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    郭建林, 贺腾, 华夏. 布地奈德联合克拉霉素治疗慢性鼻-鼻窦炎疗效观察其对黏膜组织重塑的影响[J]. 徐州医科大学学报, 2020, 40(11): 825-829. DOI: 10.3969/j.issn.2096-3882.2020.11.010
    引用本文: 郭建林, 贺腾, 华夏. 布地奈德联合克拉霉素治疗慢性鼻-鼻窦炎疗效观察其对黏膜组织重塑的影响[J]. 徐州医科大学学报, 2020, 40(11): 825-829. DOI: 10.3969/j.issn.2096-3882.2020.11.010
    The effect of budesonide combined with clarithromycin on the treatment of chronic rhinosinusitis and its effects on mucosal tissue remodeling[J]. Journal of Xuzhou Medical University, 2020, 40(11): 825-829. DOI: 10.3969/j.issn.2096-3882.2020.11.010
    Citation: The effect of budesonide combined with clarithromycin on the treatment of chronic rhinosinusitis and its effects on mucosal tissue remodeling[J]. Journal of Xuzhou Medical University, 2020, 40(11): 825-829. DOI: 10.3969/j.issn.2096-3882.2020.11.010

    布地奈德联合克拉霉素治疗慢性鼻-鼻窦炎疗效观察其对黏膜组织重塑的影响

    The effect of budesonide combined with clarithromycin on the treatment of chronic rhinosinusitis and its effects on mucosal tissue remodeling

    • 摘要: 目的 评估布地奈德联合克拉霉素治疗慢性鼻-鼻窦炎(CRS)的疗效,并观察其对黏膜组织重塑的影响.方法 选取2017年8月—2019年1月常熟市第二人民医院收治的CRS患者,共162例.将患者随机分为布地奈德组、克拉霉素组、联合用药组,每组54例.记录患者在治疗前后鼻黏膜分泌物和血清嗜酸性粒细胞阳离子蛋白(ECP)含量、血清指标和炎性因子水平、鼻内镜检查形态学得分与鼻窦断层扫描评分,比较2组患者治疗效果.结果 与治疗前相比,治疗15 d后3组患者鼻黏膜分泌物及血清ECP含量、鼻内镜形态评分及鼻窦断层扫描评分均显著降低,差异有统计学意义(P<0.05),且此时3组患者组间比较,其鼻黏膜分泌物及血清ECP含量、鼻内镜形态评分与鼻窦断层扫描评分差异有统计学意义(P<0.05).与治疗前相比,治疗15 d后3组患者血清免疫球蛋白(IgE)、白细胞介素6(IL-6)、IL-8、超敏C反应蛋白(Hs-CRP)水平差异有统计学意义(P<0.05),治疗30 d后3组患者血清IgE、IL-6、IL-8、肿瘤坏死因子α(TNF-α)、Hs-CRP水平差异有统计学意义(P<0.05).治疗后,与联合用药组比较,布地奈德组和克拉霉素组治疗总有效率更低,差异有统计学意义(P<0.05).结论 联合使用布地奈德和克拉霉素能显著改善CRS患者的状况,减轻黏膜组织重塑,值得临床推广.

       

      Abstract: ob<x>jective to investigate the efficacy of budesonide combined with clarithromycin in the treatment of chronic rhinosinusitis and to observe its effect on mucosal tissue remodeling. Methods selected 162 patients were randomly divided into budesonide, clarithromycin group and combination group, the records of patients before and after treatment and different point detection level of ECP content, blood IgE, inflammatory substances, nasal endoscopic morphology scores, sinus CT and clinical curative effect, and comparison analysis. Results after treatment, ECP and blood ECP in nasal or sinus mucosa were significantly lower in the combined group than in the other two groups (P < 0.05).15 days after the treatment groups of patients’ blood IgE, inflammatory cytokines IL - 6, IL - 8 and Hs - CRP significant difference (P < 0.05), and 30 days after treatment group patients with blood IgE, inflammatory cytokines IL - 6, IL - 8, TNF alpha and Hs - CRP levels differ significantly (P < 0.05);The serum and biochemical indexes of the three groups were significantly different at different time points (P < 0.05).There were statistically significant differences in clinical efficacy between the three groups (X2=84.21, P=0.00).The difference of nasal endoscopic morphological score and sinus CT score between the three groups was statistically significant (X2=79.64, P=0.00). Conclusion budesonide combined with clarithromycin can significantly improve the condition of patients with chronic rhinosinusitis and reduce the remodeling of mucosal tissue.

       

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