Carlsen K H, Kramer J, Fagertun H E, Larsen S
Voksentoppen Children's Center for Asthma and Allergy, University Hospital, Oslo, Norway.
Allergy. 1993 Aug;48(6):431-6. doi: 10.1111/j.1398-9995.1993.tb00741.x.
The efficacy of loratadine and terfenadine in perennial allergic rhinitis was evaluated in a double-blind, selected cross-over study consisting of two phases. During the first phase, 76 patients with perennial allergic rhinitis, 8-67 years old, were included in the study. Of these, 41 patients received loratadine 10 mg daily, and 35 patients received terfenadine 60 mg twice daily, for 2 weeks. According to symptoms and side-effects, 32 patients were classified as responders to loratadine, and 28 patients as responders to terfenadine. All observed symptoms were significantly reduced in both treatment groups, but with no significant differences between the two groups. Side-effects were few and mild. In patients with normal IgE, loratadine was significantly superior to terfenadine in relieving nasal secretion, whereas terfenadine was significantly superior to loratadine in relieving nasal congestion. In patients with increased IgE, patients treated with loratadine showed significantly greater reduction in sneezing than patients treated with terfenadine. A positive correlation between total IgE and reduction in overall symptoms was found for patients treated with loratadine, whereas a negative correlation was found for patients treated with terfenadine. During the second study phase, the nonresponders received the other drug for 2 weeks. All seven nonresponders to terfenadine responded to loratadine after crossing over, whereas four of nine nonresponders to loratadine responded to terfenadine. Nonresponders to one drug may respond to the other drug. Thus, more than one antihistamine drug should be tried in perennial allergic rhinitis if the first fails.
在一项由两个阶段组成的双盲、选择性交叉研究中，评估了氯雷他定和特非那定治疗常年性变应性鼻炎的疗效。在第一阶段，76例年龄在8至67岁的常年性变应性鼻炎患者被纳入研究。其中，41例患者每日服用10毫克氯雷他定，35例患者每日两次服用60毫克特非那定，持续2周。根据症状和副作用，32例患者被归类为对氯雷他定有反应者，28例患者被归类为对特非那定有反应者。两个治疗组中所有观察到的症状均显著减轻，但两组之间无显著差异。副作用少且轻微。在IgE正常的患者中，氯雷他定在缓解鼻分泌物方面显著优于特非那定，而特非那定在缓解鼻塞方面显著优于氯雷他定。在IgE升高的患者中，服用氯雷他定的患者打喷嚏次数的减少显著大于服用特非那定的患者。发现服用氯雷他定的患者总IgE与总体症状减轻之间呈正相关，而服用特非那定的患者呈负相关。在第二个研究阶段，无反应者接受另一种药物治疗2周。所有7例对特非那定无反应者在交叉后对氯雷他定有反应，而9例对氯雷他定无反应者中有4例对特非那定有反应。对一种药物无反应者可能对另一种药物有反应。因此，如果第一种抗组胺药物治疗失败，在常年性变应性鼻炎中应尝试使用不止一种抗组胺药物。
