缓冲高渗盐水鼻腔冲洗对有症状的儿童过敏性鼻炎的疗效：一项随机双盲研究。
Efficacy of buffered hypertonic saline nasal irrigation in children with symptomatic allergic rhinitis: a randomized double-blind study.
作者信息
Satdhabudha A, Poachanukoon O
机构信息
Division of Pulmonology, Department of Pediatrics, Thammasat University, Prathumthani, Thailand.
出版信息
Int J Pediatr Otorhinolaryngol. 2012 Apr;76(4):583-8. doi: 10.1016/j.ijporl.2012.01.022. Epub 2012 Feb 11.
BACKGROUND
Nasal irrigation has been used as an adjunctive therapy of allergic rhinitis (AR). Available evidence suggested that buffered hypertonic saline (BHS) is superior to buffer normal saline (BNS) for relief nasal symptoms.
OBJECTIVE
To evaluate the effectiveness of BHS nasal irrigation in the management of children with symptomatic AR.
DESIGN
This was a randomized, prospective, double-blind placebo-controlled study.
METHODS
The present study was a randomized prospective double-blind placebo-controlled study. Eighty-one children with symptomatic AR who had a total nasal symptom score (TNSS)≥4 were included in this study. Each participant was randomly treated with either normal saline (NSS) or BHS by a blinded investigator. Nasal saccharine clearance time (SCT) and TNSS were measured before and 10 min after nasal irrigation. Quality of life (QoL) was assessed using the questionnaire for Thai allergic rhinoconjunctivitis patients (Rcq-36). The 7-point Likert scale for satisfaction was also performed. All participants were assigned to perform nasal irrigation twice daily for the period of 4 weeks. During this period, they recorded TNSS, side effects and antihistamine use on daily diary card. A physical examination and subjective evaluation were performed at 2nd and 4th week visits, and daily diary cards were collected.
RESULTS
Patients with BHS were significantly improved in SCT (39.2% versus 15.5%, P=0.009) and TNSS (82.7% versus 69.3%, P=0.006) compared to the NSS group. However, at 2nd and 4th week both groups had improvement in TNSS and QoL compared to baseline visit. There was a significant improvement in mean QoL score in BHS group at 2nd week visit compared to NSS group (P=0.04) but not at the 4th week. Nasal congestion but not TNSS was significantly improved in the BHS group (P=0.04). Moreover, a decreased use of oral antihistamine was observed in BHS group (P=0.04). There were few complaints reported, and side effects were seen equally in both groups.
CONCLUSION
Nasal irrigation with BHS causes an improvement in SCT, TNSS and QoL compare to NS in children with symptomatic AR.
背景
鼻腔冲洗已被用作过敏性鼻炎（AR）的辅助治疗方法。现有证据表明，缓冲高渗盐水（BHS）在缓解鼻部症状方面优于缓冲生理盐水（BNS）。
目的
评估BHS鼻腔冲洗对有症状AR儿童的治疗效果。
设计
这是一项随机、前瞻性、双盲、安慰剂对照研究。
方法
本研究为随机前瞻性双盲安慰剂对照研究。纳入81名总鼻症状评分（TNSS）≥4的有症状AR儿童。由一名盲法研究者对每位参与者随机给予生理盐水（NSS）或BHS治疗。在鼻腔冲洗前及冲洗后10分钟测量鼻内糖精清除时间（SCT）和TNSS。使用泰国过敏性鼻结膜炎患者问卷（Rcq - 36）评估生活质量（QoL）。还采用7点李克特量表进行满意度调查。所有参与者被分配每天进行两次鼻腔冲洗，为期4周。在此期间，他们在每日日记卡上记录TNSS、副作用和抗组胺药使用情况。在第2周和第4周就诊时进行体格检查和主观评估，并收集每日日记卡。
结果
与NSS组相比，BHS组患者的SCT（39.2%对15.5%，P = 0.009）和TNSS（82.7%对69.3%，P = 0.006）有显著改善。然而，与基线就诊相比，在第2周和第4周两组的TNSS和QoL均有所改善。与NSS组相比（P = 0.04），BHS组在第2周就诊时平均QoL评分有显著改善，但在第4周时无显著差异。BHS组鼻充血（而非TNSS）有显著改善（P = 0.04）。此外，观察到BHS组口服抗组胺药的使用减少（P = 0.04）。报告的投诉较少，两组副作用出现情况相同。
结论
对于有症状的AR儿童，与生理盐水相比，BHS鼻腔冲洗可改善SCT、TNSS和QoL。
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