Adhikari Prakash, Bhatta Rishi, Bhandari Sukmit, Pyakurel Bhatta Manita
Department of ENT and Head and Neck Surgery, TU Teaching Hospital, Kathmandu, Nepal.
Int J Pediatr Otorhinolaryngol. 2011 Apr;75(4):500-3. doi: 10.1016/j.ijporl.2011.01.004. Epub 2011 Feb 2.
This study was carried out with the objective of comparing clinical efficacy of 10% ichthammol glycerine (IG) pack with steroid-antibiotic pack for relieving pain in cases of acute otitis externa.
A prospective quasi-randomized clinical trial was completely carried out in 65 patients at Department of ENT and Head and Neck Surgery, TU Teaching Hospital, Kathmandu. Patients of less or equal to 12 years of age and both gender presenting in our outpatient department from October 2008 to December 2009 and diagnosed to have acute otitis externa was evaluated. Six patients were excluded from the study because of not meeting the inclusion criteria. Alternately IG and steroid antibiotic packing were done. For steroid antibiotic group, we use betnovate-N, a combination of betnovate sodium phosphate 0.1% and neomycin sulphate 0.5%. Before packing was carried out, pain was assessed using Wong Baker Scale. Statistical analysis was done using "Z" test of mean to compare average number of pain score and visits in two different groups.
There were 33 patients in IG pack group and 32 patients in steroid antibiotic group. In less than 4 years, there were 30 children and in more than 4 years children, there were 35 children. There was male predominance in both the treatment groups and disease was most common in age group less than 4 years. There was statistical significant decrease in number of visits in steroid group in both children less than and more than 4 years. There was also significantly less pain in children with steroid antibiotic group.
Use of steroid antibiotic pack in children presenting with acute otitis externa causes earlier relief of pain as well as significantly lesser number of visits. Thus, steroid antibiotic pack is better than 10% ichthammol glycerine packs in relieving pain in acute otitis externa in children.
本研究旨在比较10%鱼石脂甘油（IG）敷料与类固醇 - 抗生素敷料缓解急性外耳道炎疼痛的临床疗效。
在加德满都TU教学医院耳鼻喉头颈外科对65例患者进行了一项前瞻性半随机临床试验。对2008年10月至2009年12月在我们门诊就诊、年龄小于或等于12岁、男女均有且被诊断为急性外耳道炎的患者进行评估。6例患者因不符合纳入标准被排除在研究之外。交替进行IG和类固醇抗生素填塞。对于类固醇抗生素组，我们使用倍他米松新霉素（Betnovate-N），它是0.1%倍他米松磷酸钠和0.5%硫酸新霉素的组合。在进行填塞前，使用面部表情疼痛评分量表评估疼痛程度。使用均值“Z”检验进行统计分析，以比较两个不同组的平均疼痛评分和就诊次数。
IG敷料组有33例患者，类固醇抗生素组有32例患者。4岁以下有30名儿童，4岁以上有35名儿童。两个治疗组均以男性为主，该疾病在4岁以下年龄组最为常见。在4岁以下和4岁以上的儿童中，类固醇组的就诊次数均有统计学意义的显著减少。类固醇抗生素组的儿童疼痛也明显减轻。
对于患有急性外耳道炎的儿童，使用类固醇抗生素敷料可使疼痛更早缓解，就诊次数也显著减少。因此，在缓解儿童急性外耳道炎疼痛方面，类固醇抗生素敷料比10%鱼石脂甘油敷料更好。
