Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2022, Vol. 36 ›› Issue (6): 77-82.doi: 10.6040/j.issn.1673-3770.0.2022.312

• 论著 • Previous Articles    

Clinical efficacy of intratympanic administration of budesonide combined with ambroxol hydrochloride in the treatment of secretory otitis media in adults

SUN Yan, YAO Hao, GU Li'an   

  1. Department of Otorhinolaryngology, Changshu No.1 People's Hospital (Changshu Hospital Affiliated to Soochow University), Changshu 215500, Jiangsu, China
  • Published:2022-12-07

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Abstract: Objective The aim of this study was to investigate the clinical efficacy of intratympanic injection comprising budesonide combined with ambroxol hydrochloride in treating secretory otitis media in adults. Methods Sixty patients with secretory otitis media who were selected and divided randomly into three groups; the observation, control, and experimental groups, each with 20 patients. The observation group received tympanocentesis and drainage; the control group was administered intratympanic ambroxol hydrochloride, and the experimental group was administered intratympanic budesonide combined with ambroxol hydrochloride. The three groups were compared prior and after the treatment with regard to the total effective rate of disease control, level of inflammatory response-related indexes, ear function-related indexes, time taken for symptom disappearance, time taken to recover based on the examination results of the internal ear, and incurrence of any adverse reactions. Results The total effective rate of disease control in patients in the experimental group was higher than those in the observation and control groups(all P<0.001). The level of inflammatory response- and ear function-related indexes in the experimental group before and after treatment improved more significantly than those in the observation and control groups(all P<0.001); the time taken for symptom disappearance and normal recovery in the experimental group was shorter than those in the observation and control groups(all P<0.001); no significantly different adverse reactions were observed between the three groups(P=0.804). Conclusions Treatment of patients with secretory otitis media by intratympanic injection of budesonide combined with ambroxol hydrochloride can effectively control the inflammatory response, improve the inflammatory indexes and ear function, shorten the treatment time, and improve the total treatment efficiency.

Key words: Secretory otitis media, Budesonide, Ambroxol hydrochloride, Intratympanic injection

CLC Number: 

