吴晓涛

[摘要] 目的 探索布地奈德（BUD）鼻腔雾化联合口服氯雷他定治疗中重度持续性变应性鼻炎（AR）的疗效。 方法 选择2013年6月～2014年10月来我院就诊的30例对常规治疗（鼻喷激素和抗组胺药）不满意的中重度持续性AR患者，将其随机分为两组，治疗组（n=15）给予BUD鼻腔雾化，对照组（n=15）采取生理盐水鼻腔雾化，1次/d，持续治疗14 d。兩组均给予氯雷他定口服。分别于开始治疗时（基线）和治疗14 d后对临床症状进行评估。 结果 与基线比较，治疗组治疗后鼻塞、流涕、鼻痒和喷嚏的评分均显著下降（P=0.000）；对照组喷嚏评分显著下降（P=0.004），其他症状评分与基线比较差异无统计学意义（P>0.05）。在各症状的改善程度上，治疗组均显著优于对照组（P<0.01）。 结论 BUD雾化联合氯雷他定口服对于常规治疗无效的中重度持续性AR，在症状控制上能取得较为满意的效果。

[关键词] 变应性鼻炎；持续性；布地奈德混悬液；雾化

[中图分类号] R562.25 [文献标识码] A [文章编号] 1674-4721（2016）03（a）-0136-03

[Abstract] Objective To explore the effect of budesonide suspension（BUD） nasal spray combined with loratadine in treating moderately severe persistent allergic rhinitis （AR）. Methods 30 patients with moderately severe persistent AR who were not satisfact to the routine treatment in our hospital from June 2013 to October 2014 were recorded，and were randomly divided into two groups.Patients in treatment group were given BUD nasal spray and patients in control group were given saline nasal spray，once a day for 14 days.All patients in two groups were given oral loratadine.The clinical symptoms were evaluated at pro-treatment（baseline） and after 14 days for treatment respectively. Results Compared with baseline，the score of nasal congestion，running nose，sneeze and rhinocnesmus in treatment group after treatment decreased obvious（P=0.000），the score of sneeze decreased obvious in control group（P=0.004），while other symptoms had no obvious difference（P>0.05）.On the improvement degree of each symptoms，the treatment group was obvious higher than that of control group respectively（P<0.01）. Conclusion For moderately severe persistent allergic rhinitis that conventional treatment is invalid，BUD nasal spray combined with oral loratadine can get more satisfactory results in control symptoms.

[Key words] Allergic rhinitis；Persistent；Budesonide suspension；Nasal spray

变应性鼻炎（allergic rhinitis，AR）的患病率逐年升高，我国AR的自报患病率为8%～20%，是严重影响人民群众身体健康的常见病[1]。AR常见的症状是喷嚏、流涕、鼻痒和鼻塞。根据持续时间及对工作、休息和睡眠的影响程度，AR分为间歇性和持续性，轻度和中重度[2]。持续性中重度AR危害患者的生活质量，还可能导致心理精神疾病。因此必须给予中重度持续性AR的治疗足够的重视[3-4]。中重度持续性AR治疗指南的建议首选是单用鼻喷糖皮质激素，如单用不能控制，则加用抗组胺药物，如联合用药仍未能控制，可口服糖皮质激素治疗，但口服糖皮质激素可能引起一系列不良反应，临床应用需谨慎[2]。

布地奈德混悬液（普米克令舒，budesonide suspension，BUD）是临床广泛应用的雾化型糖皮质激素，在哮喘、支气管炎、咽喉炎等疾病的治疗中取得较好的疗效，并具有较好的安全性。因此……