Section of Otolaryngology, Department of Neuroscience and Sensory Organs, University of Bari, Bari, Italy.
Int Forum Allergy Rhinol. 2013 Oct;3(10):807-13. doi: 10.1002/alr.21193. Epub 2013 Jun 25.
Rhinitis is an extremely common medical problem characterized by nasal congestion, clear rhinorrhea, sneezing, and itching. Hyaluronate is an endogenous compound that has an important role in mucociliary clearance by the epithelial surface of the nasal passages and in mucosal surface healing and repair. The objective of this work was to determine the effects of intranasal administration of sodium hyaluronate on nasal cytology in patients with allergic and nonallergic rhinitis.
In a single-center, randomized, blinded trial, 78 patients received intranasal mometasone and oral desloratadine plus either intranasal sodium hyaluronate or saline for 1 month. Nasal cytology was performed and the change from baseline in the numbers of neutrophils, eosinophils, mast cells, lymphocytes, and infective species was determined. Other outcomes included changes in symptoms and the endoscopic appearance of the nasal mucosa, and tolerability.
Patients receiving sodium hyaluronate experienced a significant decrease in the median neutrophil count seen on nasal cytology compared with controls (p = 0.001). Sodium hyaluronate was associated with significant improvements in sneezing, rhinorrhea, and nasal congestion, and on exudate seen on endoscopy at 1 month compared with baseline. Intranasal sodium hyaluronate received better tolerability scores than saline over the 1-month treatment period.
The addition of sodium hyaluronate to intranasal corticosteroid and systemic antihistamine reduced the neutrophil count seen on nasal cytology in patients with allergic and nonallergic rhinitis and improved several clinical and endoscopic parameters while being well tolerated. These data provide encouraging evidence of the efficacy of sodium hyaluronate in the treatment of this common disease.
鼻炎是一种极为常见的医学问题，其特征为鼻塞、流清涕、打喷嚏和瘙痒。透明质酸钠是一种内源性化合物，在鼻腔上皮表面的黏液纤毛清除以及黏膜表面愈合和修复方面具有重要作用。本研究旨在确定鼻内给予透明质酸钠对变应性和非变应性鼻炎患者鼻细胞学的影响。
在一项单中心、随机、双盲试验中，78 例患者接受鼻内莫米松和口服地氯雷他定治疗，同时加用鼻内透明质酸钠或生理盐水，疗程 1 个月。进行鼻细胞学检查，并确定中性粒细胞、嗜酸性粒细胞、肥大细胞、淋巴细胞和感染性物种数量与基线相比的变化。其他结局包括症状和鼻黏膜内镜表现的变化以及耐受性。
与对照组相比，接受透明质酸钠治疗的患者鼻细胞学检查中中性粒细胞计数的中位数显著降低（p = 0.001）。与基线相比，在 1 个月时，透明质酸钠治疗组打喷嚏、流涕和鼻塞以及内镜下渗出显著改善。在 1 个月的治疗期间，鼻内透明质酸钠的耐受性评分优于生理盐水。
在鼻内皮质类固醇和全身抗组胺药中加入透明质酸钠可降低变应性和非变应性鼻炎患者鼻细胞学检查中所见的中性粒细胞计数，并改善多项临床和内镜参数，同时具有良好的耐受性。这些数据为透明质酸钠治疗这种常见疾病的疗效提供了令人鼓舞的证据。
