【摘要】 目的 觀察低溫等離子射頻治療阻塞性睡眠呼吸暫停低通氣綜合征（obstructive sleep apnea-hypopnea syndrome，OSAHS）合并變應性鼻炎的療效。 方法 對2010年1－5月收治的42例OSAHS合并變應性鼻炎患者，采用低溫等離子射頻雙下鼻甲減容、鼻腔內蝶腭神經及篩前神經末梢阻滯，并配合鼻中隔成形等手術。使用Epworth嗜睡評分量表（epworth sleepiness scale， ESS）和視覺模擬評分法（visual analogue scale，VAS）對治療前及治療3個月后的總體感受評分。 結果 ESS評分與VAS評分均符合正態分布，手術前、后ESS評分[（14.22±4.21）分，（6.78±4.12）分]與VAS評分[（8.34±2.72）分，（3.96±1.02）分]差異有統計學意義（Plt;0.05）。 結論 低溫等離子射頻治療OSAHS合并變應性鼻炎療效較好。【Abstract】 Objective To observe the clinical effect of treatment by low-temperature plasma radio frequency on obstructive sleep apnea-hypopnea syndrome (OSAHS) complicated with allergic rhinitis. Methods A total of 42 patients with OSAHS complicated with allergic rhinitis between January 2010 and May 2010 were chosen. All of the patients were treated by low-temperature plasma radio frequency nerve block, concha nasalis inferior ablation and other operations such as nasal septal construction. The nerve terminals of sphenopalatine nerve and anterior ethmoid nerve were blocked by ablation. Epworth sleepiness scale (ESS) and visual analogue scale (VAS) were used to estimate the curative effects. Results The results of ESS and VAS were consistent with gaussian distribution. There were statistical significant difference between the scores of pre-and post-operation (Plt;0.05). Conclusion The low-temperature plasma radio frequency treatment for OSAHS complicated with allergic rhinitis is easy，safe and efficient.
ObjectiveTo systematically review the efficacy and safety of dust mite sublingual immunotherapy (SLIT) in the treatment of children with allergic rhinitis. MethodsRandomized controlled trials (RCTs) about SLIT treating allergic rhinitis in pediatric patients was searched in PubMed, EMbase, CBM, Ovid, The Cochrane Library (Issue 5, 2014), CNKI, VIP and WanFang Data from inception to May 2014. Two reviewers independently screened literature according to inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Then meta-analysis was conducted using RevMan 5.3 software. ResultsA total of nine RCTs including 663 patients were finally included. The results of meta-analysis indicated that:the trial group was superior to the control group in reducing the scores of drug use (SMD=-0.61, 95%CI-0.94 to-0.27, P=0.000 4) and mite-specific serum IgE levels (follow-up time > 22 weeks:SMD=0.71, 95%CI 0.31 to 1.12, P=0.000 5). However, no significant difference was found between the two groups in the scores of nasal symptoms (SMD=0.06, 95%CI-0.13 to 0.25, P=0.55) and the incidence of adverse reaction (OR=1.3, 95%CI 0.89 to 1.90, P=0.17). ConclusionSLIT could decrease the use frequency of antihistamine, β-agonist and nasal spray steroids, and it has less adverse reaction and better safety in the treatment of children with allergic rhinitis. But SLIT could neither effectively alleviate nasal symptoms nor reduce mite-specific serum IgE levels of pediatric patients with allergic rhinitis in a short time.
