盐酸氮斯汀鼻喷剂治疗变应性鼻炎临床评价

变应性鼻炎是常见的耳鼻喉科疾病,由于其不易根治且频繁发作,极大地影响患者生活质量。近年来临床上使用的第二代抗组胺药盐酸氮斯汀鼻喷剂,具有抗组胺和抗炎双重作用,对变应性鼻炎的治疗起效迅速,安全性好,其疗效已逐渐获得临床肯定。     

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.     

药物治疗常年性变应性鼻炎的临床研究

目的评估伯克纳、氯雷他定、皿治林、孟鲁司特钠及氯雷他定与孟鲁司特钠联合治疗变应性鼻炎(AR)的临床疗效及安全性。方法采用前瞻性随机对照非盲法研究。100例AR患者随机分为A组(伯克纳2喷/鼻孔,2次/d)、B组(口服氯雷他定片10 mg/次,1次/d)、C组(口服皿治林10 mg/次,1次/d)、D组(口服孟鲁司特钠片10 mg/次,1次/d)与BD组(同时口服氯雷他定片10 mg/次与孟鲁司特钠片10 mg/次,1次/d)。评定5组基线水平以及分别于治疗后第3天(访视1)、第7天(访视2)和第14天(访视3)由患者和观察者对鼻部症状进行评估计分,根据得分多少进行疗效评价和统计学处理。结果与治疗前比较,治疗后鼻部各单项症状评分呈下降趋势,且后一次访视的评分比前一次访视下降;访视1时:BD组各项症状评分较其他各组较低(P<0.05),其他各组之间差异无统计学意义(P>0.05);访视2时:鼻塞症状评分B组、C组较其他组高,差异有统计学意义(P<0.05),C组鼻塞症状评分虽低于B组,但差异无统计学意义(P>0.05);其他各项症状评分BD组较其他4组低(P<0.05);访视3时:鼻塞症状评分B组较其他组高,差异有统计学意义(P<0.05),C组鼻塞症状评分虽高于其他组但无统计学意义(P>0.05);其他各项症状评分5组之间差异无统计学意义(P>0.05)。结论抗组胺药与抗白三烯药物相结合能起效更快、更有效地控制变应性鼻炎的各项症状。     

阿托品喷鼻剂治疗变应性鼻炎鼻漏

目的 :验证阿托品喷鼻剂治疗变应性鼻炎鼻漏的安全、有效性。方法 :选择变应性鼻炎鼻漏12 0例 ,其中男性 67例、女性 5 3例 ,年龄 (32±s 9)a ,6～ 5 9a ,病程 3mo～ 37a ;擤鼻后每侧鼻腔内喷阿托品喷鼻剂 0 .10mL ,qid ,连用 2wk。结果 :有效率 95 .8% ,未见不良反应。结论 :0 .0 5 %阿托品鼻腔内喷药治疗变应性鼻炎鼻漏是安全、有效的     

咪唑斯汀治疗季节性变应性鼻炎的临床观察

目的：观察眯唑斯汀（Mizolastine）治疗季节性变应性鼻炎的、临床疗效。方法：180例季节性变应性鼻炎患者，服用咪唑斯汀，10mg，qd，疗程为14d，患者将当天的病情以记分的形式记录在日记中，服药后每2周随访1次，共随访2次。治疗结束后计算出患者治疗前和治疗后的症状积分。并计算出治疗前、后的症状积分下降指数（SSRI）。结果：治疗后180例患者症状体征分级记分较治疗前明显下降（P〈0．01）；且治疗结束时和用药1个月后有效率分别为98％和97％。结论：咪唑斯汀是治疗季节性变应性鼻炎的有效药物，不良反应发生率低。     

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。     

盐酸司他斯汀片治疗常年性变应性鼻炎的疗效分析

目的观察盐酸司他斯汀片对常年性变应性鼻炎的临床疗效。方法随机双盲双模拟平行对照临床试验,实际纳入试验组19例,对照组20例。试验组（盐酸司他斯汀,1.0 mg）及对照组（富马酸氯马斯汀片,1.0 mg）,两组均每天服药2次、模拟片1片,均连服14 d。在服药第7天、第14天观察治疗前后两组的疗效。结果两组均能有效控制和改善病情,试验组与对照组的总有效率均为65%,两组间差异无显著性。结论盐酸司他斯汀片治疗常年性变应性鼻炎临床疗效确切,与富马酸氯马斯汀疗效相当。     

