摘要
目的：比较鼻内糖皮质激素、白三烯受体拮抗剂和第2代口服抗组胺药对儿童变应性鼻炎（AR）症状评分和生活质量评分的改善作用，探讨鼻炎的个体化药物治疗方案。方法：将186例年龄6．14岁的中、重度持续性AR患儿，随机分入布地奈德（BUD）组、孟鲁司特（MON）组和氯雷他定（LORA）组。BUD组使用布地奈德鼻喷剂256μg／d，MON组每晚口服孟鲁司特5mg，LORA组每日口服氯雷他定片5mg或10mg。进行鼻炎症状评分和鼻结膜炎生命质量问卷（RQLQ）评分，评分越低症状越轻。结果：治疗4周．三组比较鼻炎症状总评分在BUD组最低（F=2．977，P〈0．05）。鼻塞症状评分BUD组改善最显著（χ2=6．488．P〈0．01），而MON组鼻塞评分亦显著低于LORA组（P〈0．01）。流涕和喷嚏评分在LORA组和BUD组改善明显．三组比较差异有统计学意义（χ2=4．176和5．806，P〈0．01）。咽痒评分在MON组和BUD组显著低于LORA组（P〈0．01）。同时BUD组RQLQ总分和RQLQ鼻部症状评分显著低于其他两组（P〈0．05）。MON组眼痒症状评分和RQLQ眼部症状评分，数值上均低于其他两组，但差异均未达显著界值（P〉0．05）。结论：布地奈德对鼻炎的总体症状和鼻塞改善更具优势；氯雷他定对喷嚏和流涕效果突出，但对鼻塞效果差；而孟鲁司特对咽瘁和鼻塞的效果优于氯雷他定，对眼部症状亦有一定的优势。
Objective To compare the effects of intranasal corticosteroid, leukotriene receptor antagonist, and oral antihistamine on persistent allergic rhinitis （AR） in children and explore invidivualized therapy for child AR. Methods 186 children （6-14years） with moderate to severe persistent AR were evenly randomized into three groups treated by nasal budesonide （BUD）, montelukast （MON）, loratadine （LORA）. The thress groups were compared in terms of symptoms scores and scores by rhinoconjunctivitis quality of life questionnaire （RQLQ）. Results After 4 weeks therapy, nasal obstruction scores were most significantly improved in BUD group （P 〈 0.01 ）, followed by MON group and then LORA group. The scores on rhinoxxhea and sneezing in LORA and BUD group were more effectively improved compared to MON group （P 〈 0.01 ）. The scores on throat itching in BUD group and MON group were lower than in LORA group （P 〈 0.01 ）. The total scores by RQLQ and nasal RQLQ were significantly improved in BUD group （all P 〈 0.05）. The scores on eye itching and eye RQLQ in MON group were insignificantly lower, than the other two groups （both P 〉 0.05）. Conclusion Nasal budesonide is a superior agent for improving nasal obstruction and the general symptoms. Loratadine is more effective in reducing rhinorrhea and sneezing. Montelukast has better results in reducing throat itching and some advantage in reducing eyes symptoms.
出处
《实用医学杂志》
CAS
北大核心
2014年第2期219-221,共3页
The Journal of Practical Medicine
基金
广东省科技厅资助项目(编号:2010B031600149)
关键词
变应性鼻炎
儿童
鼻内激素
白三烯受体拮抗剂
抗组胺药
Children
Allergic rhinitis
Intranasal cortieosteroids
Leukotriene receptor antagonists
Antihistamines
