鼻内类固醇与鼻内抗组胺喷雾剂或单独鼻内类固醇喷雾剂治疗变应性鼻炎的比较研究

Deepa Shivnani, E. V. Raman
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引用次数: 0

摘要

过敏性鼻炎是世界范围内最常见的鼻炎形式,影响全球近10%至30%的人口。遗传和环境暴露可能导致过敏倾向。药物治疗以及有效的过敏原避免措施形成变应性鼻炎管理的支柱。有证据表明,在控制变应性鼻炎症状方面,鼻内皮质类固醇比抗组胺药更有效。这种“优势”主要与它们对鼻塞的作用有关。为了了解联合喷雾剂比单独使用类固醇喷雾剂的疗效而进行的研究数量很少,而且提供的见解也不够充分。本研究的目的是确定是否应将联合鼻喷雾剂作为变应性鼻炎的标准医疗管理,以获得更好的治疗后生活质量,并最大限度地改善鼻症状总评分(TNSS)。本研究共纳入100名受试者,每组50名,符合纳入和排除标准。受试者根据咨询师的偏好分为两组。在治疗开始前和治疗开始后对受试者进行鼻总症状评分(TNSS)和迷你犀牛结膜炎生活质量问卷(MiniRQLQ)评分。研究根据给药情况分为两组,分别在给药2周和4周后对两组患者进行TNSS和MiniRQLQ评分。变应性鼻炎在年轻人群中更为常见。两种药物均能显著降低总鼻症状评分(TNSS)和MiniRQLQ评分(p<0.001)。然而,联合鼻腔喷雾剂(鼻内皮质类固醇与鼻内抗组胺药)被发现在统计学上优于仅鼻内类固醇喷雾剂。联合鼻喷雾剂疗效显著且优于类固醇鼻喷雾剂,因此本研究证实了联合鼻喷雾剂的优越性,并推荐联合鼻喷雾剂作为过敏性鼻炎的一线治疗方法。
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A comparative study of intranasal steroids with intranasal antihistamines sprays v/s intranasal steroids sprays alone in management of allergic rhinitis
Allergic rhinitis is the most common form of rhinitis, worldwide, affecting close to 10% to 30% of the global population. Heredity and environmental exposures may contribute to a predisposition to allergies. Pharmacotherapy along with effective allergen avoidance measures forms the mainstay of management of Allergic Rhinitis. The evidence indicates that intranasal corticosteroids are more efficacious than are antihistamines in the control of Allergic Rhinitis symptoms. This "superiority" is principally related to their effect on nasal obstruction. The numbers of studies done to know the efficacy of combination sprays over steroidal sprays alone are very few and provide insufficient insight.The purpose of this study was to ascertain whether the combination nasal sprays should be prescribed as a standard medical management for allergic rhinitis or not, as to achieve better quality of life after treatment with maximum improvement in Total Nasal Symptom Score (TNSS). 100 subjects were taken up for this study, 50 in each group after fulfilling the inclusion and exclusion criteria. Subjects were allocated in two groups according to consultant’s preference. Subjects were evaluated for Total Nasal Symptom Score (TNSS) and score of Mini Rhino conjunctivitis Quality of Life Questionnaire (MiniRQLQ) before and after the treatment initiation The study was conducted in two groups based on drug given and both the groups were evaluated after 2 weeks and 4 weeks of medication on the basis of TNSS and MiniRQLQ score. Allergic Rhinitis was found to be more common in younger age group. Both the drugs were effective in reducing the Total nasal symptom scores (TNSS) and score of MiniRQLQ significantly (p<0.001). However, Combination Nasal Sprays (Intra-nasal corticosteroids with intranasal antihistamines) were found to be statistically superior when compared to only intranasal steroid sprays.Combination Nasal Sprays are highly efficacious and statistically better to steroid nasal sprays hence this study confirms the superiority of combination nasal sprays and recommends combination nasal sprays as first line of treatment for allergic rhinitis.
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