Efficacy of Clarithromycin Combined with Fluticasone Propionate on Nasal Function, Nasal Mucociliary Transport Function, and Serum Inflammatory Markers in Chronic Rhinosinusitis Patients After Functional Endoscopic Sinus Surgery.

Yuhua Wu, Xuezheng Shi, Shuren Ni, Hao Sun
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Abstract

Objective: This study aims to assess the efficacy of clarithromycin (CAM) combined with fluticasone propionate (FP) in patients with chronic rhinosinusitis (CRS) after functional endoscopic sinus surgery (FESS), focusing on nasal function, nasal mucociliary transport (MCT) function, and serum inflammatory markers. Methods: The control group (n = 48) was treated with FESS alone, while the study group (n = 48) was treated with FESS plus CAM combined with FP. The clinical effects, symptom scores, nasal function, nasal MCT function, serum inflammatory marker levels, and the occurrence of adverse reactions were compared. Results: The total efficacy rate of the study group (95.83%) was significantly higher than that of the control group (83.33%). After treatment, the study group showed lower symptom scores for nasal congestion, runny nose, sneezing and dizziness, and headache compared to those in the control group. The study group also had lower nasal airway resistance, shorter distance from the minimal cross-sectional area to the nostril, and lower T&T olfactory scores. In contrast, their nasal cavity volume and minimal cross-sectional area were higher than those of the control group. Additionally, the nasal mucociliary clearance and MCT rates were higher in the study group. Serum levels of interleukin-6, interleukin-8, tumor necrosis factor-α, and procalcitonin were significantly lower in the study group compared to the control group (all P < .05). Conclusion: The use of CAM combined with FP in patients after FESS for CRS is effective, leading to the relief of clinical symptoms, improvement of nasal function, enhancement of MCT function, and reduction of inflammatory response, without increasing the incidence of adverse reactions.

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克拉霉素联合丙酸氟替卡松对功能性内窥镜鼻窦手术后慢性鼻窦炎患者的鼻功能、鼻黏膜纤毛运输功能和血清炎症标志物的疗效
研究目的本研究旨在评估克拉霉素(CAM)联合丙酸氟替卡松(FP)对功能性内窥镜鼻窦手术(FESS)后慢性鼻窦炎(CRS)患者的疗效,重点关注鼻腔功能、鼻黏膜纤毛运输(MCT)功能和血清炎症指标。研究方法对照组(48 人)单独接受 FESS 治疗,研究组(48 人)接受 FESS 加 CAM 联合 FP 治疗。比较临床效果、症状评分、鼻腔功能、鼻腔 MCT 功能、血清炎症标志物水平和不良反应发生率。结果显示研究组的总有效率(95.83%)明显高于对照组(83.33%)。治疗后,研究组的鼻塞、流涕、打喷嚏、头晕和头痛症状评分低于对照组。研究组的鼻腔气道阻力也较小,最小横截面到鼻孔的距离较短,T&T嗅觉评分也较低。相比之下,研究组的鼻腔容积和最小横截面积均高于对照组。此外,研究组的鼻粘膜纤毛清除率和 MCT 率也更高。与对照组相比,研究组的血清白细胞介素-6、白细胞介素-8、肿瘤坏死因子-α 和降钙素原水平明显降低(均 P < .05)。结论对 FESS 治疗 CRS 后的患者使用 CAM 联合 FP 是有效的,可缓解临床症状、改善鼻功能、增强 MCT 功能并减轻炎症反应,且不会增加不良反应的发生率。
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