盐酸氮卓斯汀与丙酸氟替卡松喷鼻剂治疗变应性鼻炎临床对比观察

目的观察并比较盐酸氮卓斯汀与丙酸氟替卡松喷鼻剂在治疗变应性鼻炎中的效果。方法 146例变应性鼻炎患者,随机分为观察组和对照组,观察组应用盐酸氮卓斯汀喷鼻剂,对照组应用丙酸氟替卡松喷鼻剂(辅舒良),比较两组疗效及不良反应。结果两组治疗效果比较差异无统计学意义。但观察组起效快、不良反应明显少于对照组。结论对于常年性变应性鼻炎的治疗,应首选盐酸氮卓斯汀,该药起效快、安全有效,值得临床推广应用。     

盐酸氮［艹卓］斯汀鼻喷剂治疗变应性鼻炎临床评价

变应性鼻炎是常见的耳鼻喉科疾病，由于其不易根治且频繁发作，极大地影响患者生活质量。近年来临床上使用的第二代抗组胺药盐酸氮［艹卓］斯汀鼻喷剂，具有抗组胺和抗炎双重作用，对变应性鼻炎的治疗起效迅速，安全性好，其疗效已逐渐获得临床肯定。     

Double-blind placebo-controlled study of bepotastine besilate in pediatric patients with perennial allergic rhinitis

Background: Although second-generation antihistamines, such as bepotastine besilate, are recommended as a first-line treatment option for adult perennial allergic rhinitis (PAR), few non-sedating second-generation antihistamines are safe for children.

Objective: A double-blind, placebo-controlled, comparative study of 473 pediatric PAR patients (7 – 15 years old) to determine the superiority and safety of bepotastine besilate (10 mg twice daily) relative to placebo for improved total and individual nasal symptom scores compared with baseline.

Research design and methods: Subjects were randomized to placebo (n = 233) or bepotastine besilate (n = 240, 10 mg orally twice daily for 2 weeks). Interference of daily life by PAR was assessed by measuring change in individual nasal symptom scores from baseline.

Results: Bepotastine besilate was superior to placebo in terms of total nasal symptom scores, with improved overall nasal symptoms of PAR compared with baseline values. Subgroup analyses demonstrated bepotastine besilate was effective irrespective of age, sex or body weight. No clinically significant adverse drug reactions often observed with first-generation antihistamines were reported and no difference in adverse events between groups was observed.

Conclusions: Bepotastine besilate is effective and safe for pediatric PAR patients aged 7 – 15 years, and has a significant clinical impact on PAR. Clinical trial registration: ClinicalTrials.gov identifier: NCT01861522 (https://clinicaltrials.gov/ct2/show/NCT01861522).     

国产与进口西替利嗪片治疗常年性变应性鼻炎的比较

目的：比较国产与进口西替利嗪片对常年性变应性鼻炎的疗效及不良反应。方法：常年性变应性鼻炎２０３ 例,国产组１１１ 例（ 男性５９ 例,女性５２例,年龄３６ ａ ±ｓ ７ ａ） ,进口组９２ 例（ 男性５２ 例,女性４０ 例,年龄３９ ａ±９ ａ） , 分别给予国产与进口西替利嗪片１０ ｍｇ , ｐｏ ,ｑｄ,７ ｄ 为一个疗程,共１ ～２个疗程。结果：有效率国产组为８６ ％ ,进口组为８７ ％ （ Ｐ＞ ０ ．０５） , 显效时间分别为２ ．５ ｄ ±１ ．３ ｄ 及２ ．４ ｄ ±１ ．２ ｄ（ Ｐ＞ ０ ．０５） ; 不良反应发生率国产组为１８ ％ ,进口组为１５ ％ ,（ Ｐ＞ ０ ．０５） 。结论：国产西替利嗪片在治疗常年性变应性鼻炎的疗效及不良反应与进口西替利嗪片相近。     

白介素-1受体拮抗剂对豚鼠变应性鼻炎的治疗作用

目的：明确白介素-1受体拮抗剂对变应性鼻炎的治疗作用。方法：采用甲苯-2,4-二异氰酸酯（TDI toluene-2,4-diisocyanate)致敏豚鼠,制作变应性鼻炎模型,观察给予白介素-1受体拮抗剂（IL-1ra）处理前后症状和体征的变化,用组织病理学方法观察鼻粘膜的改变,测量鼻粘膜中组胺、血中IgE的含量。结果：用IL-1ra治疗后,变应性鼻炎症状和体征明显改善,HE染色显示,鼻粘膜水肿及炎性细胞浸润,随IL-1ra浓度的提高而改善,鼻粘膜中组胺、血中IgE的含量下降,随白介素-1拮抗剂浓度升高而下降。特别是高剂量组,各指标好于其它各治疗组,阳性对照组也有鼻粘膜水肿,及炎性细胞浸润。结论：局部使用IL-1ra拮抗剂能治疗变应性鼻炎。     

