盐酸氮卓斯汀喷鼻剂与辅舒良在治疗变应性鼻炎中的疗效分析

目的比较盐酸氮卓斯汀喷鼻剂同辅舒良在治疗常年性变应性鼻炎中的疗效。方法在确诊为常年性变应性鼻炎的231例患者,随机分成两组,其中123例患者对其用盐酸氮卓斯汀喷鼻剂进行治疗,另外108例用辅舒良(丙酸氟替卡松鼻喷剂)进行治疗,对比两组的疗效。结果盐酸氮卓斯汀组与辅舒良组治疗效果相当,但盐酸氮卓斯汀起效时间更快。从不良反应看,盐酸氮卓斯汀有个别患者诉有一过性轻微口苦;辅舒良组有10例出现鼻黏膜干燥,有3例出现鼻出血。盐酸氮卓斯汀不良反应更少。结论当常年性变应性鼻炎需要快速、安全和高效减轻症状时盐酸氮卓斯汀喷鼻剂是重要的选择之一。     

盐酸氮卓斯汀喷鼻剂联合辛芩颗粒治疗变应性鼻炎效果观察

目的:观察盐酸氮卓斯汀喷鼻剂联合辛芩颗粒治疗变应性鼻炎的临床效果.方法:将56例变应性鼻炎患者随机分为观察组与对照组,对照组采用盐酸氮卓斯汀喷鼻剂治疗,观察组给予盐酸氮卓斯汀喷鼻剂联合辛芩颗粒治疗,两组疗程均为2周,比较两组临床疗效、药物不良反应以及治疗后4~8周复发情况.结果:观察组总有效率92.8%,对照组为71.5%,组间比较差异显著(P<0.01);不良反应发生情况组间比较无显著差异(P>0.05);治疗后4~8周观察组复发率10.7%,对照组为25.0%,组间比较差异显著(P<0.05).结论:盐酸氮卓斯汀喷鼻剂联合辛芩颗粒治疗变应性鼻炎可提高临床疗效,减少复发,且不增加不良反应.     

氮卓斯汀联合氟替卡松治疗变应性鼻炎的临床观察

目的:观察氮卓斯汀联合氟替卡松治疗变应性鼻炎(AR)的有效性及安全性。方法:选择2015年1月-2016年7月笔者所在3家医院中的AR患者135例作为研究对象,按随机数字表法分为氮卓斯汀组、氟替卡松组和联合用药组,各45例。在给予减充血剂盐酸羟甲唑啉喷雾剂的基础上,氮卓斯汀组患者给予盐酸氮卓斯汀鼻喷剂,每个鼻孔1喷,早晚各1次;氟替卡松组患者给予丙酸氟替卡松鼻喷雾剂,每个鼻孔1喷,早晚各1次;联合用药组患者给予盐酸氮卓斯汀鼻喷剂联合丙酸氟替卡松鼻喷雾剂,用法用量同前。3组患者均持续用药30 d。比较3组患者的鼻部症状总评分(TNSS)和眼部症状总评分(TOSS)下降指数、鼻腔最小横截面积(NMCA)、鼻腔总阻力(TNR),以及不良反应发生情况。结果:试验过程中因不同原因脱落,剩余127例患者进入全分析数据集、130例患者进入安全数据集。治疗后,联合用药组患者的TNSS下降指数明显高于氮卓斯汀组和氟替卡松组,差异均有统计学意义(P<0.05);氮卓斯汀组与氟替卡松组患者的TNSS下降指数,以及3组患者的TOSS下降指数比较,差异均无统计学意义(P>0.05)。治疗前,3组患者均有不同程度的鼻通气障碍,但TNR和NMCA比较差异均无统计学意义(P>0.05);治疗后,3组患者的NMCA以及在75、150 Pa下的TNR均明显小于治疗前,且联合用药组的TNR明显小于氮卓斯汀组和氟替卡松组,差异均有统计学意义(P<0.05);但3组患者间NMCA比较,差异无统计学意义(P>0.05)。3组患者总不良反应发生率比较,差异无统计学意义(P>0.05)。结论:氮卓斯汀和氟替卡松均可有效缓解AR患者的鼻部症状,改善鼻通气障碍;联合用药的疗效优于单一用药方案,而且并未增加不良反应的发生概率。     

