阶梯疗法治疗常年性变应性鼻炎及对补体C3的影响

目的 研究补体C3在常年性变应性鼻炎（PAR）病理、康复过程中的意义，探讨应用阶梯疗法治疗PAR的效果。方法 对114例PAR患者进行随机分组研究，观察、比较阶梯疗法组与鼻腔局部用药为主的对照治疗组的近、远期疗效，并测定补体C3和血清免疫球蛋白IgG、IgA、IgM含量。结果 ①阶梯疗法对PAR的近、远期显效率分别为86.84%和87.10%，对照治疗组分别为47.37%和10.34%，阶梯疗法的近、远期疗效优于对照治疗组，经统计处理差异有非常显著性。②治疗前PAR患者血清C3含量显著低于健康对照检测组正常人，经阶梯疗法治疗2－4周的患者症状完全控制或显著改善，血清C3水平明显提高，达到正常范围。结论 阶梯疗法具有见效快，近、远期显效率高，医疗费用低，以及药物不良反应少而轻等特点，其疗效机制可能与提高补体至适当水平有关，从而在有效消除补体C3对鼻粘膜损伤作用的同时，保持了补体C3对鼻粘膜的保护作用。

Step-by-step medication regimen in the treatment of perennial allergic rhinitis and its influence on complement C3

Objective To study the effectiveness of specially designed Step by Step Medication Regimen(SSMR) in the treatment of Perennial Allergic Rhinitis(PAR)and the influence of complement C3 on pathology and recovery of PAR. Methods The short and long term treatment effects were investigated in 114 patients with PAR who received SSMR and topical(intranasal) administration in a randommized study. The concentrations of complement C3 and immunoglobulins (IgG,IgA,IgM)were measured. Results The short and long term marked effect rates were 86.84 and 87.10% in SSMR group, and 47.37 and 10.34% respectively in the patients who received intranasal administration. The results were significantly better in patients receiving SSMR than those receiving intranasal administration. The level of serum C3 in PAR patients was significantly lower than that in normal controls before treatment. The serum C 3 concentration was significantly increased, which was within normal limits,2 4 weeks after SSMR in patients whose symptoms disappeared or greatly diminished. Conclusion The results suggest that the SSMR may become the first choice treatment of PAR because of its rapid effectiveness, high marked effect rate of both short and long term,lower cost and unnoticeable side effects. It is conceivable that therapeutic mechnism of SSMR on PAR maybe related to the favourable elevation of complement C3.