Jazi Seyed Mostafa Hashemi, Barati Behrouz, Kheradmand Azadeh
Associate Professor, Department of Otorhinolaryngology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2011 Dec;16(12):1590-7.
The aim of this study was to compare the efficacy of azithromycin vs. fluticasone in treatment of adenotonsillar hypertrophy (AH).
In a clinical trial, 39 AH patients were selected using a convenient time-based sequential sampling method. The subjects were randomized into two treatment groups. Patients in group A (fluticasone) and B (azithromycin) were respectively treated with fluticasone spray and azithromycin suspension for a 6-week period. Data regarding the grade of obstruction (based on tonsillar size), level of adenotonsillar hypertrophy, and obstructive sleep apnea (OSA) symptoms (including mouth breathing, snoring, hyponasal speech, and sleep apnea) were collected by a self-administrated questionnaire before treatment, as well as 1 week and 8 weeks after treatment.
Twenty AH patients in group A and 19 AH patients in group B were studied. AH related symptoms, including mouth breathing, snoring, hyponasal speech and sleep apnea, improved significantly in both groups (p < 0.05). We also found a statistically significant reduced grade of obstruction among patients in both groups. However, fluticasone was not effective on adenotonsillar hypertrophy. One week after treatment, outcomes related to apnea and hyponasal speech were better in group B than group A. Decreases in mouth breathing and snoring were not significantly different between group A and B.
It could explain that though both of the improved and mentioned symptoms comparing within initial status, Azithromycin seems to be more effective than fluticasone in improving AH-related symptoms. Short term efficacy of the antibiotic is much significant than its long term effect.
本研究旨在比较阿奇霉素与氟替卡松治疗腺样体扁桃体肥大（AH）的疗效。
在一项临床试验中，采用基于时间的便利序贯抽样方法选取39例AH患者。将受试者随机分为两个治疗组。A组（氟替卡松）和B组（阿奇霉素）的患者分别接受氟替卡松喷雾剂和阿奇霉素混悬液治疗6周。在治疗前、治疗后1周和8周，通过自填问卷收集有关阻塞程度（基于扁桃体大小）、腺样体扁桃体肥大程度和阻塞性睡眠呼吸暂停（OSA）症状（包括口呼吸、打鼾、鼻通气不足语音和睡眠呼吸暂停）的数据。
研究了A组的20例AH患者和B组的19例AH患者。两组中与AH相关的症状，包括口呼吸、打鼾、鼻通气不足语音和睡眠呼吸暂停，均有显著改善（p<0.05）。我们还发现两组患者的阻塞程度在统计学上均显著降低。然而，氟替卡松对腺样体扁桃体肥大无效。治疗1周后，B组与呼吸暂停和鼻通气不足语音相关的结果优于A组。A组和B组在口呼吸和打鼾方面的改善没有显著差异。
这可以解释为，尽管与初始状态相比，两种药物都改善了上述症状，但阿奇霉素在改善与AH相关的症状方面似乎比氟替卡松更有效。抗生素的短期疗效比长期疗效更显著。
