阶梯式应用抗组胺药物治疗变应性鼻炎临床效果观察.docVIP

阶梯式应用抗组胺药物治疗变应性鼻炎临床效果观察 　　【摘要】 目的：研究阶梯式应用抗组胺药物治疗变应性鼻炎的最佳治疗方案。方法：选取2014年7月-2016年7月来自本院耳鼻喉门诊的变应性鼻炎患者217例，设置三级阶梯式治疗方案，比较观察三组的治疗效果及不良反应情况。结果：三级阶梯式治疗后，第三级治疗组的总有效率为77.19%，均明显高于第一、二级治疗组的62.21%、30.49%，差异均有统计学意义（字2=4.47、29.34，P=0.034、0.001）；第一级治疗组明显高于第二级治疗组，差异有统计学意义（字2=24.08，P=0.001）。结论：治疗变应性鼻炎首选使用第三代抗组胺药物联用，对治疗效果不满意的患者选择在第三代抗组胺药物的基础上再加用白三烯受体拮抗剂如孟鲁司特，可取得满意的治疗效果。 　　【关键词】 变应性鼻炎； 抗组胺药物； 阶梯式治疗； 白三烯受体拮抗剂 　　【Abstract】 Objective：To study the best treatment of allergic rhinitis by ladder-type antihistamines.Method：A total of 217 patients with allergic rhinitis in Otolaryngology Clinic from July 2014 to July 2016 were selected，three grades of ladder-type treatment were set up，the treatment effects and the adverse reactions were compared and observed.Result：After three grades of ladder-type treatment，the total effective rate of the third grade treatment group was 77.19%，which was significantly higher than those of the first，second grades treatment group 62.21% and 30.49%，respectively，the differences were statistically significant（字2=4.47，29.34，P=0.034，0.001）；the first grade treatment group was significantly higher than that of the second grade treatment group，the difference was statistically significant（字2=24.08，P=0.001）.Conclusion：In the treatment of allergic rhinitis，the third generation of antihistamines combined with other antihistamines is preferred，and the patients who are not satisfied with the treatment effect choose to add leukotriene receptor antagonists such as Montelukast on the basis of the third generation of antihistamines，which can obtain satisfactory treatment effect. 　　【Key words】 Allergic rhinitis； Antihistamine drug； Ladder-type treatment； Leukotriene receptor antagonist 　　First-author’s address：The First People’s Hospital of Zhaoqing，Zhaoqing 526041，China 　　doi：10.3969/j.issn.1674-4985.2018.15.005 　　变应性鼻炎是一种发生与鼻部黏膜的高敏反应，是因接触致敏变应原使得特异性递质激活效应细胞释放炎性介质而引发的，其发病率与遗传、环境、地理区域、文化差异有关。据调查显示，全球变应性鼻炎患者占10%～14%[1-2]，美国约有16%的成人确诊[3]。因此，很多学者已将缓解鼻炎症状的药物治疗方案的选取作为一项重要的科学研究，