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[关于慢性鼻息肉鼻窦炎的药物治疗问题]

[On the problem of medicamentous therapy of chronic polypous rhinosinusitis].

作者信息

Volkov A G, Trofimenko S L, Riabtseva O A, Bodzhokov A R

出版信息

Vestn Otorinolaringol. 2010(4):41-4.

Abstract

Chronic polypous rhinosinusitis (CPS) is currently regarded as a condition requiring medicamentous therapy rather than surgical treatment at the early stages. The choice of therapeutic modalities depends on pathogenetic mechanisms underlying formation of polyps. The International Consensus Conference on Nasal Polyposis (2006) and European documents EAACI - EP3OS (2007) recommend topical (endonasal) glucocorticoids, systemic antibiotics (long-term treatment with low doses of macrolides), antimycotic preparations, and other pharmaceuticals as the main medicinal products for the management of polypous rhinosinusitis (PR). Based on the concept of CPS as an immune-dependent condition, the authors developed the rationale for the use of immunomodulators in combination with etiotropic drugs (antiviral, antibacterial, and antimycotic) for the management of this disease. Advantages of Imunofan application (both local and systemic) during surgical intervention for the treatment of nasal polyps are discussed. It is concluded that combined medicamentous treatment restricts the growth and recurrence of nasal polyps.

摘要

慢性鼻息肉性鼻窦炎(CPS)目前被视为一种在早期阶段需要药物治疗而非手术治疗的病症。治疗方式的选择取决于息肉形成的发病机制。鼻息肉国际共识会议(2006年)和欧洲文件EAACI - EP3OS(2007年)推荐局部(鼻内)糖皮质激素、全身性抗生素(低剂量大环内酯类药物长期治疗)、抗真菌制剂以及其他药物作为治疗鼻息肉性鼻窦炎(PR)的主要药品。基于CPS是一种免疫依赖性病症的概念,作者阐述了将免疫调节剂与病因特异性药物(抗病毒、抗菌和抗真菌药物)联合用于治疗该疾病的基本原理。讨论了在手术干预治疗鼻息肉期间应用免疫增强剂(局部和全身)的优势。得出的结论是,联合药物治疗可限制鼻息肉的生长和复发。

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