Jung Seon Min, Kwak Jin Hye, Kim Moo Keon, Tae Kyung, Cho Seok Hyun, Jeong Jin Hyeok
Department of Otolaryngology-Head & Neck Surgery, Hanyang University College of Medicine, Seoul 04763, Korea.
J Clin Med. 2022 May 10;11(10):2690. doi: 10.3390/jcm11102690.
Chronic rhinosinusitis with nasal polyps (CRSwNP) in asthmatic patients has a high recurrence rate even after surgery. For this reason, oral steroids are frequently used, but their long-term use may cause side effects. The purpose of this study is to investigate the long-term effects of budesonide nasal irrigation (BNI) in CRSwNP and asthma. An analysis of 33 patients with CRSwNP and well-controlled asthma, who performed BNI for more than 12 months, was performed. We compared oral steroid and antibiotic dosages as well as nasal endoscopy scores before, and every six months after, BNI. The six-month dosages of oral steroids and antibiotics prescribed were significantly decreased at all time points after BNI compared to before BNI. When the dosages were compared at the time point immediately preceding six months, oral steroid intake decreased significantly until 12 months, and antibiotic intake decreased until 6 months. Furthermore, the endoscopic score decreased significantly until 12 months. The nasal symptom questionnaire score also significantly improved after BNI. Therefore, BNI is considered an effective treatment method that can improve subjective symptoms and objective intranasal findings while reducing oral steroid and antibiotic doses after long-term use in patients with CRSwNP accompanied by asthma.
患有鼻息肉的慢性鼻窦炎（CRSwNP）患者即便接受手术后复发率仍很高。因此，口服类固醇药物经常被使用，但长期使用可能会产生副作用。本研究的目的是调查布地奈德鼻腔冲洗（BNI）对CRSwNP和哮喘的长期影响。对33例CRSwNP且哮喘病情得到良好控制、进行BNI超过12个月的患者进行了分析。我们比较了BNI前以及BNI后每六个月的口服类固醇和抗生素剂量以及鼻内镜评分。与BNI前相比，BNI后所有时间点的口服类固醇和抗生素的六个月处方剂量均显著降低。当比较紧接六个月前时间点的剂量时，口服类固醇摄入量直到12个月时显著下降，抗生素摄入量直到6个月时下降。此外，内镜评分直到12个月时显著降低。鼻症状问卷评分在BNI后也显著改善。因此，BNI被认为是一种有效的治疗方法，在伴有哮喘的CRSwNP患者长期使用后，可改善主观症状和鼻内客观表现，同时减少口服类固醇和抗生素剂量。
