布地奈德联合生理盐水鼻腔冲洗对慢性鼻-鼻窦炎的疗效及对鼻腔分泌物IL-6、IL-8、TNF-α的影响

doi:10.6040/j.issn.1673-3770.0.2017.455

摘要/Abstract

摘要： 目的探讨布地奈德联合生理盐水鼻腔冲洗对慢性鼻-鼻窦炎(CRS)的疗效及对鼻腔分泌物白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子(TNF-α)的影响。方法研究对象选自2016年2月至2017年5月收治的128例CRS患者,采取随机数字表将其分成两组,每组64例。对照组给予生理盐水鼻腔冲洗,观察组在生理盐水中加入布地奈德混悬液,比较两组临床疗效、治疗前后鼻腔分泌物IL-6、IL-8、TNF-α水平变化情况以及患侧鼻腔Lund-Kennedy评分、鼻窦CT评分变化情况。结果经过4周治疗,观察组总有效率为93.75%(60/64),与对照组71.88%(46/64)相比明显上升(P<0.01)。治疗后两组患侧鼻腔Lund-Kennedy评分、鼻窦CT评分均较治疗前显著降低(P<0.01),但观察组评分下降更明显(P<0.01)。治疗后两组鼻腔分泌物IL-6、IL-8、TNF-α水平均较治疗前显著降低(P<0.01),但观察组各项炎性因子水平降低更明显(P<0.01)。两组治疗过程中均未出现明显不良反应。结论布地奈德联合生理盐水鼻腔冲洗治疗CRS可显著缓解鼻腔炎症反应,改善鼻腔充血、肿胀等症状,疗效确切。

关键词: 鼻-鼻窦炎, 慢性, 炎性因子, 鼻腔冲洗, 布地奈德

Abstract: Objective To investigate the effects of budesonide combined with saline nasal irrigation on chronic rhinosinusitis(CRS)and nasal secretion of interleukin(IL)-6, IL-8, and tumor necrosis factor-alpha(TNF-α). Methods One hundred and twenty-eight subjects were selected for the study from the patients with CRS treated in our hospital from February 2016 to May 2017. They were divided using a random number table generator into a control group that received saline nasal lavage alone(n=64)and an observation group that received saline nasal lavage to which budesonide suspension was added(n=64). The clinical efficacy and changes in IL-6, IL-8 and TNF-α levels in nasal secretions, the Lund-Kennedy score for the nasal cavity, and the computed tomography score for the paranasal sinuses were compared between the two groups before and after 4 weeks of treatment. Results The efficacy rate was significantly higher in the observation group than in the control group(93.75% ［60/64］ vs. 71.88% ［46/64］; P<0.01). The nasal Lund-Kennedy and paranasal sinus computed tomography scores were significantly lower in both study groups after treatment than before treatment(P<0.01); however, the decreases in these scores were significantly greater in the observation group(P<0.01). The IL-6, IL-8, and TNF-α levels in nasal secretions were also significantly lower in both study groups after treatment than before treatment(P<0.01); however, the decreases in levels of these inflammatory markers were significantly greater in the observation group(P<0.01). No obvious adverse reactions occurred in either study group during treatment. Conclusion Budesonide combined with saline nasal irrigation can significantly relieve nasal inflammation, help to relieve symptoms such as nasal congestion and swelling, and have a curative effect in patients with CRS.

Key words: Budesonide, Inflammatory factor, Rhinosinusitis, chronic, Nasal irrigation

中图分类号:

R765.4

郑雅霓, 刘鹤, 马亮, 张明生, 孙中武. 布地奈德联合生理盐水鼻腔冲洗对慢性鼻-鼻窦炎的疗效及对鼻腔分泌物IL-6、IL-8、TNF-α的影响[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 58-62.

ZHENG Yani, LIU He, MA Liang, ZHANG Mingsheng, SUN Zhongwu. Effects of budesonide combined with saline nasal irrigation on chronic rhinosinusitis and nasal secretion of[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(3): 58-62.

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