长期小剂量克拉霉素在治疗儿童慢性鼻鼻窦炎中的作用

目的探讨长期使用小剂量克拉霉素治疗儿童慢性鼻-鼻窦炎（chronic rhinosius-itis,CRS）的临床疗效。方法采用随机对照将74例诊断为CRS儿童分为常规治疗（38例）和克拉霉素治疗（36例）两组,常规治疗组采用喷鼻剂糠酸莫米松喷鼻和碱性盐水行鼻腔冲洗;克拉霉素组采用上述方法加用克拉霉素,疗程为12周。采用视觉模拟量表（visual analog scale,VAS）评估其症状,鼻内镜观察评估鼻腔,分别安排在治疗前,治疗后4、8和12周。鼻窦CT采用Lund-Mackay评分法,分别安排在治疗前和治疗后12周。结果两组病例经过4周治疗后,其症状VAS总分和鼻内镜评分均较治疗前明显下降（P〈0.05）,但两组间差异无显著性意义（P〉0.05）;经过8周治疗,两组病例症状VAS总分和鼻内镜评分均较治疗前和治疗4周明显下降（P〈0.01）,且克拉霉素组疗效明显优于常规治疗组（P〈0.01）;至治疗后12周,两组病例症状VAS总分和鼻内镜评分均较治疗前、治疗4周和治疗8周明显下降（P〈0.01）,鼻窦CT评分也较治疗前明显下降（P〈0.01）,两组间疗效差异亦有显著性意义（P〈0.01）。结论长期小剂量克拉霉素应用治疗儿童CRS近期有着较好的疗效,是一种安全有效的治疗选择。

Long term low dose clarithromycin in the treatment of pediatric chronic rhinosinusitis

Objective To detect the effect of long-term low-dose clarithromycin in the treatment of pediatric chronic rhinosinusitis(CRS).Methods 74 patients with pediatric CRS were randomly divided into clarithromycin group(36 cases)and control group(38 cases).The patients in the control group received a 12-week treatments of alkaline nasal douche,and intranasal momestasone furoate.The patients in clarithromycin group received a 12-week treatments of clarithromycin,alkaline nasal douche and intranasal momestasone furo...