Bernstein D I, Creticos P S, Busse W W, Cohen R, Graft D F, Howland W C, Lumry W R, Pedinoff A J, Ratner P H, Lim J, Stokes A, McNally C
Division of Immunology, University of Cincinnati College of Medicine, OH 45267, USA.
J Allergy Clin Immunol. 1996 Mar;97(3):749-55. doi: 10.1016/s0091-6749(96)80151-5.
Few clinical trials have directly compared the efficacy of antihistamines with topical nasal corticosteroids.
The study was performed to compare the efficacy and safety of triamcinolone acetonide nasal spray at a dose of 110 micro g in each nostril once daily with 10 mg of oral astemizole once daily for the treatment of seasonal allergic rhinitis.
A multicenter, double-blind, parallel-group study was conducted in 239 patients who were randomized to receive either triamcinolone acetonide or astemizole. A 5-day, drug-free, lead-in period was followed by 4 weeks of double-blind treatment. One hundred four patients treated with triamcinolone acetonide and 105 patients treated with astemizole could be evaluated.
Overall, triamcinolone acetonide was more effective than astemizole in reducing total nasal symptoms, nasal stuffiness, nasal itching, and sneezing (p </= 0.01). Triamcinolone acetonide was superior to astemizole at weeks 1, 2, and 3 in reduction of the total nasal symptom score (p </= 0.0401) and in reduction of nasal stuffiness (p </= 0.05). Improvements in individual nasal symptoms (itching, postnasal drip, runny nose, and sneezing) were greater for triamcinolone acetonide at week 2 (p </= 0.01). Ocular symptoms improved from baseline in both groups. When pollen counts were correlated to mean nasal rhinitis scores, the triamcinolone acetonide group showed continued improvement from week 1 to week 2 in nasal symptoms when pollen counts were at their highest. During the same period, patients treated with astemizole failed to show improvement from week 1 to week 2. This study demonstrated that once daily administration of triamcinolone acetonide was more effective than astemizole for controlling nasal symptoms of seasonal allergic rhinitis, especially during the peak pollination period.
很少有临床试验直接比较抗组胺药与局部鼻用皮质类固醇的疗效。
本研究旨在比较每日每侧鼻孔110微克曲安奈德鼻喷雾剂与每日10毫克口服阿司咪唑治疗季节性变应性鼻炎的疗效和安全性。
对239例患者进行了一项多中心、双盲、平行组研究，这些患者被随机分为接受曲安奈德或阿司咪唑治疗。经过5天的无药导入期后，进行4周的双盲治疗。可以对104例接受曲安奈德治疗的患者和105例接受阿司咪唑治疗的患者进行评估。
总体而言，曲安奈德在减轻总鼻症状、鼻塞、鼻痒和打喷嚏方面比阿司咪唑更有效（p≤0.01）。在第1、2和3周，曲安奈德在降低总鼻症状评分（p≤0.0401）和减轻鼻塞方面优于阿司咪唑（p≤0.05）。在第2周，曲安奈德对个体鼻症状（瘙痒、鼻后滴漏、流涕和打喷嚏）的改善更大（p≤0.01）。两组的眼部症状均较基线有所改善。当花粉计数与平均鼻炎评分相关时，在花粉计数最高的第1周和第2周期间，曲安奈德组的鼻症状持续改善。同期，接受阿司咪唑治疗的患者在第1周和第2周未显示出改善。本研究表明，每日一次使用曲安奈德在控制季节性变应性鼻炎的鼻症状方面比阿司咪唑更有效，尤其是在授粉高峰期。
