摘要
目的探讨38℃高渗盐水鼻腔冲洗联合糖皮质激素治疗变应性鼻炎(AR)疗效及对外周血嗜酸性粒细胞(Eos)、血清变应原特异性IgE(sIgE)水平的影响。方法回顾性分析该院行单纯糖皮质激素(布地奈德鼻喷雾剂)治疗(A组,n=60)、单纯38℃高渗盐水鼻腔冲洗(B组,n=60)治疗和同期行上述疗法联合(C组,n=60)治疗的AR患者的临床资料。比较3组患者临床疗效及不良反应发生情况差异,记录其治疗前后鼻腔冲洗液中白细胞介素-17A(IL-17A)、Eos及外周血Eos,血清sIgE阳性率差异,分析其治疗前后症状改善情况[鼻部总症状视觉模拟量表(Uni-VAS)]及生活质量改善情况[鼻结膜炎相关生活质量问卷(RQLQ)]评估结果差异。结果 C组治疗总有效率明显高于其他两组(P<0.05);A组和B组治疗总有效率比较差异无统计学意义(P>0.05)。3组不良反应发生率比较差异无统计学意义(P>0.05)。治疗4周时,3组鼻腔冲洗液IL-17A、鼻腔冲洗液Eos、血清sIgE及外周血Eos阳性率及Uni-VAS、RQLQ评估结果均较治疗前明显降低(均P<0.05),且C组明显低于其他两组(P<0.05);A组和B组比较差异则无统计学意义(P>0.05)。结论 38℃高渗盐水鼻腔冲洗联合糖皮质激素能有效提高AR患者临床疗效,有利于其预后恢复。
Objective To investigate the effect of nasal lavage with hypertonic saline at 38℃on allergic rhinitis(AR)treated with glucocorticoids,and the levels of peripheral blood eosinophils(Eos),serum allergen-specific IgE(sIgE)levels.Methods The clinical data of 60 AR patients treated with glucocorticoid alone(budesonide nasal spray,group A),60 AR patients treated with hypertonic saline at 38℃(group B)and 60 AR patients treated with hypertonic saline at 38℃and glucocorticoid(group C)was analyzed retrospectively.The clinical efficacy and adverse reactions of the three groups were compared.The positive rates of interleukin-17A(IL-17A),Eos in nasal lavage fluid,peripheral blood Eos and serum sIgE before and after treatment were recorded.The relief of symptoms[nasal universal visual analogue scale(Uni-VAS)]and improvement of life quality[rhinoconjunctivitis quality of life questionnaire(RQLQ)]were analyzed.Results The total effective rate of treatment in group C was significantly higher than that in the other two groups(P<0.05),but there was no significant difference between group A and group B(P>0.05).The incidence of adverse reactions showed no significant difference among the three groups(P>0.05).After 4 weeks of treatment,the positive rates of IL-17A and Eos in nasal lavage fluid,serum sIgE,peripheral blood Eos and evaluation results of Uni-VAS,RQLQ were significantly lower than those before treatment,and those were lower in group C than the other two groups(P<0.05).There was no significant difference between group A and group B(P>0.05).After 4 weeks of treatment,the scores of Uni-VAS and RQLQ in the three groups were significantly lower than those before treatment,group C was significantly lower than the other two groups(P<0.05),and there was no significant difference between group A and group B(P>0.05).Conclusion Nasal lavage with hypertonic saline at 38℃combined with glucocorticoids can effectively improve the clinical curative effect,and it is beneficial to the prognosis of AR patients.
作者
哈再古丽.贾汉
雍军
JIAHAN·Hazaiguli;YONG Jun(Department of Otolaryngology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang Uygur Autonomous Region 830000,China)
出处
《重庆医学》
CAS
2018年第30期3909-3912,共4页
Chongqing medicine
基金
新疆维吾尔自治区自然科学基金(H1301)