丙酸氟替卡松联合氮卓斯汀鼻喷剂治疗过敏性鼻炎疗效观察

过敏性鼻炎也称变应性鼻炎(AR),临床表现为鼻痒、喷嚏、清涕和鼻塞,常反复发作,患病率高,而且呈上升趋势。我们应用丙酸氟替卡松联合氮卓斯汀鼻喷剂治疗过敏性鼻炎取得较好疗效,现报告如下。1资料与方法1.1一般资料:对我院2008年以来门诊患者中诊断为过敏性鼻炎的患者曾应用丙酸氟替卡松联合氮卓斯汀鼻喷剂     

美国FDA批准Dymista喷鼻剂用于治疗季节性过敏性鼻炎

美国FDA近日批准Meda公司Dymista(盐酸氮卓斯汀和丙酸氟替卡松)用于治疗≥12岁的季节性过敏性鼻炎(SAR)患者。本品是一种喷鼻剂,含有一种H1受体拮抗剂和一种皮质激素。每次使用时对两侧鼻孔各喷1下,每日给药2次。Dymista的有效性与安全性已在多项研究中得到了评估。其中3项随机、多中心、双盲、安慰剂对照临床试验共招募853例SAR患者,受试患者被随机分为Dymista喷鼻剂组、盐酸氮卓斯汀喷鼻     

鼻用丙酸氟替卡松治疗变应性鼻炎的临床疗效

目的研究探讨鼻用丙酸氟替卡松临床治疗变应性鼻炎的效果,为今后的临床工作提供参考价值。方法将2010年2月到2012年3月在本院门诊就诊的78例变应性鼻炎患者,随机分为观察组（39例）和对照组（39例）,观察组予以丙酸氟替卡松鼻腔喷入治疗,对照组予以口服千柏鼻炎片治疗,15d后观察两组的疗效和不良反应。结果观察组的总有效率为87.18%,明显高于对照组的64.10%,两组对比差异,具有统计学意义（P〈0.05）,且未出现不良反应。结论鼻用丙酸氟替卡松用于变应性鼻炎疗效确切,无严重不良反应,值得在临床上进一步研究应用。     

中西医结合治疗过敏性鼻炎的临床观察

目的观察分析使用玉屏风散结合西药治疗过敏性鼻炎的临床效果。方法从我院经治的过敏性鼻炎患者中抽取60例,随机分为观察组与对照组,对照组患者使用左西替利嗪片口服及丙酸氟替卡松喷鼻剂喷鼻进行治疗,观察组患者在此基础上加用玉屏风散加减进行治疗,对比观察两组患者的临床疗效。结果观察组患者治疗总有效率明显高于对照组,差异有统计学意义(P<0.05)。结论使用玉屏风散配伍左西替利嗪片口服及丙酸氟替卡松喷鼻剂喷鼻治疗过敏性鼻炎,具有更为理想的临床治疗效果,值得进一步推广应用。     

丙酸氟替卡松联合氯雷他定治疗变应性鼻炎34例

目的：探讨丙酸氟替卡松联合氯雷他定治疗变应性鼻炎的疗效。方法：选择本院收治的68例临床确诊为中重度常年性变应性鼻炎的患者,将其随机分为治疗组和对照组,每组34例,治疗组给予丙酸氟替卡松鼻喷雾剂与氯雷他定片联合治疗,对照组仅予丙酸氟替卡松鼻喷雾剂治疗,观察两组的疗效及副反应发生情况。结果：治疗组总有效率为91.2%,对照组总有效率为79.4%,治疗组疗效优于对照组（P〈0.05）。结论：丙酸氟替卡松鼻喷雾剂联合氯雷他定片治疗中重度常年性变应性鼻炎疗效显著,优于单用丙酸氟替卡松鼻喷雾剂治疗。     

