经鼻雾化吸入布地奈德混悬液联合克拉霉素治疗慢性鼻-鼻窦炎鼻息肉伴支气管哮喘患者的临床研究

doi:10.3969/j.issn.1007-3205.2021.08.014

河北医科大学学报 ›› 2021, Vol. 42 ›› Issue (8): 930-934,949.doi: 10.3969/j.issn.1007-3205.2021.08.014

经鼻雾化吸入布地奈德混悬液联合克拉霉素治疗慢性鼻-鼻窦炎鼻息肉伴支气管哮喘患者的临床研究

1.河北省保定市第四中心医院耳鼻喉科，河北保定 072350；2.河北医科大学第二医院耳鼻咽喉头颈外科，河北石家庄 050000

出版日期:2021-08-25 发布日期:2021-08-27
作者简介:邵长宝（1968-），男，河北唐县人，河北省保定市第四中心医院副主任医师，医学学士，从事耳鼻咽喉疾病诊治研究。
基金资助:
保定市科技计划项目（18zf161)

Clinical study of nasal nebulization of budesonide suspension combined with clarithromycin in the treatment of chronic rhinosinusitis and nasal polyps with bronchial asthma

1.Department of Otolaryngology, the Fourth Central Hospital of Baoding City, Hebei Province, Baoding
072350, China; 2.Department of Otolaryngology, Head and Neck Surgery, the Third Hospital of
Hebei University, Hebei Province, Shijiazhuang 050000, China

Online:2021-08-25 Published:2021-08-27

摘要/Abstract

摘要： 目的分析经鼻雾化吸入布地奈德混悬液联合克拉霉素治疗慢性鼻-鼻窦炎（chronic rhinosinusitis，CRS）鼻息肉伴支气管哮喘的效果。
方法选取于河北保定市第四中心医院与河北医科大学第二医院耳鼻喉科诊断为CRS行鼻内镜手术且伴支气管哮喘的128例作为研究对象，按照抽签法分为克拉霉素组和联合组各64例。2组患者均行功能性鼻内镜手术（functional endoscopic surgery，FESS）手术治疗，2组患者在术前均行支气管哮喘常规治疗，克拉霉素组采用克拉霉素治疗，联合组在克拉霉素组的基础上经鼻雾化吸入布地奈德混悬液。评价患者临床症状改善时间、下气道肺功能、嗜酸粒细胞（eosinophils，EOS）计数、中性粒细胞/淋巴细胞比值（neutrophil/Lymphocyte ratio，NLR）、血小板/淋巴细胞比值（platelet/Lymphocyte ratio，PLR）、哮喘控制测试（asthma control test，ACT）评分、可溶性白细胞介素2受体（soluble interleukin-2 receptor，sIL-2R）、干扰素γ（interferon-γ，IFN-γ）、可溶性CD23（soluble CD23，sCD23）、白细胞介素4（interleukin-4，IL-4）水平及疗效。
结果与克拉霉素组相比，联合组湿罗音、哮鸣音、喘息、咳嗽改善时间均缩短（P＜0.05）。与克拉霉素组相比，联合组肺功能指标FEV1、FVC、PEF升高（P＜0.05）。与克拉霉素组相比，联合组EOS计数、NLR、PLR、sIL-2R、sCD23、IL-4水平降低，ACT评分、IFN-γ水平升高（P＜0.05）。与克拉霉素组相比，联合组治疗总有效率较高（P=0.023）。
结论 CRS鼻息肉伴支气管哮喘患者采用经鼻雾化吸入布地奈德混悬液联合克拉霉素治疗，临床症状、肺功能显著改善，效果显著。

关键词: 鼻息肉, 哮喘, 布地奈德, 克拉霉素

Abstract: Objective To analyze the effect of nasal nebulization of budesonide suspension combined with clarithromycin on the treatment of chronic rhinosinusitis(CRS), nasal polyps and bronchial asthma.
Methods A total of 128 patients with CRS and bronchial asthma undergoing endoscopic sinus surgery at the Fourth Central Hospital of Baoding City(Hebei Province), and the Department of Otolaryngology, the Second Hospital of Hebei Medical University were selected as the research subjects and divided into clarithromycin group(n=64) and combination group(n=64) according to the lottery method. Two groups of patients were treated with FESS operation, after conventional treatment of bronchial asthma before operation. The clarithromycin group was treated with clarithromycin, while the combination group was treated with nasal aerosol inhalation of budesonide suspension on the basis of clarithromycin group. The improvement time of clinical symptoms, lung function of lower airway, eosinophils(EOS) count, neutrophil/lymphocyte ratio(NLR), platelet/lymphocyte ratio(PLR), asthma control test(ACT) score, soluble interleukin-2 receptor(sIL-2R), interferon- γ（IFN- γ, the levels of soluble CD23(sCD23) and interleukin-4(IL-4) as well as the curative effect were measured.
Results Compared with clarithromycin group, the improvement time of moist rales, wheezing, asthma and cough in combination group was shorter(P＜0.05). Compared with clarithromycin group, FEV1, FVC and PEF in combination group were higher(P＜0.05). Compared with clarithromycin group, EOS count, NLR, PLR, sIL-2R, sCD23, and IL-4 levels were decreased in combination group, while ACT score and IFN-γ levels were increased(P＜0.05). Compared with clarithromycin group, the total response rate of combination group was higher(P=0.023).
Conclusion Patients with CRS, nasal polyps and bronchial asthma were treated with nasal nebulization of budonide suspension combined with clarithromycin, which significantly improved clinical symptoms and lung function, and had a significant effect.

Key words: nasal polyps, asthma, budesonide, clarithromycin

邵长宝, 王元桥, 马琳娟, 尹浩, 王建星. 经鼻雾化吸入布地奈德混悬液联合克拉霉素治疗慢性鼻-鼻窦炎鼻息肉伴支气管哮喘患者的临床研究[J]. 河北医科大学学报, 2021, 42(8): 930-934,949.

SHAO Chang-bao, WANG Yuan-qiao, MA Lin-juan, YIN Hao, WANG Jian-xing. Clinical study of nasal nebulization of budesonide suspension combined with clarithromycin in the treatment of chronic rhinosinusitis and nasal polyps with bronchial asthma[J]. Journal of Hebei Medical University, 2021, 42(8): 930-934,949.

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经鼻雾化吸入布地奈德混悬液联合克拉霉素治疗慢性鼻-鼻窦炎鼻息肉伴支气管哮喘患者的临床研究

Clinical study of nasal nebulization of budesonide suspension combined with clarithromycin in the treatment of chronic rhinosinusitis and nasal polyps with bronchial asthma

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