Lund V J, Flood J, Sykes A P, Richards D H
Institute of Laryngology and Otology, Royal National Throat, Nose and Ear Hospital, London, England.
Arch Otolaryngol Head Neck Surg. 1998 May;124(5):513-8. doi: 10.1001/archotol.124.5.513.
To investigate the effect of intranasal corticosteroids in the treatment of polyps in patients with severe polyposis listed for surgical treatment and to determine the treatment effect on the progression of the disease.
A double-blind, randomized, parallel-group, placebo-controlled, 12-week study at a single center.
A tertiary referral center in London, England.
Thirty-four patients with severe polyposis listed for endoscopic surgical treatment.
By random allocation, fluticasone propionate aqueous nasal spray (FPANS), 200 microg twice a day; beclomethasone dipropionate aqueous nasal spray, 200 microg twice a day; or placebo nasal spray twice a day was administered. Patients received 2 actuations to each nostril in the morning and in the evening.
Efficacy end points were the need for polypectomy at the end of treatment, the results of acoustic rhinometry, the polyp score, the peak nasal inspiratory flow rate, and an assessment of symptoms.
The polyp score was significantly decreased in the FPANS-treated group (P < or = .01). The nasal cavity volume was significantly increased in both the FPANS-treated group and the group receiving beclomethasone compared with placebo (P < or = .01) at the end of treatment. The percentage change in the mean morning peak nasal inspiratory flow rate was greater in the FPANS-treated group, with a significant effect observed at week 2 (P = .01). Nasal blockage was significantly decreased in both active groups compared with the group receiving placebo. No significant difference was observed between the treatment groups in the number of patients requiring polypectomy.
Fluticasone and beclomethasone aqueous nasal sprays are effective in treating the symptoms of severe nasal polyps. There was some evidence that the group treated with FPANS responded more quickly to intervention and that the magnitude of the response was greater than in the group receiving beclomethasone.
研究鼻内用皮质类固醇对列入手术治疗的重度息肉病患者息肉的治疗效果，并确定其对疾病进展的治疗作用。
在单一中心进行的一项双盲、随机、平行组、安慰剂对照的12周研究。
英国伦敦的一家三级转诊中心。
34例列入内镜手术治疗的重度息肉病患者。
通过随机分配，给予丙酸氟替卡松水鼻喷雾剂（FPANS），每日2次，每次200微克；二丙酸倍氯米松水鼻喷雾剂，每日2次，每次200微克；或安慰剂鼻喷雾剂，每日2次。患者早晚各向每个鼻孔喷2次。
疗效终点为治疗结束时息肉切除的必要性、鼻声反射测量结果、息肉评分、最大鼻腔吸气流量以及症状评估。
FPANS治疗组的息肉评分显著降低（P≤0.01）。治疗结束时，与安慰剂组相比，FPANS治疗组和接受倍氯米松治疗组的鼻腔容积均显著增加（P≤0.01）。FPANS治疗组平均早晨最大鼻腔吸气流量的百分比变化更大，在第2周观察到显著效果（P = 0.01）。与接受安慰剂的组相比，两个活性药物组的鼻塞均显著减轻。在需要息肉切除的患者数量上，各治疗组之间未观察到显著差异。
氟替卡松和倍氯米松水鼻喷雾剂对治疗重度鼻息肉症状有效。有证据表明，FPANS治疗组对干预的反应更快，且反应程度大于接受倍氯米松治疗的组。
