Dabirmoghaddam Payman, Mehdizadeh Seraj Jalal, Bastaninejad Shahin, Meighani Ali, Mokhtari Zahra
Otorhinolaryngology Research Center, Department of Otolaryngology Head Neck Surgery, Tehran University of Medical Sciences, Tehran, Iran.
Acta Med Iran. 2013 Jul 13;51(6):359-64.
Although several treatments have been suggested for nasal polyposis, from medical to surgical, there is no standard guideline for the management of this disease. During recent years increasing attention has been directed toward the effects of macrolide antibiotics on chronic sinusitis and nasal polyposis. In this study, the efficacy of clarithromycin on severe nasal polyposis were examined. In a Prospective, before - after study, forty patients with severe nasal polyposis received clarithromycin 500 mg twice a day for 8 weeks. At the beginning and end of treatment, the severity of patients' symptoms (using subjective analogue scale), computed tomography (CT) scan and endoscopic findings were recorded. After treatment, the severity of nasal obstruction, smelling problems, Post Nasal Discharge and rhinorrhea decreased significantly (P<0.05). Furthermore, the degree of sinus opacification in CT scan and endoscopic findings showed significant improvement. Most patients completed their treatment course without significant side effects. Although a course of clarithromycin improved nasal symptoms, polyp size and CT findings, further studies with more patients are required to recommend this drug as a general treatment in nasal polyposis.
虽然针对鼻息肉已经提出了多种治疗方法，从药物治疗到手术治疗，但对于这种疾病的管理尚无标准指南。近年来，大环内酯类抗生素对慢性鼻窦炎和鼻息肉的影响受到了越来越多的关注。在本研究中，考察了克拉霉素对重度鼻息肉的疗效。在一项前瞻性前后对照研究中，40例重度鼻息肉患者每天两次服用500毫克克拉霉素，持续8周。在治疗开始和结束时，记录患者症状的严重程度（使用主观视觉模拟量表）、计算机断层扫描（CT）和内镜检查结果。治疗后，鼻塞、嗅觉问题、鼻后滴漏和流涕的严重程度显著降低（P<0.05）。此外，CT扫描中的鼻窦混浊程度和内镜检查结果显示有显著改善。大多数患者完成了治疗疗程，且无明显副作用。虽然克拉霉素疗程改善了鼻部症状、息肉大小和CT检查结果，但需要更多患者参与的进一步研究，才能推荐将这种药物作为鼻息肉的常规治疗方法。
