Jia M H, Chen X Y, Zhang Y, Liao Z S
Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Mar 5;31(5):369-373. doi: 10.13201/j.issn.1001-1781.2017.05.010.
To evaluate the effect of nasal glucocorticoid combined with second-generation antihistamines or leukotriene receptor antagonists on the treatment of moderate severe allergic rhinitis, and explore the optimal scheme of personalized treatment for AR patients.Fiftyseven patients with persistent moderatesevere allergic rhinitis were randomly divided into three groups and treated by mometasone furoate aqueous nasal spray (group MOM), mometasone furoate aqueous nasal spray combined with loratadine (group MOM+L), mometasone furoate aqueous nasal spray combined with montelukast (group MOM+M) for 4 weeks. Four major clinical symptoms of allergic rhinitis: nasal congestion, nose itching, sneezing and runny nose were evaluated by "symptom rating score" before treatment and after treatment for 4 weeks.After treatment, the total nasal symptom scores of each group showed a decreasing tendency, and the differences between various time points were statistically significant (< 0.05). For the symptom of nasal congestion, the symptom score of MOM+M group was significantly lower than that of MOM group and MOM+L group at the 2nd and 4th week after treatment. For the symptoms of sneezing and nasal itching, MOM+L group had the lowest score at each time point after treatment and the difference was statistically significant compared with MOM group (< 0.05), but there was no significant difference between MOM group and MOM+M group (> 0.05). For the symptom of runny nose, the score of MOM+L group was significantly lower than MOM group (< 0.05) at the 1st and 2nd week, MOM+M group was significantly lower than MOM group (< 0.05) at the 2nd and 4th week, while there was no significant difference between MOM+L group and MOM+M group (> 0.05).Nasal glucocorticoid alone or combined with secondgeneration antihistamines or leukotriene receptor antagonists can effectively control nasal symptoms of moderatesevere allergic rhinitis, yet the effect of combination therapy is better. For nasal congestion, nasal glucocorticoid combined with leukotriene receptor antagonists have a better effect. For nasal itching and sneezing, the choice of nasal glucocorticoid combined with second-generation antihistamines may be more sensible. For runny nose, nasal glucocorticoid combined with second-generation antihistamines or leukotriene receptor antagonists have similar efficacy.
评估鼻用糖皮质激素联合第二代抗组胺药或白三烯受体拮抗剂治疗中重度过敏性鼻炎的效果，探索变应性鼻炎（AR）患者个性化治疗的最佳方案。将57例持续性中重度过敏性鼻炎患者随机分为三组，分别采用糠酸莫米松鼻喷雾剂（MOM组）、糠酸莫米松鼻喷雾剂联合氯雷他定（MOM + L组）、糠酸莫米松鼻喷雾剂联合孟鲁司特（MOM + M组）治疗4周。采用“症状评分”对过敏性鼻炎的四大临床症状：鼻塞、鼻痒、打喷嚏和流涕在治疗前及治疗4周后进行评估。治疗后，各组的总鼻症状评分均呈下降趋势，各时间点之间的差异具有统计学意义（<0.05）。对于鼻塞症状，MOM + M组在治疗后第2周和第4周的症状评分显著低于MOM组和MOM + L组。对于打喷嚏和鼻痒症状，MOM + L组在治疗后的各时间点评分最低，与MOM组相比差异具有统计学意义（<0.05），但MOM组和MOM + M组之间无显著差异（>0.05）。对于流涕症状，MOM + L组在第1周和第2周的评分显著低于MOM组（<0.05），MOM + M组在第2周和第4周的评分显著低于MOM组（<0.05），而MOM + L组和MOM + M组之间无显著差异（>0.05）。单独使用鼻用糖皮质激素或联合第二代抗组胺药或白三烯受体拮抗剂均可有效控制中重度过敏性鼻炎的鼻症状，但联合治疗效果更佳。对于鼻塞，鼻用糖皮质激素联合白三烯受体拮抗剂效果更好。对于鼻痒和打喷嚏，选择鼻用糖皮质激素联合第二代抗组胺药可能更明智。对于流涕，鼻用糖皮质激素联合第二代抗组胺药或白三烯受体拮抗剂疗效相似。
