药物性鼻炎阶梯治疗的临床分析

Clinical analysis of rhinitis medicamentosa treated with stage therapy

摘要:

目的 分析药物性鼻炎采用3个阶段阶梯治疗的临床效果，为临床治疗提供参考。方法 78例药物性鼻炎患者根据致病原因分为口服药物组12例和减充血剂组66例。采用鼻用激素+抗组胺药（第一阶段）、鼻用激素+抗组胺药物+高渗海水（第二阶段）和手术治疗（第三阶段）阶梯治疗方法，对两组患者在治疗的不同阶段采用视觉模拟评分（VAS）量表、鼻内镜Lund-Kennedy评分量表及鼻阻力检查评价治疗的效果。结果 口服药物组患者在经过一、二阶段的药物治疗后，治愈率到达100%（12/12）；减充血剂组患者经过一、二、三个阶段治疗后，脱离药物依赖患者分别为1.5%（1/66）、18.5%（12/65）和94.3%（50/53）。两组患者治疗后第一、二、三阶段的VAS评分、鼻阻力及鼻内镜Lund-Kennedy评分均较治疗前改善，差异具有统计学意义（P<0.05）。结论 对药物性鼻炎进行分类并采取阶梯式治疗效果满意，值得临床推荐。

Abstract:

Objective To analyze the clinical effect of three-stage therapy for rhinitis medicamentosa and provide reference for clinical treatment. Methods Seventy-eight cases of rhinitis medicamentosa were divided into oral medicine group (n=12) and nasal decongestant group (n=66) according to their pathogenic causes. These cases were treated with topical nasal steroids+ antihistamine (the first stage therapy), topical nasal steroids+ antihistamine + Hypertonic saline (the second stage therapy) and surgical treatment (the third stage therapy). VAS score, Lund-Kennedy scale of nasal endoscopy and nasal airway resistance examination were used to evaluate the effect of treatment at different stages of treatment between two groups. Results The cured cases were 100%(12/12) after the first and second stage treatment in oral medicine patients. The first/second/third stage treatment were used in the nasal decongestant cases of rhinitis medicamentosa with 1.5%(1/66), 18.5%(12/65) and 94.3%(50/53) cure rates, respectively. Conclusion It is worthy of clinical recommendation for application of stage-therapy as a treatment for rhinitis medicamentosa.