鼻腔冲洗联合鼻用糖皮质激素对AR患者FeNO、肺功能及生活质量的影响

doi:10.6040/j.issn.1673-3770.0.2018.236

摘要/Abstract

摘要： 目的探讨变应性鼻炎(AR)患者采用鼻腔冲洗联合鼻用糖皮质激素治疗对呼出气一氧化氮(FeNO)、肺功能及生活质量的影响。方法选取我院2016年3月至2017年3月收治的AR患者120例,采用随机数字表法分为观察组和对照组各60例,对照组采用布地奈德喷雾剂治疗,60 μg,每侧1次,每日早晚1次,连续治疗3个月;观察组早晚各采用100 mL生理盐水冲洗治疗,每侧早晚各冲洗1次,冲洗后采用布地奈德鼻喷雾剂治疗,连续治疗3个月。对比两组的FeNO、用力肺活量占预计值的百分比(FVC%)、第1秒用力肺活量占预计值的百分比(FEV₁%)、最高呼气流速(PEF)、平静呼气肺活量(VC%)占预计值的百分比及鼻-结膜炎相关生活质量问卷(RQLQ)评分。结果治疗后观察组与对照组FeNO水平分别为(750.2±89.4)×10^-10mol/L、(816.3±92.7)×10^-10mol/L,两组FeNO水平比较差异有统计学意义(t=-3.976, P<0.001)。治疗后,观察组FVC%、FEV₁%、PEF%、VC%水平高于对照组(t分别为3.207、4.211、2.780、3.272, P分别为0.002、<0.001、0.006、0.001)。治疗后观察组与对照组RQLQ评分分别为(29.0±6.4)、(34.4±7.0)分,两组比较差异有统计学意义(t=-4.410, P<0.001)。结论采用鼻腔冲洗联合鼻用糖皮质激素治疗AR能降低患者FeNO,在一定程度上改善患者肺功能,提高患者的生活质量。

关键词: 变应性鼻炎, 鼻腔冲洗, 鼻用糖皮质激素, 呼出气一氧化氮, 肺功能

Abstract: Objective To investigate the effects of nasal irrigation combined with glucocorticoid on exhaled nitric oxide(FeNO), pulmonary function, and quality of life in patients with allergic rhinitis(AR). Methods A total of 120 AR patients, admitted to our hospital from March 2016 to March 2017, were selected and randomly divided into the observation group and control group(n=60 cases, each). The control group was treated with budesonide spray(60 μg, once on each side)once every morning and evening for 3 months. The observation group was treated with saline irrigation(100 mL, once on each side)once every morning and evening, and then with budesonide nasal spray for 3 months. The FeNO, FVC%, FEV₁%, PEF, VC%, and RQLQ scores were compared between the two groups. Results The levels of FeNO in the observation group and the control group were(750.2±89.4)×10^-10mol/L and(816.3±92.7)×10^-10mol/L, respectively, following treatment. There was a significant difference in the levels of FeNO between the two groups(t=-3.976, P<0.001). After treatment, the levels of FVC, FEV₁%, PEF, and VC% in the observation group were higher than those in the control group(t=3.207, 4.211, 2.780, 3.272 and P=0.002, <0.001, 0.006, 0.001, respectively). The RQLQ scores of the observation group and the control group were(29.0±6.4)and(34.4±7.0), respectively, with a statistically significant difference(t=-4.410, P<0.001). Conclusion Nasal irrigation combined with nasal glucocorticoid therapy can reduce FeNO, and improve the pulmonary function and quality of life of AR patients to a certain extent.

Key words: Allergic rhinitis, Nasal irrigation, Nasal glucocorticoid, Exhaled nitric oxide, Pulmonary function

中图分类号:

R765.21

杜经纬,冯俊,马鹏,李志勇,李红光. 鼻腔冲洗联合鼻用糖皮质激素对AR患者FeNO、肺功能及生活质量的影响[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 124-127.

DU Jingwei, FENG Jun, MA Peng, LI Zhiyong, LI Hongguang. Effect of nasal irrigation combined with intranasal corticosteroids to treat allergic rhinitis and influence on exhaled nitric oxide and lung function[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(1): 124-127.

