgesics (group 4). The children with middle ear effusion were followed up for three months.
Group 1, 2, 3 and 4 had persistent middle ear effusion and the presence of middle ear effusion was 27.2%, 18.8%, 25.9%, 28.8% at the 1st month and 5.8%, 0%, 0% and 5.9% at the end of the 3rd month, respectively. At the end of the 3rd month, there was no significant difference between the groups regarding the resolution rates of the middle ear fluids in the antibiotic group and decongestants groups (p>0.05).
We do not recommend the use of decongestants and antihistamines in the treatment of acute otitis media as they do not change the natural course of the disease.
本研究旨在评估滴鼻减充血剂、口服减充血剂以及口服减充血剂 - 抗组胺药联合使用治疗儿童急性中耳炎及中耳积液消退的有效性。
回顾性评估318名诊断为急性中耳炎并接受不同药物治疗方案的儿童的355只耳朵（160名男孩[179只耳朵]和158名女孩[176只耳朵]）中耳积液的消退情况。151只耳朵接受抗生素和镇痛药治疗（第1组），64只耳朵接受抗生素、局部减充血剂和镇痛药治疗（第2组），81只耳朵接受抗生素、口服减充血剂和镇痛药治疗（第3组），59只耳朵接受抗生素、口服减充血剂 - 抗组胺药联合制剂和镇痛药治疗（第4组）。对有中耳积液的儿童进行了三个月的随访。
第1、2、3和4组均存在持续性中耳积液，中耳积液在第1个月时的发生率分别为27.2%、18.8%、25.9%、28.8%，在第3个月末分别为5.8%、0%、0%和5.9%。在第3个月末，抗生素组和减充血剂组之间中耳积液消退率无显著差异（p>0.05）。
我们不建议在急性中耳炎治疗中使用减充血剂和抗组胺药，因为它们不会改变疾病的自然病程。