  • R764.21
[1] 胡林, 陈建超. 耳内镜下鼓室置管联合药物灌注治疗鼻咽癌放疗后分泌性中耳炎的疗效分析[J]. 国际耳鼻咽喉头颈外科杂志, 2020(4): 191-194. doi: 10.3760/cma.j.issn.1673-4106.2020.04.002. HU Lin, CHEN Jianchao. Effectiveness of endoscope-guided myringotomy and ventilation tube insertion combined with drug perfusion in the treatment of otitis media with effusion in patients with post-irradiated nasopharyngeal carcinoma[J]. International Journal of Otolaryngology-Head and Neck Surgery, 2020(4): 191-194. doi: 10.3760/cma.j.issn.1673-4106.2020.04.002.
[2] 林悦权. 桉柠蒎联合盐酸氨溴索治疗急性分泌性中耳炎的效果分析[J]. 中国现代药物应用, 2021, 15(7): 201-203. doi:10.14164/j.cnki.cn11-5581/r.2021.07.084.
[3] 严斌, 吴文文, 刘博, 等. 氨溴索联合雷诺考特鼻喷雾剂对分泌性中耳炎患者血清与耳积液HA sIL-2R Fn炎性介质的影响[J]. 河北医学, 2018, 24(5): 782-786. doi: 10.3969/j.issn.1006-6233.2018.05.021. YAN Bin, WU Wenwen, LIU Bo, et al. Influence of ambroxol joint Reynolds nasal spray on serum and middle ear effusion on HA, sIL-2R, fn and inflammatory media in the treatment secretory otitis media[J]. Hebei Medicine, 2018, 24(5): 782-786. doi: 10.3969/j.issn.1006-6233.2018.05.021.
[4] 李大鹏, 黄辉, 何苗, 等. 分泌性中耳炎的临床诊治进展[J]. 中华耳科学杂志, 2017, 15(1):105-109. doi: 10.3969/j. issn. 1672-2922.2017.01.019.
[5] 余朝阳, 敖强勇, 蒋慈英, 等. 鼓室注入盐酸氨溴索治疗分泌性中耳炎疗效观察[J]. 海南医学, 2017, 28(20): 3406-3407. doi: 10.3969/j.issn.1003-6350.2017.20.046.
[6] 叶青, 曾卓琴, 陈帆. 布地奈德联合氨溴索鼓室内注射治疗分泌性中耳炎的疗效研究[J]. 中国医学文摘(耳鼻咽喉科学), 2021, 36(1): 7-9. doi:10.19617/j.issn1001-1307.2021.01.7. YE Qing, ZENG Zhuoqin, CHEN Fan. Effect of intratympanic injection of budesonide combined with Ambroxol on Secretory otitis media[J]. Chinese Medical Digest(Otorhinolaryngology), 2021, 36(1): 7-9. doi:10.19617/j.issn1001-1307.2021.01.7.
[7] 中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会小儿学组. 儿童分泌性中耳炎诊断和治疗指南(2021)[J]. 中华耳鼻咽喉头颈外科杂志, 2021(6): 556-567. doi: 10.3760/cma.j.cn115330-20210511-00264.
[8] 王青海, 熊向菁, 李俊娟, 等. 地塞米松联合盐酸氨溴索鼓室内注射治疗分泌性中耳炎的临床效果及其机制[J]. 山东医药, 2017, 57(44): 86-89. doi: 10.3969/j.issn.1002-266X.2017.44.028.
[9] Li YQ, Chen YB, Yin GD, et al. Effect of balloon dilation eustachian tuboplasty combined with tympanic tube insertion in the treatment of chronic recurrent secretory otitis media[J]. Eur Arch Otorhinolaryngol, 2019, 276(10): 2715-2720. doi:10.1007/s00405-019-05512-7.
[10] 张家鹏, 郭亿莲, 卢标清, 等. 咽鼓管球囊扩张联合鼓膜切开置管术治疗复发性分泌性中耳炎的应用分析[J]. 临床耳鼻咽喉头颈外科杂志, 2018, 32(7): 551-553. doi:10.13201/j.issn.1001-1781.2018.07.019. ZHANG Jiapeng, GUO Yilian, LU Biaoqing, et al. Preliminary exploration for recurrent secretory otitis media treatment by balloon dilation Eustachian tuboplasty combined with tympanotomy tube insertion[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2018, 32(7): 551-553. doi:10.13201/j.issn.1001-1781.2018.07.019.
[11] 李建华, 董庆汉, 姜华. 探讨氨溴索联合地氯雷他定、地塞米松对分泌性中耳炎患者咽鼓管功能及炎症反应的影响[J]. 现代诊断与治疗, 2019, 30(5): 711-712.
[12] 黎润球, 何锦添, 毛志强. 地塞米松和盐酸氨溴索联合鼓室内注射治疗分泌性中耳炎的有效性、安全性评价[J]. 中国医药科学, 2019, 9(9): 74-76, 90. doi:10.3969/j.issn.2095-0616.2019.09.022. LI Runqiu, HE Jintian, MAO Zhiqiang. Evaluation on efficacy and safety of dexamethasone and ambroxol hydrochloride combined with intratympanic injection in the treatment of secretory otitis media[J]. China Medicine and Pharmacy, 2019, 9(9): 74-76, 90. doi:10.3969/j.issn.2095-0616.2019.09.022.
[13] 马钊恩, 翟锦明, 廖礼兵, 等. 咽鼓管球囊扩张术治疗慢性分泌性中耳炎的短期疗效观察[J]. 山东大学耳鼻喉眼学报, 2017, 31(5): 54-56. doi: 10.6040/j.issn.1673-3770.0.2017.137. MA Zhaoen, ZHAI Jinming, LIAO Libing, et al. Short-term effect of eustachian tube balloon dilation in the treatment of chronic otitis media with effusion[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2017, 31(5): 54-56. doi: 10.6040/j.issn.1673-3770.0.2017.137.
