Nakabayashi S, Suzuki N, Nakatsuka S, Ikeda K, Takasaka T, Inamura N
Department of Otolaryngology, Tohoku University School of Medicine, Sendai.
Nihon Jibiinkoka Gakkai Kaiho. 1996 Sep;99(9):1162-71. doi: 10.3950/jibiinkoka.99.1162.
It is well known that an initial treatment with several kinds of antiallergic medicines is useful for patients suffering from Japanese cedar pollinosis to reduce nasal symptoms during the pollen season. Also topical corticosteroids show a preventive effect as antiallergic medicines. In this study, the preventive effect of topical corticosteroids with antiallergic medicine as an initial treatment was evaluated during the 1995 cedar pollen season a season in which a high pollen count was anticipated. Twenty-five patients with cedar pollinosis were selected and divided into two groups. A and B, A topical corticosteroid (fluticasone propionate; Flunase) as well as antiallergic medicine (azelastin) were administered to patients in group A 4 weeks before the beginning of the pollen season. In group B, only antiallergic medicine was given at the same time as group A and a topical corticosteroid was administered after the appearance of the symptoms. Nasal symptoms and mucosal conditions of the nasal cavity were monitored throughout the pollen season. The inflammatory cells in the mucoepithelial layer of the nasal mucosa were also periodically evaluated by immunohistochemical staining. Nasal symptoms and mucosal conditions in group A were significantly improved compared with patients in group B. The infiltration of macrophages in the mucoepithelial layer of the nasal mucosa was strongly inhibited in group A. The numbers of mast cells and EG2-positive cells in group A were not significantly different from those in group B during the pollen season. According to these results, although not all inflammatory cells were inhibited, the initial treatment with Flunase aqueous nasal spray in addition to the conventional initial treatment with antiallergic medicine is very useful for reducing symptoms even in a season with a large amount of cedar pollen.
众所周知，对于患有日本雪松花粉症的患者，最初使用几种抗过敏药物进行治疗有助于在花粉季节减轻鼻部症状。局部用皮质类固醇作为抗过敏药物也显示出预防作用。在本研究中，评估了在1995年雪松花粉季节（预计花粉计数较高的季节），局部用皮质类固醇与抗过敏药物联合作为初始治疗的预防效果。选择了25名雪松花粉症患者并将其分为两组，A组和B组。在花粉季节开始前4周，对A组患者给予局部用皮质类固醇（丙酸氟替卡松；辅舒良）以及抗过敏药物（氮卓斯汀）。在B组中，仅在与A组相同的时间给予抗过敏药物，并在症状出现后给予局部用皮质类固醇。在整个花粉季节监测鼻部症状和鼻腔黏膜状况。还通过免疫组织化学染色定期评估鼻黏膜黏液上皮层中的炎症细胞。与B组患者相比，A组的鼻部症状和黏膜状况有显著改善。A组鼻黏膜黏液上皮层中巨噬细胞的浸润受到强烈抑制。在花粉季节，A组中肥大细胞和EG2阳性细胞的数量与B组无显著差异。根据这些结果，尽管并非所有炎症细胞都受到抑制，但除了传统的抗过敏药物初始治疗外，使用辅舒良鼻喷雾剂进行初始治疗对于减轻症状非常有用，即使在雪松花粉量大的季节也是如此。
