作　　者： (阙镇如）; (冉骞）; (蔡继壹）; (张智斌）; (黄钦辉）;

机构地区： 解放军第一八0医院耳鼻咽喉科,福建泉州362008

出　　处： 《医学综述》 2017年第17期3525-3528,共4页

摘　　要： 目的探讨盐酸非索非那定片联合布地奈德鼻喷雾剂治疗变应性鼻炎(AR)的疗效。方法选择2012年4月至2015年10月在解放军第一八○医院就诊的82例AR患者作为研究对象,按照随机数字法分为对照组和观察组,各41例。对照组给予布地奈德鼻喷雾剂治疗(64μg/次喷鼻、早晚各1次,持续治疗2周),观察组给予盐酸非索非那定片联合布地奈德鼻喷雾剂治疗(盐酸非索非那定片60 mg/次、早晚各1次,布地奈德鼻喷雾剂用法用量同对照组,持续治疗2周)。治疗后,比较两组患者的临床症状评分、嗜酸粒细胞数目及辅助性T细胞(Th)1、Th2细胞因子水平。结果治疗后,两组患者的鼻塞、鼻痒、流涕、喷嚏评分均显著低于治疗前(P<0.01);且观察组低于对照组[(0.68±0.09)分比(1.05±0.15)分、(0.52±0.08)分比(0.89±0.12)分、(0.33±0.06)分比(0.72±0.09)分、(0.51±0.08)分比(1.14±0.18)分](P<0.05)。治疗后,两组患者鼻灌洗液及诱导痰中嗜酸粒细胞数量均显著低于治疗前;且观察组低于对照组[(7.84±0.92)个/高倍镜视野(HP)比(13.31±1.87)个/HP、(4.27±0.66)个/HP比(10.38±1.43)个/HP](P<0.05)。治疗后,两组患者血清的白细胞介素(IL)4、IL-6、IL-10水平均显著低于治疗前,α干扰素(IFN-α)水平显著高于治疗前;且观察组的IL-4、IL-6、IL-10水平低于对照组[(1.49±0.22)mg/L比(2.32±0.42)mg/L、(7.49±1.03)mg/L比(11.32±1.86)mg/L、(2.94±0.36)mg/L比(4.42±0.68)mg/L],IFN-α水平高于对照组[(357.39±51.38)μg/L比(232.25±35.56)μg/L](P<0.05)。结论盐酸非索非那定片联合布地奈德鼻喷雾剂治疗能够改善患者的临床症状、减少嗜酸粒细胞浸润、纠正Th1/Th2的比例失衡,是治疗AR的理想方案。 Objective To study the effect of fexofenadine hydrochloride tablets combined with budesonide nasal spray on eosinophils and T cell subsets function of allergic rhinitis（AR）. Methods A total of 82 AR patients in PLA 180th Hospital for treatment during Apr. 2012 and Oct. 2015 were divided into an observation group and a control group according to the random number method,41 cases each. Patients in the control group were treated with budesonide nasal spray treatment（64μg/time,q12h,lasted for two weeks） and those in the observation group were treated with fexofenadine hydrochloride tablets combined with budesonide nasal spray treatment （fexofenadine hydrochloride tablets 60 mg/time, q12h, budesonide nasal spray usage and dosage was same as the control group, both lasted for 2 weeks）. The clinical symptoms scores, eosinophils contents,Thl and Th2 cytokines contents of the two groups were compared. Results After treatment,the nasal congestion, runny nose, nasal itching, sneezing scores in both groups were significantly lower than those before treatment（P 〈0. 01 ）, and scores in the observation group were lower than those in the control group[ （0. 68±0. 09） score vs （ 1.05 ± 0. 15 ） score, （0.52 ± 0. 08 ） score vs （ 0. 89 ± 0. 12 ） score, （ 0. 33 ± 0. 06 ） score vs （ 0. 72 ± 0. 09 ） score, （0. 51 ± 0. 08 ） score vs （ 1.14 ± 0. 18） score ] （P 〈 0. 05 ）. After treatment, the number of eosinophils in nasal lavage fluid and inducedsputum in the two groups were significantly lower than those before treatment, and those in the observation group were lower than those in the control group [ （ 7. 84 ± 0. 92 ） count/high power field （HP） vs （ 13.31 ± 1.87 ） count/HP, （4. 27 ± 0. 66） eount/HP vs （ 10. 38 ± 1.43 ） count /HP] （ P 〈 0. 05 ）. After treatment, serum contents of interleukin （IL）-4, IL-6, IL-10 in the two groups were lower than those before treatment, interferon（ IFN ） -α was higher than that before treatment, and cont

关 键 词： 变应性鼻炎 布地奈德 盐酸非索非那定 嗜酸粒细胞 辅助性 细胞