盐酸氮(卓)司汀与丙酸氟替卡松治疗青少年季节性变应性鼻炎疗效比较

目的 研究盐酸氮(卓)司汀与丙酸氟替卡松治疗青少年季节性变应性鼻炎(SAR)的疗效及安全性.方法 选取2009年3月至2012年3月在我院诊治的SAR青少年患者76例,随机分为盐酸氮(革)司汀组和丙酸氟替卡松组,各38例,分别给予盐酸氮(卓)司汀鼻喷剂和丙酸氟替卡松鼻喷剂治疗,评价2组疗效,并通过鼻部症状总评分(TNSS)和服部症状总评分(TOSS)比较2组临床症状改善情况.结果 盐酸氮革司汀组和丙酸氟替卡松组总有效率分别为76.3％ (29/38)和81.6％ (31/38),组间差异无统计学意义(x2=0.32,P＞0.05).盐酸氮(卓)司汀组治疗前后TNSS分别为(8.7±2.3)分和(5.5±1.6)分,TOSS分别为(6.5±1.8)分和(3.9±1.2)分;丙酸氟替卡松组治疗前后TNSS评分分别为(8.4±2.2)分和(4.6±1.6)分,TOSS分别为(6.6±1.6)分和(4.5±1.3).2组治疗前后TNSS和TOSS的差异均有统计学意义(P＜0.05);治疗后,盐酸氮(卓)司汀组与丙酸氟替卡松组的TNSS和TOSS差异均无统计学意义(P＞0.05).盐酸氮革司汀组有2例患者发生嗜睡,丙酸氟替卡松组1例鼻出血.结论 盐酸氮(草)司汀与丙酸氟替卡松在治疗青少年SAR中均安全有效,二者在改善患者鼻部及眼部症状中效果相似.     

糠酸氟替卡松鼻用喷雾剂治疗变应性鼻炎的效果评价

目的:探讨糠酸氟替卡松鼻用喷雾剂治疗变应性鼻炎的效果。方法:随机选取140例变应性鼻炎的患者作为研究对象,随机分为对照组70例,观察组70例。对照组给予布地奈德鼻喷雾剂喷鼻;观察组给予糠酸氟替卡松鼻用喷雾剂治疗。比较两组的治疗效果。结果:观察组治疗有效率与对照组相比,明显高于后者;观察组生活质量评分与对照组相比较,明显高于后者,差异具有统计学意义(P0.05)。结论:对于变应性鼻炎的患者使用糠酸氟替卡松鼻用喷雾剂治疗,治疗有效率高,提高患者生活质量,值得在临床进一步探讨=和推广。     

丙酸氟替卡松鼻喷雾剂对儿童哮喘控制及过敏性鼻炎症状改善的作用

目的 比探讨丙酸氟替卡松鼻喷雾剂在改善儿童过敏性鼻炎症状以及控制哮喘反复发作方面的作用.方法 将100例过敏性鼻炎合并哮喘综合征患儿按照随机数字表法分为对照组和观察组.对照组应用氯雷他定及经口腔吸人糖皮质激素,观察组在此基础上使用丙酸氟替卡松鼻喷雾剂治疗,观察两组疗效.结果 观察组总有效率（94％）明显优于对照组（76％）（x2=6.35,P＜0.05）.10 ～ 12周以后,观察组与对照组鼻炎症状评分及哮喘症状评分差异均有统计学意义（t=2.47、2.64、3.41;2.30、3.17、2.47,均P＜0.05）.不良反应方面两组鼻腔干燥、鼻出血发生率差异均有统计学意义（x2 =7.11、7.53,均P＜0.05）.结论 丙酸氟替卡松鼻喷雾剂在改善儿童过敏性鼻炎和哮喘症状复发方面有很好疗效,值得临床大力推广.     