[14] 肖俊, 王轶, 涂恩毅. 盐酸氨溴索鼓室内注射联合普米克令舒雾化治疗分泌性中耳炎的疗效及其对患者耳积液与血清PCT、hs-CRP的影响[J]. 海南医学, 2019, 30(16): 2106-2109. doi:10.3969/j.issn.1003-6350.2019.16.020. XIAO Jun, WANG Yi, TU Enyi. Effectiveness evaluation of ambroxol hydrochloride intratympanic injection combined with Pulmicort resuscitation in the treatment of secretory otitis media and its effect on otorrhea and serum PCT, hs-CRP[J]. Hainan Medical Journal, 2019, 30(16): 2106-2109. doi:10.3969/j.issn.1003-6350.2019.16.020.
[15] 吴军德. 地塞米松联合盐酸氨溴索鼓室内注射治疗渗出性中耳炎的临床研究及应用[J]. 世界最新医学信息文摘, 2017, 17(85): 121, 124. doi:10.19613/j.cnki.1671-3141.2017.85.089.
[16] Aslam MA, Javed A, Moiz A. Comparison of auditory brainstem response and auditory steady state response audiometry by evaluating the hearing thresholds obtained in children with different severity of hearing loss[J]. Pak J Med Sci, 2019, 35(2): 320-324. doi:10.12669/pjms.35.2.688.
[17] 安平, 赵宇, 杨奉玲, 等. 鼓室内注射布地奈德治疗12岁以上儿童及成人分泌性中耳炎的长期疗效分析[J]. 临床耳鼻咽喉头颈外科杂志, 2017, 31(16): 1231-1237. doi:10.13201/j.issn.1001-1781.2017.16.004. AN Ping, ZHAO Yu, YANG Fengling, et al. Effect of intratympanic injection of budesonide for otitis media with effusion in adolescents and adults[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2017, 31(16): 1231-1237. doi:10.13201/j.issn.1001-1781.2017.16.004.
[18] 邓成梅. 地塞米松联合氨溴索鼓膜穿刺灌洗治疗分泌性中耳炎的效果分析[J]. 吉林医学, 2018, 39(10): 1929-1930. doi:10.3969/j.issn.1004-0412.2018.10.052.
[19] 袁外. 鼓室注射甲泼尼龙琥珀酸钠和α糜蛋白酶治疗分泌性中耳炎疗效观察[J]. 中国社区医师, 2019, 35(1): 84-85. doi:10.3969/j.issn.1007-614x.2019.01.059. YUAN Wai. Clinical effect observation of intratympanic injection of methylprednisolone sodium succinate and alpha chymotrypsin in the treatment of secretory otitis media[J]. Chinese Community Doctors, 2019, 35(1): 84-85. doi:10.3969/j.issn.1007-614x.2019.01.059.
[20] 王鹏军, 周月, 王慧, 等. 鼓室分泌物涂片阴性的嗜酸粒细胞性中耳炎1例及文献复习[J]. 临床耳鼻咽喉头颈外科杂志, 2020, 34(5): 465-467. doi:10.13201/j.issn.2096-7993.2020.05.020. WANG Pengjun, ZHOU Yue, WANG Hui, et al. A case of eosinophil otitis media with smear-negative middle ear effusion and literature review[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2020, 34(5): 465-467. doi:10.13201/j.issn.2096-7993.2020.05.020.
[21] 余力生, 郑宏伟, 韩琳. 分泌性中耳炎与中耳通气系统[J]. 中华耳科学杂志, 2020, 18(3): 428-430. doi:10.3969/j.issn.1672-2922.2020.03.001.
[22] YU Lisheng, ZHENG Hongwei, HAN Lin. Otitis media with effusion and venting system in middle ear[J]. Chinese Journal of Otology, 2020, 18(3): 428-430. doi:10.3969/j.issn.1672-2922.2020.03.001.
[23] 倪菁,雷飞,白丹,等. 儿童分泌性中耳炎耳积液中免疫相关指标表达分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 56-59. doi: 10.6040/j.issn.1673-3770.0.2018.230. NI Jing, LEI Fei, BAI Dan, et al. Expression of immunological markers in middle ear effusion in children with secretory otitis media[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(4): 56-59. doi:10.6040/j.issn.1673-3770.0.2018.230.
[24] 侯薇, 张铁英. 盐酸氨溴索联合糖皮质激素治疗分泌性中耳炎疗效观察[J]. 中国生化药物杂志, 2017(7): 191-193. doi: 10.3969/j.issn.1005-1678.2017.07.075. HOU Wei, ZHANG Tieying. Efficacy of treatment otitis media with effusion by Ambroxol combined with glucocorticoids[J]. Chinese Journal of Biochemical and Pharmaceuticals, 2017(7): 191-193. doi: 10.3969/j.issn.1005-1678.2017.07.075.
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