射频治疗常年性变应性鼻炎的临床研究

目的 探讨射频行筛前神经分支和下鼻甲点状烧灼术治疗常年性变应性鼻炎（PAR）的疗效。方法 在鼻内窥镜下运用射频治疗PAR患者48例（手术组），手术同时射频行双侧鼻腔筛前神经鼻外侧支和鼻中隔支以及双下鼻甲黏膜点状烧灼术，用症状和体征评分方法评定其疗效，并与保守治疗患者27例（对照组）进行比较。结果 一年后手术组有效率为98％，对照组为67％，其差异有显著性（P〈0．05）。结论 鼻内窥镜下筛前神经分支和下鼻甲联合射频术是治疗PAR的一种有效而简便的方法，联合手术疗效更确切。     

地洛他定治疗过敏性鼻炎114例的临床疗效和安全性评价

目的 :评价地洛他定治疗过敏性鼻炎的临床疗效和安全性。方法 :采用多中心、随机、双盲、阳性药物平行对照研究。入选过敏性鼻炎病人 2 4 0例 ,完成 2 2 4例 ,其中地洛他定组 114例 ,男性 5 5例 ,女性 5 9例 ,年龄 (4 0±s 7)a ,病程 (6 6± 9)mo ,服用地洛他定 ,5mg,po ,qd ;氯雷他定组 110例 ,男性 4 5例 ,女性 6 5例 ,年龄 (39± 7)a ,病程 (6 3± 8)mo ,予氯雷他定 ,10mg,po ,qd。 2组疗程均为2wk ,观察 2组疗效和不良反应。结果 :地洛他定用于治疗过敏性鼻炎 2wk后的显效例数和有效率分别为 4 6例和 92 .1% ,氯雷他定组的显效例数和有效率分别为 32例和 88.2 %。 2组疗效差异无显著意义 (P >0 .0 5 )。 2组均未出现严重及预料之外的不良反应 ,地洛他定组和氯雷他定组的不良反应发生率分别为 8.3%和 15 .0 % ,P >0 .0 5。结论 :地洛他定治疗过敏性鼻炎具有明显疗效 ,不良反应轻微     

Meta-analysis of azelastine nasal spray for the treatment of allergic rhinitis

STUDY OBJECTIVE: To systematically review the efficacy of azelastine nasal spray for the treatment of allergic rhinitis. DESIGN: Meta-analysis of published randomized controlled trials reported in English. DATA SOURCE: Published literature from the PubMed-MEDLINE database. PATIENTS: Patients aged at least 12 (United States) or 16 years (Europe) with allergic rhinitis or nonallergic vasomotor rhinitis. MEASUREMENTS AND MAIN RESULTS: A global assessment of efficacy was used to estimate the number needed to treat for azelastine nasal spray compared with placebo or active comparators. The total symptom score was used to compare the effect size between azelastine and placebo. In five comparisons of azelastine and placebo, azelastine was most efficacious, with a summary number needed to treat of 5.0 (95% confidence interval [CI] 3.3-10.0). In reviewing 11 studies of azelastine versus active comparators, we found no significant difference between azelastine and active comparators (number needed to treat 66.7, 95% CI 14.3 to infinity to 25). Azelastine was more efficacious than placebo in terms of total symptom score (effect size of 0.36, 95% CI 0.26-0.46). CONCLUSION: Azelastine nasal spray was more efficacious than placebo in the treatment of allergic rhinitis. No significant differences were observed between azelastine and active comparators for the treatment of allergic rhinitis; however, when azelastine was compared with oral antihistamines as monotherapy, the trend favored azelastine. Because azelastine appears to be as efficacious as oral antihistamines, the choice of treatment for seasonal allergic rhinitis should depend on the patient's preference regarding the route of administration, adverse effects, and the cost of the drug.     

