鼻腔盥洗及联合鼻用糖皮质激素治疗变应性鼻炎及血管运动性鼻炎效果观察

doi:10.6040/j.issn.1673-3770.0.2018.620

Abstract

Abstract: Objective

The aim of this study was to compare the efficacy of nasal lavage alone and nasal lavage in combination with nasal corticosteroids in allergic rhinitis (AR) and vasomotor rhinitis (VMR).

Methods

This study included 93 patients with AR and 56 patients with VMR, who were randomly divided into three groups each: A1, A2, and A3 (n = 31 in each group) and V1 (n = 19), V2 (n = 17), and V3 (n = 20), respectively. Patients in groups A1 and V1, A2 and V2, and A3 and V3 were treated with budesonide nasal spray, nasal flushing with 0.9% sodium chloride solution, and a combination of nasal lavage and budesonide nasal spray, respectively, for three months each. Nasal symptoms were assessed using the visual analog scale (VAS) before and after the intervention; the rhinoconjunctivitis quality of life questionnaire (RQLQ) was used to evaluate the quality of life, and the fractional exhaled nitric oxide (FENO) values were measured by the exhaled NO assay system..

Results

All patients completed the experiment with good tolerance, and no serious adverse reactions occurred. The VAS, RQLQ, and FENO values in the A3 group after three months were significantly lower than the values before intervention. There was no statistically significant difference in the total VAS scores among the A1, A2 and A3 groups (F = 1.465, P = 0.174). There were statistically significant differences in the total RQLQ scores between the A3 and A1 groups (t = 2.668, P = 0.014), but not between the A2 and A3 groups (t = 1.545, P = 0.136). There were statistically significant differences in the FENO values between the A3 and A1 groups (t= 3.241, P=0.004) and between the A3 and A2 groups (t= 2.987，P = 0.008). At the end of the third month of treatment, VAS, RQLQ, and FENO values in the V3 group were significantly lower than the values before intervention. The differences in total VAS scores were statistically significant between the V3 and V1 groups (t = 2.352, P = 0.027) and between the V3 and V2 groups (t = 2.083, P = 0.043). There were statistically significant differences in RQLQ scores between the V3 and V1 groups (t = 2.581, P=0.013) and between the V3 and V2 groups (t = 2.339, P = 0.031). There was no significant difference in the FENO values among the V1, V2 and V3 groups (F=1.563, P=0.159).

Conclusion

Nasal lavage alone or nasal lavage in combination with glucocorticoids was more efficient in the long-term treatment of AR and VMR.

Key words: Rhinitis, allergic, Rhinitis, vasomotor, Nasal irrigation, Treatment outcome

CLC Number:

R765.21

Minghong SUN,Xian GAO,Ting ZHAO,Wenjun LIU. Comparison between the efficacy of nasal lavage and combination treatment in allergic rhinitis and vasomotor rhinitis[J].Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5): 73-78.

Figures/Tables 6

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References 13

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组别	VAS总分
组别	治疗前	1个月末	2个月末	3个月末
A1组	4.16±0.76	3.84±0.59	3.42±0.81	3.15±1.03
A2组	3.98±0.48	3.65±0.72	3.44±0.83	3.05±0.97
A3组	4.10±0.37	3.75±0.47	3.34±0.70	2.96±0.35
t₁		1.851 ^b	3.709 ^a	4.392 ^a
t₂		2.123 ^a	3.136 ^a	4.784 ^a
t₃		3.258 ^a	5.344 ^a	9.462 ^a

组别	RQLQ总分
组别	治疗前	1个月末	2个月末	3个月末
A1组	58.93±22.31	48.56±20.25	40.62±18.49	36.24±21.24
A2组	62.44±28.30	48.67±22.62	40.55±17.83	34.47±18.92
A3组	61.03±18.42	47.33±20.45	38.57±18.63	31.56±19.73
t₁		1.916 ^b	3.518 ^a	4.101 ^a
t₂		2.116 ^a	3.644 ^a	4.575 ^a
t₃		2.771 ^a	4.773 ^a	6.079 ^a

组别	FENO值
组别	治疗前	1个月末	2个月末	3个月末
A1组	60.8±19.2	50.5±19.7	43.5±14.9	37.6±17.8
A2组	57.5±13.7	51.9±15.4	44.2±15.8	38.3±17.3
A3组	57.0±17.6	47.6±16.9	39.8±16.7	30.2±14.8
t₁		2.085 ^a	3.963 ^a	4.934 ^a
t₂		1.513 ^b	3.541 ^a	4.844 ^a
t₃		2.145 ^a	3.947 ^a	6.489 ^a

组别	VAS总分
组别	治疗前	1个月末	2个月末	3个月末
V1组	4.39±1.13	3.01±0.94	3.63±0.88	4.05±0.68
V2组	4.24±1.34	3.91±1.14	3.66±0.95	3.32±1.22
V3组	4.36±2.01	2.47±0.94	3.13±1.26	2.85±1.34
t₁		3.789 ^a	2.312 ^a	1.124 ^b
t₂		0.770 ^b	2.201 ^a	2.093 ^a
t₃		3.809 ^a	2.318 ^a	2.795 ^a

组别	RQLQ总分
组别	治疗前	1个月末	2个月末	3个月末
V1组	59.14±21.49	42.56±20.14	45.32±17.63	47.05±19.87
V2组	57.65±17.68	48.26±16.83	40.75±18.37	38.65±16.79
V3组	56.31±27.74	40.27±18.67	36.36±19.83	29.25±15.20
t₁		2.454 ^a	2.167^a	1.801^b
t₂		1.586 ^b	2.733^a	3.213^a
t₃		2.145 ^a	2.617 ^a	3.826 ^a

Comparison between the efficacy of nasal lavage and combination treatment in allergic rhinitis and vasomotor rhinitis

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