盐酸氮卓斯汀与曲安奈德治疗变应性鼻炎的临床观察

目的:比较盐酸氮卓斯汀与曲安奈德治疗变应性鼻炎的临床疗效和安全性。方法:96例变应性鼻炎患者按随机数字表法分为A组(55例)和B组(41例)。A组患者给予盐酸氮卓斯汀鼻喷雾剂,每鼻孔1喷,bid,于晨起和睡前给药;B组患者给予曲安奈德鼻喷雾剂,每鼻孔2喷,qd,于晨起给药。两组患者疗程均为4周。观察两组患者的临床疗效、治疗前后的症状与体征评分及不良反应发生情况。结果:两组患者总有效率比较,差异无统计学意义(P>0.05)。治疗前两组患者症状与体征评分比较,差异均无统计学意义(P>0.05);治疗后两组患者症状与体征评分均显著低于同组治疗前,差异均有统计学意义(P<0.05),但两组间比较差异无统计学意义(P>0.05)。A组患者不良反应发生率为5.5%,B组患者为19.5%,A组显著低于B组,两组比较差异有统计学意义(P<0.05)。结论:盐酸氮卓斯汀与曲安奈德治疗变应性鼻炎均具有显著疗效,但盐酸氮卓斯汀安全性更好。     

探讨糠酸莫米松吸入治疗过敏性鼻炎对支气管哮喘的影响

目的试验和分析糠酸莫米松吸入治疗过敏性鼻炎对支气管哮喘的影响。方法选取本院收治的过敏性鼻炎及支气管哮喘患者158例,作为研究对象。随机分为糠酸莫米松吸入治疗观察组和普通疗法对照组。比较两组患者治疗前及治疗2月后的咳嗽,鼻塞,鼻痒,喷嚏的次数。综合以上的几种临床症状判断糠酸莫米松吸入治疗过敏性鼻炎对支气管哮喘的临床疗效。记录患者的并发症并分析。结果两组患者治疗2月后,观察组的总有效率有明显具有优势,P均〈0.05,差异均具有统计学意义。观察组的总不良反应明显小于对照组,两组比较差异明显,P均〈0.05,差异均具有统计学意义。结论糠酸莫米松吸入治疗过敏性鼻炎积极有效,并对支气管哮喘有积极影响。值得临床的广泛推广与应用。     

Effect of fluticasone propionate nasal spray on bioavailability of intranasal hydromorphone hydrochloride in patients with allergic rhinitis

STUDY OBJECTIVE: To investigate the effect of the nasal corticosteroid fluticasone propionate on the bioavailability and pharmacokinetics of single-dose intranasal hydromorphone hydrochloride in patients with allergic rhinitis. DESIGN: Randomized, three-way, crossover pharmacokinetic study. SETTING: University clinical research unit. PATIENTS: Twelve patients with allergic rhinitis. INTERVENTION: Hydromorphone hydrochloride 2.0 mg was administered by intravenous infusion (treatment A), intranasal spray without allergic rhinitis treatment (treatment B), and intranasal spray after 6 days of fluticasone propionate (treatment C). Blood samples were collected serially from 0-16 hours. MEASUREMENTS AND MAIN RESULTS: Pharmacokinetic parameters were determined by noncompartmental methods. An analysis of variance (ANOVA) model was used for statistical analysis. Mean (% coefficient of variation) absolute bioavailability of intranasal hydromorphone was 51.9% (28.2) and 46.9% (30.3) in patients with allergic rhinitis with and without treatment with fluticasone propionate, respectively. Mean maximum concentration (Cmax) values were 3.02 and 3.56 ng/ml, respectively. No statistical differences in Cmax and area under the concentration versus time curve were detected between intranasal treatments. Bioavailability values for both intranasal treatments were lower than those in healthy volunteers (57%). Median time to Cmax (Tmax) values were significantly different (p=0.02) for treatments B and C (15 and 30 min, respectively) using rank-transformed Tmax for ANOVA. Adverse effects were consistent with known effects of hydromorphone administered by other routes, with the exception of bad taste after intranasal administration. CONCLUSION: Hydromorphone was rapidly absorbed after nasal administration, with maximum concentrations occurring for most subjects within 30 minutes. Allergic rhinitis may affect pain management strategies for intranasal hydromorphone, with a delay in onset of action for patients treated with fluticasone propionate.     

