孟鲁司特钠、氯雷他定联合糠酸莫米松治疗儿童过敏性鼻炎并腺样体肥大疗效观察

目的：评估孟鲁司特钠、氯雷他定联合糠酸莫米松鼻喷剂治疗过敏性鼻炎（AR）合并轻、中度腺样体肥大（AH）患儿的临床疗效。方法：将就诊于我院门诊的患过敏性鼻炎合并轻、中度AH儿童90例按随机数字表法分为三组，其中A组27例给予口服孟鲁司特钠及氯雷他定治疗，B组31例给予糠酸莫米松鼻喷剂喷鼻治疗，C组32例给予孟鲁司特钠、氯雷他定联合糠酸莫米松鼻喷剂治疗，三组患儿均给予相同的基础对症治疗。比较三组治疗前后鼻部症状评分、呼吸相关睡眠障碍症状指标评分、腺样体厚度/鼻咽宽度（A/N）值的变化及停药3个月的复发率。结果：三组患儿治疗后鼻部症状评分、呼吸相关睡眠障碍症状指标评分及A/N值较治疗前均显著下降，差异均有统计学意义（P<0.01），但C组的复发率（25.0%）显著低于A、B组（55.0%、52.2%），差异有统计学意义（P<0.01）。结论：孟鲁司特钠、氯雷他定联合糠酸莫米松鼻喷剂治疗儿童过敏性鼻炎合并轻、中度腺样体肥大，其疗效优于孟鲁司特钠联合氯雷他定或单用糠酸莫米松鼻喷剂，且能降低复发率。

Observation of Effect of Montelukast, Loratadine Tablets Combined with Mometasone Furoate in the Treatment of Children with Allergic Rhinitis and Adenoidal Hypertrophy

Objective: To explore the clinical effect of montelukast, loratadine tablets combined with mometasone furoate in the treatment of children with allergic rhinitis (AR) and mild to moderate adenoidal hypertrophy (AH). Methods: 90 children with allergic rhinitis and mild to moderate adenoidal hypertrophy were divided into three groups based on the random control principle, while montelukast, loratadine tablets were added to group A (27 cases), mometasone furoate was added to group B (31 cases), montelukast, loratadine tablets combined with mometasone furoate were added to group C (32 cases). The above groups were given symptomatic treatment and antibiotics. The nasal symptom scores, respiratory-related sleep disorder symptom index and the A/N ratio (width/nasopharyngeal adenoid body thickness ) of three group were compared before and after treatment and withdrawal relapse rate three months. Results: After treatment, the nasal symptom scores, respiratory-related sleep disorder symptom index and the A/N ratio in three groups were lower than before treatment, while the recurrence rate of group C (25.0%) was significantly lower than group A (55.0%) and group B (52.2%),The differences were statistically significant (P<0.01). Conclusion: The clinical effect of montelukast, loratadine tablets or mometasone furoate used alone in the treatment of children with allergic rhinitis (AR) and mild to moderate adenoidal hypertrophy (AH) is lower than three in combination, and higher recurrence.