布地奈德联合氟康唑冲洗对变应性真菌性鼻窦炎术后的疗效分析

摘要/Abstract

摘要： 目的探讨变应性真菌性鼻窦炎术后采用丙酸氟替卡松鼻喷雾剂与布地奈德鼻喷雾剂联合氟康唑局部冲洗治疗的疗效和安全性。方法选取2015—2022年于内蒙古兴安盟人民医院接受治疗的80例变应性真菌性鼻窦炎患者作为研究对象,根据抛币法将患者随机分为布地奈德组和丙酸氟替卡松组,每组40例。两组患者均行鼻内镜手术,布地奈德组接受布地奈德鼻喷雾剂联合氟康唑局部冲洗治疗,丙酸氟替卡松组接受丙酸氟替卡松鼻喷雾剂联合氟康唑局部冲洗治疗,疗程为8周。对比两组患者白细胞介素-2（IL-2）、白细胞介素-6（IL-6）、降钙素原（PCT）、血清总免疫球蛋白E（TIgE）及嗜酸性粒细胞阳离子蛋白（ECP）水平、视觉模拟评分法（VAS）评分、不良反应发生情况。结果治疗后布地奈德组IL-2、IL-6、PCT水平均低于丙酸氟替卡松组（P<0.05）。术后3 d布地奈德组VAS评分明显低于丙酸氟替卡松组（P<0.05）。治疗后布地奈德组TIgE、ECP水平均低于丙酸氟替卡松组（P<0.05）。布地奈德组不良反应发生率显著低于丙酸氟替卡松组（P<0.05）。结论相比于丙酸氟替卡松鼻喷雾剂,布地奈德鼻喷雾剂可明显抑制炎性反应,减轻疼痛感,改善变态反应,且安全性更高,值得临床应用。

关键词: 丙酸氟替卡松, 布地奈德, 氟康唑, 变应性真菌性鼻窦炎, 疗效, 安全性

Abstract: Objective To explore the efficacy and safety of fluticasone propionate nasal spray and budesonide nasal spray combined with fluconazole topical irrigation treatment after allergic fungal sinusitis. Methods A total of 80 patients with allergic fungal sinusitis who received treatment in Xing'an League People's Hospital from 2015 to 2022 were selected as research objects. According to coin toss method, the patients were randomly divided into control group and observation group, with 40 cases in each group. The two groups underwent nasal endoscopic surgery, and budesonide group received nasal spray with fluconazole and fluticasone propionate group received fluticasone nasal spray with propionate with fluconazole for 8 weeks. The levels of interleukin-2 (IL-2), interleukin-6 (IL-6), procalcitonin (PCT), visual analogue scale (VAS), serum total immunoglobulin E (TIgE) and eosinophil cationic protein (ECP), and the occurrence of adverse reactions were compared between the two groups. Results After treatment, the levels of IL-2, IL-6 and PCT in budesonide group were lower than those in fluticasone propionate group (P<0.05). The VAS score of budesonide group was significantly lower than that of fluticasone propionate group 3 days after surgery (P<0.05). After treatment, TIgE and ECP levels in budesonide group were lower than those in fluticasone propionate group (P<0.05). The incidence of adverse reactions in budesonide group was significantly lower than that in fluticasone propionate group (P<0.05). Conclusion Compared with fluticasone propionate nasal spray, Budesonide nasal spray can significantly inhibit inflammation, relieve pain, improve allergic reactions, and has higher safety, worthy of clinical use.

Key words: fluticasone propionate, budesonide, fluconazole, allergic fungal sinusitis, curative effect, security

中图分类号:

张皓, 孙焕颖. 布地奈德联合氟康唑冲洗对变应性真菌性鼻窦炎术后的疗效分析[J]. 中华养生保健, 2023, 41(16): 52-55.

ZHAN Hao, SUN Huan-ying. Analysis of the Efficacy of Budesonide Combined with Fluconazole Irrigation after Allergic Fungal Sinusitis[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(16): 52-55.

参考文献

[1] 王丹,赵祎芃,史剑波,等.复发性变应性真菌性鼻窦炎1例治疗体会[J].中华耳鼻咽喉头颈外科杂志,2022,57(5):612-614.
[2] 徐涛,孙敬武,汪银凤.变应性真菌性鼻窦炎的发病因素与治疗策略[J].中华耳鼻咽喉头颈外科杂志,2022,57(1):72-78.
[3] 侯军才,赵艳庚.鼻腔冲洗方式对慢性鼻-鼻窦炎鼻内镜术后鼻腔粘连的影响[J].中国耳鼻咽喉头颈外科,2021,28(10):650-652.
[4] 李瑛,王惠利,张卫杰.鼻内窥镜术后复发性上颌窦霉菌感染应用氟康唑注射液联合中药的治疗效果及预后影响[J].世界中医药,2019,14(5):1198-1201.
[5] 佘秀梅,江玉刚.中医序贯疗法联合丙酸氟替卡松鼻喷雾剂治疗慢性鼻窦炎的疗效探讨[J].山西医药杂志,2021,50(19):2819-2821.
[6] 黄河银,张勤修,何恒胜,等.布地奈德鼻喷剂和针刺蝶腭神经节治疗变应性鼻炎的疗效观察[J].中国中西医结合耳鼻咽喉科杂志,2021,29(1):22-25.
[7] 中华耳鼻咽喉头颈外科杂志编委会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.变应性鼻炎诊断和治疗指南(2009年武夷山)[J].中华耳鼻咽喉头颈外科杂志,2009, 44(12):977-978.
[8] 古庆家,李静娴,樊建刚,等.变应性真菌性鼻窦炎的诊断和治疗[J].中国耳鼻咽喉颅底外科杂志,2020,26(5):517-521.
[9] 李静波,王俊杰,蔡纪堂,等.温阳化湿法联合常规治疗对变应性真菌性鼻窦炎患者的临床疗效[J].中成药,2019,41(7):1739-1742.
[10] 洪伟,蔡福果,刘慧娟,等.氟康唑注射液治疗化脓性中耳炎合并真菌感染的随机对照研究[J].中华医院感染学杂志,2021,31(13):1977-1981.
[11] 朱成霞,陈彦芳,张小广.布地奈德鼻喷雾剂用于慢性鼻-鼻窦炎伴变应性鼻炎术后的效果观察[J].实用中西医结合临床,2020,20(3):111-112.
[12] 李征. 鼻腔冲洗联合丙酸氟替卡松鼻喷雾剂在鼻窦炎患者鼻内镜术后的应用效果[J].中国民康医学,2020,32(8):39-41.
[13] 吕丹雨,白广平,孙青.布地奈德喷雾剂辅助治疗慢性鼻-鼻窦炎伴变应性鼻炎的疗效及鼻腔黏膜的超微结构的影响[J].湖南师范大学学报(医学版),2020,17(1):62-65.
[14] 安江霞,白银娥.鼻腔冲洗联合布地奈德鼻喷剂治疗变应性鼻炎的效果及对炎性因子的影响[J].中国药物与临床,2021,21(24):4019-4021.

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