摘要:目的:評價孟魯司特用于過敏性鼻炎的臨床療效和安全性。方法:計算機檢索PubMed、維普及CNKI數據庫,手工收集有關孟魯司特用于過敏性鼻炎治療的臨床研究,根據納入和剔除標準匯集文獻,采用Jadad量表進行納入文獻質量評價,對總體治療有效性使用Revman4.2軟件進行Meta分析。結果:療效評價共納入9個臨床隨機對照研究共650例。有效率孟魯司特組高于對照組,異質性檢驗顯示各亞組及其合并總有效率P值均大于0.1,I2lt;50%,采用固定效應模型計算。2周時孟魯司特組和對照組無統計學差異(Pgt;0.1),但2月、3月時二組均有顯著性統計學差異(Plt;0.000 01),三個亞組綜合分析孟魯司特組和對照組有顯著性統計學差異(Plt;0.000 01),不良反應差異無統計學意義。結論:現有臨床證據顯示孟魯司特較傳統抗過敏藥物對過敏性鼻炎的治療有效,但由于納入研究存在選擇性偏倚和測量性偏倚的可能性,勢必影響結果的論證強度。故期待更多高質量的隨機雙盲對照試驗性研究,以提供更高質量的證據。Abstract: Objective: To evaluate montelukast for allergic rhinitis clinical efficacy and safety. Methods: We searched the PubMed,VIP and CNKI databases, manual collection of clinical study about allergic rhinitis treatment of montelukast, based on inclusion and exclusion criteria for pooling of literature, Jadad scale used for quality assessment of the literature. Then use Revman4.2 Meta analysis software to evaluate the overall effectiveness. Results: Nine RCT clinical study have been included, The results showed that montelukast group was higher than control group on efficient control, Heterogeneity test showed that the subgroup and its total effective rate is Pgt;01,I2lt;50%. Therefore, we adopted a fixed effects model. After 2 weeks montelukast group and the control group no significant difference (Pgt;0.1). But after 2,3 month the two groups were statistically significant differences(Plt;0.000 01). On a comprehensive analysis of the three subgroups, montelukast group and the control group statistically significant differences(Plt;0.000 01), adverse drug reactions was no significant difference. Conclusion: The available clinical evidence to show that montelukast for the treatment of allergic rhinitis and effective, However, due to the existence of selection and measurement bias, This may affect the outcome of the argument strength.Therefore look forward to more highquality randomized and doubleblind controlled trials to provide highquality evidence.
Objective To evaluate the clinical effectiveness and safety of compound loratadine capsule in the treatment of allergic rhinitis. Methods A multi-center randomized single blind controlled trial (by using a random number table generated random sequence and the sequence was concealed by sealed envelopes) was designed. Two hundred and forty outpatients with allergic rhinitis who met the inclusion and exclusion criteria were randomized to the treatment group (n=120 with compound loratadine capsule, 1 capsule q 24 h) or the control group (n=120 with loratadine tablet, 1 tablet q 12 h). All patients were given standard therapy. Results ① At the end of the treatment, in the compound loratadine group, 101 patients completed the study, and 19 patients withdrew. In the loratadine group, 103 patients completed the study, 17 patients withdrew. According to intention-to-treat analysis (ITT), the improvement rates of the treatment and control groups were 89.17% (107/120) and 88.33% (106/120) respectively. No significant difference was seen between the two groups (rank sum test, u=-1.8348, P＞0.05). According to per-protocol analysis (PP), the improvement rates of the treatment and control groups were 96.04% (97/101) and 91.26% (94/103) respectively. No significant difference was seen between the two groups (rank sum test, u=-1.625 7, P＞0.05). ② Adverse events were slight to moderate.The adverse event rates were 22.5% (27/120) and 21.67% (26/120) in the treatment and control groups respectively. No significant difference was seen between the two groups ( χ2 test, P＞0.05). Conclusion Compound loratadine capsule is effective and safe for allergic rhinitis.