参考文献 15

[1]	Bellanti JA, Settiane RA. Perspectives on allergic rhinitis and its treatment[J]. Allergy Asthma Proc, 2013, 34(6):485-487. doi:10.2500/aap.2013.34.0018.
[2]	Zajac AE, Adams AS, Turner JH. A systematic review and meta-analysis of probiotics for the treatment of allergic rhinitis[J]. Int Forum Allergy Rhinol, 2015, 5(6):524-532. doi:10.1002/alr.21492.
[3]	张继民,张冰,张燕霞,等.鼻用糖皮质激素对变应性鼻炎鼻黏膜中PLCε1表达的影响及意义[J].中国临床研究,2016,29(2):231-233. doi: 10.13429/j.cnki.cjcr.2016.02.024 ZHANG Jimin, ZHANG Bing, ZHANG Yanxia, et al. The effect and significance of intranasal glucocorticoid on the expression of PLC epsilon 1 in nasal mucosa of allergic rhinitis[J]. China Clinical Study, 2016,29(2):231-233. doi:10.13429/j.cnki.cjcr.2016.02.024
[4]	于玲. 鼻腔冲洗联合药物治疗婴幼儿变应性鼻炎的疗效分析[J]. 中国妇幼保健, 2017, 32(16):3986-3987. doi:10.7620/zgfybj.j.issn.1001-4411.2017.16.100.
[5]	杨笑染, 刘为民, 张淼, 等. 宁夏回族变应性鼻炎患者鼻腔冲洗治疗的临床观察[J]. 宁夏医学杂志, 2015, 37(2):148-150. doi:10.13621/j.1001-5949.2015.02.0148. YANG Xiaoran, LIU Weimin, ZHANGNIAO, et al. Clinical observation on nasal irrigation treatment in patients with allergic rhinitis[J]. Ningxia Medical Journal, 2015, 37(2):148-150. doi:10.13621/j.1001-5949.2015.02.0148.
[6]	林旸. 不同方法治疗变应性鼻炎的疗效观察[J]. 中国现代医药杂志, 2016,18(12):20-22. doi:10.3969/j.issn.1672-9463.2016.12.006. LIN Yang. Curative effect of allergic rhinitis treated by varied intervention[J]. Modern Medicine Journal of China, 2016, 18(12):20-22. doi:10.3969/j.issn.1672-9463.2016.12.006.
[7]	Lierl MB. New developments in the treatment of pediatric allergic rhinitis and conjunctivitis[J]. Pediatr Ann, 2014, 43(8):e192-e200. doi:10.3928/00904481-20140723-09.
[8]	Licari A, Ciprandi G, Marseglia A, et al. Current recommendations and emerging options for the treatment of allergic rhinitis[J]. Expert Rev Clin Immunol, 2014, 10(10):1337-1347. doi:10.1586/1744666X.2014.955476.
[9]	Bernstein DI, Schwartz G, Bernstein JA. Allergic rhinitis: mechanisms and treatment[J]. Immunol Allergy Clin North Am, 2016, 36(2):261-278. doi:10.1016/j.iac.2015.12.004.
[10]	刘岷, 李彩霞, 张秋红. 罗红霉素联合丙酸氟替卡松鼻喷雾剂治疗变应性鼻炎的研究[J]. 中国民族民间医药, 2011, 20(15):10,12. doi:10.3969/j.issn.1007-8517.2011.15.008.
[11]	陈祖尧, 罗志葵, 朱发梅, 等. 糖皮质激素对变应性鼻炎豚鼠鼻黏膜嗜酸性粒细胞及肥大细胞浸润及P物质含量的影响[J]. 中南医学科学杂志, 2017, 45(2): 122-126. doi:10.15972/j.cnki.43-1509/r.2017.02.004. CHEN Zuyao, LUO Zhikui, ZHU Famei, et al. Effect of glucocorticoid on the infiltration of eosinophils, mast cells andSP in nasal mucosa of guinea pigs with allergic rhinitis[J]. Medical Science Journal of Central South China, 2017, 45(2):122-126. doi:10.15972/j.cnki.43-1509/r.2017.02.004.
[12]	吴杏梅, 许庚. 鼻用糖皮质激素联合鼻用抗组胺药在变应性鼻炎中的应用[J]. 中华耳鼻咽喉头颈外科杂志, 2014, 49(2):170-172. doi:10.3760/cma.j.issn.1673-0860.2014.02.019.
[13]	徐才成, 曾玉芝, 章学军. 不同浓度盐水鼻腔冲洗治疗变应性鼻炎效果观察[J]. 白求恩医学杂志, 2017, 15(2):178-180. doi:10.16485/j.issn.2095-7858.2017.02.018.
[14]	史丽, 赵莉, 张红萍. 变应性鼻炎的长期抗炎治疗[J]. 山东大学耳鼻喉眼学报, 2017, 31(3):9-12. doi:10.6040/j.issn.1673-3770.0.2017.184. SHI Li, ZHAO Li, ZHANG Hongping. Long-term anti-inflammatory treatment of allergic rhinitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2017, 31(3):9-12. doi:10.6040/j.issn.1673-3770.0.2017.184.
[15]	关凯, 李丽莎. 鼻腔冲洗在变应性鼻炎防治中的应用[J]. 山东大学耳鼻喉眼学报, 2017, 31(3):22-27. doi:10.6040/j.issn.1673-3770.0.2017.151. GUAN Kai, LI Lisha. Nasal irrigation and its role in the treatment of allergic rhinitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2017, 31(3):22-27. doi:10.6040/j.issn.1673-3770.0.2017.151.