曲安奈德喷雾剂对变应性鼻炎的作用

目的研究曲安奈德鼻腔局部给药对实验性变应性鼻炎动物模型的治疗作用及对组胺致大鼠鼻气道阻力增加的缓解作用。方法以实验性变应性鼻炎模型豚鼠和组胺致鼻气道阻力增加模型大鼠为试验对象 ,以豚鼠鼻腔分泌物量、喷嚏次数、搔鼻次数、鼻组织学及大鼠鼻气道阻力为指标 ,全面考察曲安奈德喷雾剂对变应性鼻炎的作用。结果曲安奈德鼻喷雾剂 (5 0、10 0、2 0 0 μg·kg-1,对卵蛋白致敏实验性变态反应性鼻炎豚鼠模型的各种变应性鼻炎的症状和体症均有明显改善作用 ;与模型对照组比较 ,各给药组动物鼻腔分泌物量、喷嚏次数、抓鼻次数明显减少 ,并可对抗组胺所致大鼠鼻气道阻力的增加。结论曲安奈德鼻喷雾剂鼻腔局部给药对实验性变应性鼻炎有显著改善作用     

右布地奈德鼻喷雾剂治疗过敏性鼻炎的临床对照研究

目的:对右布地奈德鼻喷雾剂治疗过敏性鼻炎的有效性和安全性进行评价,并与布地奈德鼻喷雾剂比较。方法:采用多中心、随机、开放、平行对照的临床试验,符合入选标准的过敏性鼻炎患者共222例,分成2组:右布地奈德组(试验组)110例,布地奈德组(对照组)112例。试验组给予右布地奈德鼻喷雾剂,25μg/喷,每次每个鼻孔2喷,早晚各1次;对照组给予布地奈德鼻喷雾剂,64μg/喷,每次每个鼻孔1喷,早晚各1次。2组均连续用药14d。疗效评价以症状积分下降指数作为主要指标,生活质量改善程度作为次要指标。结果:试验组和治疗组相比,症状积分下降指数、生活质量改善程度、不良反应发生率均相似,即0.78±0.24,0.76±0.23;96.4%,94.6%;以及13.6%,14.3%。结论:右布地奈德鼻喷雾剂治疗过敏性鼻炎与布地奈德鼻喷雾剂同样安全有效。     

Recent pharmacological developments in the treatment of perennial and persistent allergic rhinitis

Introduction: Allergic rhinitis (AR) has a major negative impact on patients’ quality of life (QoL) and carries a high socio economic burden. This is particularly the case for patients who experience symptoms for extended periods of time (i.e. those with perennial (PAR) or persistent AR (PER), depending on the classification system used). This review covers available pharmacological advances and recent developments in the treatment of PAR or PER.

Areas covered: Pharmacological AR treatment is used to reduce symptom burden and help restore patients’ normal daily routine. Traditionally, non-sedating antihistamines and intranasal corticosteroids (INS) were the two drug classes recommended for use first line. These, along with antileukotrienes, decongestants, mast cell stabilizers and anticholinergics, constituted the bulk of the AR treatment arsenal. MP-AzeFlu (Dymista®, Meda, Solna, Sweden) is the most recent addition to that arsenal. It is a novel intranasal formulation of azelastine hydrochloride (AZE) and fluticasone propionate (FP) delivered in a single spray and has surpassed available therapies in terms of symptom control and treatment response. Other relatively new treatments for PAR or PER include H₃ antihistamines, toll-like receptor (TLR) agonists, cellulose powders and micro-emulsions, novel biomolecular formulations and omalizumab. Each of these new additions is reviewed here.

Expert opinion: A new AR drug class has recently been introduced (i.e. RO1AD58). Currently MP-AzeFlu is the only treatment option within this drug class. It can be estimated that combination treatments like MP-AzeFlu will become the mainstay of PAR and PER therapy since use will result in better compliance, improved efficacy over INS and a faster response together with good levels of tolerability. The challenge is to find other equally, or more effective, combination treatments, as has been the therapeutic standard in bronchial asthma for decades. The potential of biologics, as well as TLR-agonists and other new treatment options needs to be further evaluated.     

卡介菌多糖核酸治疗常年性变应性鼻炎临床分析

目的:探讨卡介菌多糖核酸注射液对常年性变应性鼻炎的治疗效果.方法:52例常年性变应性鼻炎患者随机分为两组,每组各26例.治疗组用介菌多糖核酸注射液肌内注射,对照组用左西替利嗪口服.结果:两组近期疗效比较,显效率及总有效率差异均无显著性(P>0.05);但远期疗效比较,治疗组显效率65.4%,显著优于对照组(P<0.01).结论:卡介菌多糖核酸对常年性变应性鼻炎具有良好的治疗作用,对控制复发亦有较好效果,不良反应极少.