Objective To evaluate the safety of intranasal use of beclomethasone dipropionate, budesonide, fluticasone propionate and mometasone for adults and children with chronic sinusitis/nasal polyps and allergic rhinitis. Methods Randomized controlled trials were located. Study quality was evaluated by two researchers independently. RevMan 4.2 was used for meta-analysis. Results Seven RCTs involving 826 patients were included. Compared with placebo, local use of fluticasone proprionate in adults showed no statistically significant trend to increase incidence of acute sinusitis (OR 16.87, 95% CI 0.87 to 301.62), but no significant difference was seen for epistaxis (OR 7.76, 95% CI 0.38 to 157.14): 1 trial, 60 patients. In another trial, no cases of nasal atrophy were reported in either fluticasone or placebo groups. No significant differences were seen between local use ofbudesonide and placebo in adults for dryness of nasal mucosa (OR 3.38, 95%CI 0.66 to 17.18) and epistaxis (OR 2.20, 95%CI 0.39 to 12.32): 1 trial, 193 participantions. No significant difference was seen between budesonide and pollinex for headache (OR 1.71, 95%CI 0.52 to 5.62). No differences were seen between placebo and fluticasone propionate in children for epistaxis (OR 0.85, 95%CI 0.20 to 3.66), headache (OR 0.25, 95%CI 0.02 to 2.83), plasma cortisol concentration (OR 1.56, 95%CI 0.06 to 38.69) and dryness of nasal mucosa (OR 4.76, 95%CI 0.25 to 89.54). Beclomethasone dipropionate in children showed no statistical differences for dryness of nasal mucosa (OR 0.51, 95%CI 0.14 to 1.87), epistaxis (OR 0.68, 95%CI 0.26 to 1.73) and rhinitis (OR 0.47, 95%CI 0.04 to 5.36). No decrease of plasma cortisol concentration was detected in either group. Mometasone and placebo showed no significant differences in children for epistaxis (OR 1.57, 95%CI 0.41 to 5.95), rhinitis (OR 0.33, 95%CI 0.01 to 8.22) or headache (OR 0.33, 95%CI 0.01 to 8.22). Decrease of plasma cortisol concentration was not detected. Conclusions According to this systematic review, long term intranasal use of steroid for adults and children may be safe based on the two high quality, four moderate quality trials and one with b bias. High quality studies with larger sample sizes and in other languages are needed to provide ber evidence.
目的:分析三種不同術式治療慢性肥厚性鼻炎的臨床療效。方法: 對206例慢性肥厚性鼻炎患者分別采用低溫等離子消融術,改良的傳統下鼻甲部分切除術及下鼻甲成形術三種術式,比較其臨床療效。結果: 206例患者中8例因術后創面出血而愈合時間延長,2例出現鼻腔干燥結痂,2例因頭痛癥狀不能改善到神經內科治療,其余患者癥狀均獲顯著改善。結論: 下鼻甲成形術、下鼻甲等離子消融術能更好地體現微創手術的理念,療效優于傳統下鼻甲部分切除術。
ObjectiveTo investigate the common inhalant allergens causing allergic rhinitis in underage patients, and provide references for clinical prevention of allergic rhinitis. MethodsUnderage patients with allergic rhinitis admitted to our hospital between January 2010 and June 2013 were screened and skin prick test (SPT) was applied to investigate the response intensity to 22 kinds of common inhalant allergens and analyze the correlation of the positive rates and grades of allergens with age and sex. ResultsA total of 402 patients were included, and 77.6% (312/402) of them reported positive reaction of SPT; and the top five allergens were dust mites (242/402, 60.2%), house dust (235/402, 58.5%), housefly (142/402, 35.3%), spring pollen Ⅲ (133/402, 33.1%) and mulberry silk (121/402, 30.1%), respectively. Compared with patients whose age was younger than 5 years, both the positive rates and grades of SPT were significantly higher in patients above 5 years old. Additionally, the higher positive rates and grades of SPT were also observed much more in male patients than female patients. ConclusionThe most common inhalant allergens causing allergic rhinitis in underage patients are dust mites and house dust. And the SPT response intensity of inhalant allergens can be affected by age and gender.
ObjectiveTo observe the effect of Budesonide formoterol inhalant on teenager patients with allergic rhinitis accompanied with asthma. MethodsForty-five teenager patients with allergic rhinitis accompanied with asthma treated between January 2012 and December 2013 were randomly divided into general treatment group, budesonide group and budesonide formoterol group, with 15 patients in each. Another 15 subjects undergoing physical examination were designated as the control group. Besides routine treatment, the budesonide group was also treated with budesonide inhalation at 100-200 μg twice a day, and the budesonide formoterol group was also treated with budesonide formoterol inhalation at 160 μg and 4.5 μg twice a day. The course of treatment lasted for four weeks. The patients were followed up for four weeks after the use of medicine halted. After treatment, exhaled nitric oxide (NO) examination were performed. ResultsThe amount of NO in the exhaled gas in all the three treatment groups were significantly different from the control group (P<0.05), and it was also significantly different between the Budesonide group and the budesonide formoterol group (P<0.05). ConclusionBudesonide formoterol inhalant has a good effect on teenager patients with allergic rhinitis accompanied with asthma in terms of improving exhaled NO.