相关文章 15

[1]	秦雅楠,王琳,姜彦,闫舒,陈敏,于龙刚,李娜. 2008~2017年青岛地区变应性鼻炎常见吸入性变应原分布[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 67-72.
[2]	洪冬冬,刘元献,邹练强,翁镌凌,邓文娴. 变应性鼻炎患者粉尘螨皮肤点刺试验阳性764例结果分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 119-123.
[3]	齐岩,刘俊其,彭舒娅,罗凯,张名霞,王振霖. 鼻内镜下选择性翼管神经切断术对伴有变应性鼻炎的慢性鼻窦炎的疗效观察[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 109-113.
[4]	郭胤仕,卢慧. Ⅱ型固有淋巴细胞在变应性鼻炎发病机制中的作用[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 9-12.
[5]	曹成,许昱. 变应性鼻炎患者舌下免疫治疗的临床依从性192例分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 114-118.
[6]	邱前辉,高俊潇. 特异性免疫治疗对过敏性鼻炎和哮喘的同步控制和远期疗效[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 33-37.
[7]	金兴,胡大宇,朱丽,邓芙蓉,刘俊秀. PM_2.5与变应性鼻炎患者上气道阻力的相关性研究[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 77-80.
[8]	李丽莎,关凯,王子熹,崔乐. 大气污染物对于变应性鼻炎症状严重度的影响[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 81-87.
[9]	洪海裕, 许光福, 杨烁伟,苏荣飞,黄伊厘,池梦诗,王玮豪,杨钦泰. 探究广东地区变应性鼻炎合并支气管哮喘的危险因素[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 94-98.
[10]	王亚坤,张宇,宋西成. 不伴有下气道疾病的慢性鼻-鼻窦炎患者肺功能及相关因素分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 99-102.
[11]	王建伟,张宇,宋西成. 慢性鼻-鼻窦炎伴鼻息肉合并哮喘患者肺功能分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 103-108.
[12]	卢汉桂,林歆胜,姚丹勉,魏永新,李创伟. 变应性鼻炎大鼠IL-35的表达及对辅助性T细胞免疫调节的影响[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 66-70.
[13]	王坛,武珂,李连庆,宫丽丽. 皮下免疫治疗注射后出现全身不良反应的伴发因素及处理[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 71-74.
[14]	浦洪波,杜晓东. 无锡地区2 000例变应性鼻炎变应原检测结果分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 105-107.
[15]	陈鸣,俞雪飞. 浅谈伴有变应性鼻炎的慢性鼻窦炎的治疗[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 18-22.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed