鼻用激素缓解季节性过敏性鼻炎眼部症状的疗效观察
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摘要
目的观察鼻用激素(糠酸莫米松喷鼻剂)缓解季节性过敏性鼻炎(seasonal allergic rhinitis,SAR)眼部症状的疗效。方法针对SAR主要鼻眼症状,制定4分度自评量表(无症状=0、轻度=1、中度=2、重度=3),收集2016-08至2017-04我院门诊就诊患者中符合标准的伴眼部症状SAR患者共计156例,以用药前医师评分作为基线,以后给予糠酸莫米松喷鼻剂200μg(50μg/喷,每侧鼻孔2喷/次,1次/d)喷鼻治疗,并由患者每日用药前自评。治疗结束后收集评分表,将每日鼻眼评分分别相加得出鼻、眼总分,对照基线变化,分析比较症状缓解程度,评价疗效。结果共计156例纳入研究,103例完成研究。第一次用药24 h后,鼻眼症状评分即迅速下降。鼻部症状评分用药2次后进入稳定期;眼部症状用药4次后进入稳定期。治疗前后各组鼻、眼症状评分变化具有统计学差异(鼻部评分:F=533.500,P<0.01;眼部评分:F=362.188,P<0.01)。用药期间未发生不良反应。结论糠酸莫米松喷鼻剂在缓解鼻部症状同时,可以缓解眼部症状,在治疗伴眼部症状的SAR时,单药治疗即可获得显著疗效。
Objective To observe the therapeutic effect of intranasal corticosteroid mometasone furoate against ocular symptoms of patients with seasonal allergic rhinitis. Methods A total of 156 patients were recruited according to the primary nasal and ocular symptoms of seasonal allergic rhinitis between August 2016 and April 2017. We made a four-grade( none = 0,mild = 1,moderate= 2,severe = 3) self-assessment scale. The first score was assessed by physicians as baseline before administration. Then,the patients received momestasone furoate spray 200 μg once daily( 50 μg twice for one nostril),and the nasal and ocular symptom scores were assessed by patients before daily administration. The total nasal and ocular scores were calculated and compared with baseline to assess the therapeutic effect. Results 103 patients completed the study. The total nasal and ocular symptom scores were reduced remarkably 24 h after the first medication. The total nasal symptom score became stable after medication twice,and the total ocular symptom score became stable after four-time medication. The significant difference of the total nasal and ocular symptom scores between these groups was confirmed with ANOVA( nasal symptom: F = 533. 500,P < 0. 01; ocular symptom: F = 362. 188,P < 0. 01). No adverse events were found during the treatment. Conclusions Intranasal corticosteroin mometasone furoate can relieve both nasal and ocular symptoms significantly. This single agent can be used to relieve the symptoms of seasonal allergic rhinitis with ocular problems effectively.
Objective To observe the therapeutic effect of intranasal corticosteroid mometasone furoate against ocular symptoms of patients with seasonal allergic rhinitis. Methods A total of 156 patients were recruited according to the primary nasal and ocular symptoms of seasonal allergic rhinitis between August 2016 and April 2017. We made a four-grade( none = 0,mild = 1,moderate= 2,severe = 3) self-assessment scale. The first score was assessed by physicians as baseline before administration. Then,the patients received momestasone furoate spray 200 μg once daily( 50 μg twice for one nostril),and the nasal and ocular symptom scores were assessed by patients before daily administration. The total nasal and ocular scores were calculated and compared with baseline to assess the therapeutic effect. Results 103 patients completed the study. The total nasal and ocular symptom scores were reduced remarkably 24 h after the first medication. The total nasal symptom score became stable after medication twice,and the total ocular symptom score became stable after four-time medication. The significant difference of the total nasal and ocular symptom scores between these groups was confirmed with ANOVA( nasal symptom: F = 533. 500,P < 0. 01; ocular symptom: F = 362. 188,P < 0. 01). No adverse events were found during the treatment. Conclusions Intranasal corticosteroin mometasone furoate can relieve both nasal and ocular symptoms significantly. This single agent can be used to relieve the symptoms of seasonal allergic rhinitis with ocular problems effectively.
引文
[1]中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉头颈外科学分会.变应性鼻炎诊断和治疗指南[J].中华耳鼻咽喉头颈外科杂志,2016,51(1):6-23.
[2]Ciprandi G,Cirillo I,Vizzaccaro A,et al.Seasonal and perennial allergic rhinitis:is this classification adherent to real life?[J].Allergy,2005,60(7):882-887.
[3]Pitt A D,Smith A F,Lindsell L,et al.Economic and quality-of-life impact of seasonal allergic conjunctivitis in Oxfordshire[J].Ophthalmic Epidemiol,2004,11(1):17-33.
[4]Smith A F,Pitt A D,Rodruiguez A E,et al.The economic and quality of life impact of seasonal allergic conjunctivitis in a Spanish setting[J].Ophthalmic Epidemiol,2005,12(4):233-242.
[5]Virchow J C,Kay S,Demoly P,et al.Impact of ocular symptoms on quality of life(Qo L),work productivity and resource utilisation in allergic rhinitis patients-an observational,cross sectional study in four countries in Europe[J].J Med Econ,2011,14(3):305-314.
[6]Bousquet J,Hellings P W,Agache I,et al.ARIA2016:Care pathways implementing emerging technologies for predictive medicine inrhinitis and asthma across the life cycle[J].Clin Transl Allergy,2016,6:47.
[7]Weiner J M,Abramson M J,Puy R M.Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis:systematic review of randomized controlled trials[J].BMJ,1998,317(7173):1624-1629.
[8]Bielory L.Ocular allergy overview[J].Immunol Allergy Clin North Am,2008,28(1):1-23.
[9]Blaiss M S.Evolving paradigm in the management of allergic rhinitis-associated ocular symptoms:role of intranasal corticosteroids[J].Curr Med Res Opin,2008,24(3):821-836.
[10]Baroody F M,Foster K A,Markaryan A,et al.Nasal ocular reflexes and eye symptoms in patients with allergic rhinitis[J].Ann Allergy Asthma Immunol,2008,100(3):194-199.
[11]Baena-Cagnani C E,Patel P.Efficacy and long-term safety of mometasone furoate nasal spray in children with perennial allergic rhinitis[J].Curr Med Res Opin,2010,26(9):2047-2055.
[12]Ozturk F,Yuceturk A V,Kurt E,et al.Evaluation of intraocular pressure and cataract formation following the longterm use of nasal corticosteroids[J].Ear Nose Throat J,1998,77(10):846-851.
[13]Derby L,Maier W C.Risk of cataract among users of intranasal corticosteroids[J].J Allergy Clin Immunol,2000,105(5):912-916.
[2]Ciprandi G,Cirillo I,Vizzaccaro A,et al.Seasonal and perennial allergic rhinitis:is this classification adherent to real life?[J].Allergy,2005,60(7):882-887.
[3]Pitt A D,Smith A F,Lindsell L,et al.Economic and quality-of-life impact of seasonal allergic conjunctivitis in Oxfordshire[J].Ophthalmic Epidemiol,2004,11(1):17-33.
[4]Smith A F,Pitt A D,Rodruiguez A E,et al.The economic and quality of life impact of seasonal allergic conjunctivitis in a Spanish setting[J].Ophthalmic Epidemiol,2005,12(4):233-242.
[5]Virchow J C,Kay S,Demoly P,et al.Impact of ocular symptoms on quality of life(Qo L),work productivity and resource utilisation in allergic rhinitis patients-an observational,cross sectional study in four countries in Europe[J].J Med Econ,2011,14(3):305-314.
[6]Bousquet J,Hellings P W,Agache I,et al.ARIA2016:Care pathways implementing emerging technologies for predictive medicine inrhinitis and asthma across the life cycle[J].Clin Transl Allergy,2016,6:47.
[7]Weiner J M,Abramson M J,Puy R M.Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis:systematic review of randomized controlled trials[J].BMJ,1998,317(7173):1624-1629.
[8]Bielory L.Ocular allergy overview[J].Immunol Allergy Clin North Am,2008,28(1):1-23.
[9]Blaiss M S.Evolving paradigm in the management of allergic rhinitis-associated ocular symptoms:role of intranasal corticosteroids[J].Curr Med Res Opin,2008,24(3):821-836.
[10]Baroody F M,Foster K A,Markaryan A,et al.Nasal ocular reflexes and eye symptoms in patients with allergic rhinitis[J].Ann Allergy Asthma Immunol,2008,100(3):194-199.
[11]Baena-Cagnani C E,Patel P.Efficacy and long-term safety of mometasone furoate nasal spray in children with perennial allergic rhinitis[J].Curr Med Res Opin,2010,26(9):2047-2055.
[12]Ozturk F,Yuceturk A V,Kurt E,et al.Evaluation of intraocular pressure and cataract formation following the longterm use of nasal corticosteroids[J].Ear Nose Throat J,1998,77(10):846-851.
[13]Derby L,Maier W C.Risk of cataract among users of intranasal corticosteroids[J].J Allergy Clin Immunol,2000,105(5):912-916.