丙酸氟替卡松治疗过敏性鼻炎疗效及对患者免疫力的影响

目的 探讨丙酸氟替卡松治疗过敏性鼻炎疗效及对患者免疫力的影响.方法 选取该院2010年1月-2012年12月收治的80例过敏性鼻炎患者进行研究分析.80例患者按照数字随机法分为观察组和对照组,每组40例.观察组采用丙酸氟替卡松治疗,对照组采用酮替芬进行治疗,观察两组患者治疗的效果及治疗前后血清中血清免疫球蛋白（Ig）定量和IL-4及IL-12的含量变化.结果 经研究发现,观察组有效率95.0%,与对照组80.0%相比,差异具有统计学意义,P〈0.05.且治疗后,IL-4、IL-12 的含量明显高于治疗前和对照组,差异均具有统计学意义,P〈0.05.结论 丙酸氟替卡松在治疗过敏性鼻炎有较好的疗效,且患者免疫力大大提高,值得临床推荐.     

氮斯汀喷鼻剂治疗常年性变应性鼻炎随机双盲试验

目的 :探讨氮斯汀喷鼻剂治疗常年性变应性鼻炎的疗效及安全性。方法 :38例中、重度常年性变应性鼻炎病人行随机、双盲、对照研究。分氮斯汀组 19例 ,给予氮斯汀液体喷鼻剂喷鼻 ,每日 2次 ,每次每侧鼻孔 1揿 (每揿 140 μg氮斯汀 ) ,治疗 4wk。左卡巴斯汀组 19例 ,用左卡巴斯汀喷鼻剂喷鼻 ,每日 2次 ,每次 2揿 ,作为对照。治疗 2wk末及 4wk末时 ,根据主观评分及客观检查结果 ,综合评定疗效。结果 :氮斯汀喷鼻剂组总有效率为 95 % ,左卡巴斯汀喷鼻剂组为 84 % (P >0 .0 5 )。 2组治疗前后喷嚏、流涕、鼻痒、鼻塞及眼部症状积分下降分别为 1.4± 0 .8和 1.3± 1.0 ,1.0±0 .7和 0 .8± 0 .9,1.3± 0 .6和 1.4± 0 .7,0 .7± 0 .7和 0 .7± 0 .8,0 .8± 0 .8和 0 .5± 0 .7(均P >0 .0 5 ) ,未发生严重的不良反应。结论 :氮斯汀喷鼻剂与左卡巴斯汀喷鼻剂在治疗常年性变应性鼻炎时具相似的疗效和安全性     

两种方法治疗支气管哮喘伴过敏性鼻炎疗效比较

目的 比较采用丙酸氟替卡松气雾剂联合鼻喷剂与单纯丙酸氟替卡松气雾剂治疗支气管哮喘伴过敏性鼻炎的疗效.方法 50例支气管哮喘伴过敏性鼻炎患者随机分成观察组和对照组各25例,观察组吸入丙酸氟替卡松气雾剂加丙酸氟替卡松鼻喷剂,对照组吸入丙酸氟替卡松吸入气雾剂.随访6个月,分别于1、3、6个月检测两组治疗后肺功能:1s用力呼气量占正常预计值的百分比(FEV1％)、哮喘急性发作次数、无症状天数.结果 观察组治疗后1、3、6个月FEV1％分别为(107.2±15.3)％、(115.3±11.9)％、(131.3±10.9)％,均明显高于对照组的(98.6±13.6)％、(102.6±13.6)％、(126.5±9.7)％(t=2.306、3.355、3.714,均P＜0.05).观察组治疗期间发生支气管哮喘次数(0.13±0.11)次、无症状天数(150.2±14.3)d、鼻炎发作次数(0.25±0.31)次,对照组分别为(0.30±0.44)次、(116.5±23.1)d、(0.65±0.24)次,两组差异均有统计学意义(t =2.413、3.435、3.734,均P＜0.05).结论 丙酸氟替卡松气雾剂联合鼻喷剂治疗支气管哮喘伴过敏性鼻炎疗效显著,值得临床推广应用.     

