Juniper E F, Guyatt G H, O'Byrne P M, Viveiros M
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
J Allergy Clin Immunol. 1990 Sep;86(3 Pt 1):380-6. doi: 10.1016/s0091-6749(05)80101-0.
to determine the effect of alternative regimens of nasal steroid administration on symptoms and quality of life.
randomized, double-blind, parallel-group comparison.
sixty ragweed-sensitive adults recruited from participants of previous studies and through media advertising.
200 micrograms of aqueous beclomethasone diproprionate nasal spray, twice daily, from 1 week before until 1 week after the ragweed-pollen season (regular) or 100 micrograms of the spray, taken as required, up to 400 micrograms daily; troublesome nasal symptoms were treated, in both groups, by increasing the daily dose to 800 micrograms until symptoms were controlled. If this treatment was insufficient, 120 mg of terfenadine, daily, was added.
One subject in the "as required"-treated group withdrew with uncontrolled nasal symptoms. In the remaining subjects, sneezing, stuffy nose, and rhinorrhea, measured by a daily diary, were significantly better controlled in the regular-treated group (p less than 0.025). Impairment of quality of life, including sleep disturbance, nonhay fever symptoms, practical problems, and uncomfortable emotions were greater in the as required-treated group (p less than 0.001). Subjects in the regular-treated group required less additional terfenadine (0.27 tablets per subject versus 1.40; p = 0.022). Eye symptoms and eye-drop use were similar in the two treated groups.
In patients with seasonal allergic rhinitis, regular use of inhaled steroids results in fewer symptoms and better quality of life than when the spray is taken only as required.
确定鼻用类固醇替代给药方案对症状和生活质量的影响。
随机、双盲、平行组比较。
从先前研究的参与者中以及通过媒体广告招募的60名对豚草敏感的成年人。
在豚草花粉季节前1周直至花粉季节后1周，每天两次使用200微克丙酸倍氯米松水性鼻喷雾剂（常规组），或按需使用100微克该喷雾剂，每日剂量最高可达400微克；两组中，若出现令人烦恼的鼻部症状，则将每日剂量增加至800微克，直至症状得到控制。若此治疗不足，则每日加用120毫克特非那定。
“按需治疗”组中有1名受试者因鼻部症状未得到控制而退出。在其余受试者中，通过每日日记记录测量，常规治疗组的打喷嚏、鼻塞和流涕症状得到了显著更好的控制（p<0.025）。“按需治疗”组的生活质量受损情况，包括睡眠障碍、非花粉热症状、实际问题和不适情绪，更为严重（p<0.001）。常规治疗组的受试者需要的额外特非那定较少（每位受试者0.27片，而按需治疗组为1.40片；p = 0.022）。两组的眼部症状和滴眼液使用情况相似。
在季节性变应性鼻炎患者中，与仅按需使用鼻喷雾剂相比，规律使用吸入性类固醇可减少症状并改善生活质量。
