地红霉素与克拉霉素治疗慢性鼻窦炎疗效观察

将54例慢性鼻窦炎（不含鼻息肉）患者随机分为治疗组（30例）和对照组（24例）,治疗组口服地红霉素（250 mg）,对照组口服克拉霉素（250 mg）,均每日一次.治疗3～6个月后,两组主观症状（鼻塞、流黏脓涕、头面部痛、嗅觉差）、VAS评分、客观体征（鼻窦CT）Lund-Mackay评分有明显改善,且与治疗时间呈正相关,同组治疗前后比较差异有统计学意义（P＜0.05）,但组间比较无统计学意义（P＞0.05）.两组总有效率（73%和67%）、不良反应发生率（7%与21%）的差异虽无统计学意义（P＞0.05）,但克拉霉素组不良反应的症状明显较重,结果表明小剂量地红霉素更适宜慢性鼻窦炎的长期治疗.

Efficacy of dirithromycin and clarithromycin in treatment chronic sinusitis

Fifty four patients with chronic sinusitis (without nasal polyps) were randomly divided into two groups. Thirty patients in experimental group were treated with dirithromycin and 24 patients in control group were treated with clarithromycin. The doses was both 250 mg q. d. and the duration of treatment was 3to 6 months. The VAS scores of subjective symptoms (nasal obstruction, purulent nasal discharge,headache, smell worse ) and Lund-Mackay scores of objective signs (sinus CT ) in both groups were improved significantly compared with the baseline(P ＜0.05), and there were no statistical significances between two groups ( P ＞ 0. 05 ). The curative effect was positively correlated with the duration of treatment.The total effective rates were 73% and 67% and adverse reaction rates 7% and 21% in two groups,respectively (P ＞ 0. 05 ); but the adverse reactions in control group were more serious than those in experimental group. During the six-month follow-up, no recurrence and aggravation were observed. The results suggest that low-dose dirithromycin may be more suitable for long-term treatment of chronic sinusitis.