Sequential therapy with azelastine in seasonal allergic rhinitis. Deutsche Rhinitis Studiengruppe (German Rhinitis Study Group)

A sequential therapy treatment with azelastine (Allergodil) in seasonal allergic rhinitis is introduced. In the critical early stage, treatment begins with a combination of azelastine tablets (azelastine hydrochloride, CAS 79307-93-0) and azelastine nasal spray (azelastine, CAS 58581-89-8), and after five days only the nasal spray is administered. This sequential therapy model aims at achieving the quickest and most complete effect without reducing the tolerability. The investigation was carried out as a randomized, controlled double-blind phase IV study of parallel group design with 300 patients during 14 days. In the first five days, one group was given one puff (0.14 mg) of azelastine nasal spray twice daily and one 2 mg tablet of azelastine at night. The other group received nasal spray and a placebo tablet. Beginning on day six, both groups received nasal spray only. Both treatments proved to be effective; the combination therapy, however, was significantly more effective beginning as early as the first treatment. The superiority of the combination therapy increased until day five. Thereafter, the two curves grew closer together; however, the superiority of the combination treatment remained. The tolerability of both treatments was similar.     

Azelastine hydrochloride:a review of pharmacology,pharmacokinetics, clinical efficacy and tolerability

ABSTRACT

Introduction: Azelastine hydrochloride (Astelin) nasal spray 0.1% solution is a second-generation intranasal antihistamine available in the US for treatment of both seasonal allergic rhinitis (SAR) and nonallergic vasomotor rhinitis (VMR).

Scope: Searches of journal articles including the title word ‘azelastine’ from 1979 through the present were conducted by the product manufacturer primarily through Medline and EMBASE but also included, at various times, Dialog, Biosis, Toxline, and Diogenes (an adverse-event database). One limitation of the present review is that it could not exclude the possibility of publication bias, whereby findings from smaller studies and/or trials with negative findings may not have been published.

Findings: Azelastine is a phthalazinone derivative with H₁-receptor binding approximately tenfold greater than chlorpheniramine on a milligram-per-milligram basis. Azelastine has demonstrated a wide range of pharmacologic effects on chemical mediators of inflammation including leukotrienes, kinins, and platelet activating factor in vitro and in vivo. The molecule also has been shown to downregulate intercellular adhesion molecule-1 expression and to reduce inflammatory cell migration in patients with rhinitis. Well-controlled studies in SAR and VMR demonstrated that azelastine nasal spray improves nasal symptoms of rhinitis, including congestion and postnasal drip, and has a rapid onset of action that appears likely due to topical activity. Azelastine nasal spray has demonstrated greater efficacy when used in combination with fluticasone propionate nasal spray when compared to either agent alone, and this combination may provide benefit for patients with moderate-to-severe rhinitis. Bitter taste is the most common side effect associated with azelastine nasal spray and this problem can be mitigated by the dosing technique recommended by the manufacturer in the product labeling. The incidence of somnolence also may be reduced with the recommended administration technique.

Conclusions: Azelastine is an effective, rapid-acting, and well-tolerated second-generation antihistamine that improves nasal symptoms associated with SAR and VMR. Clinical studies demonstrated that azelastine nasal spray can improve symptoms of SAR in patients who remained symptomatic after treatment with oral antihistamines and that azelastine nasal spray in combination with fluticasone nasal spray provided significantly (?p < 0.05) greater relief than either agent alone in patients with SAR.