OBJECTIVE:To investigate clinical efficacy and safety of oral loratadine combined with physiological seawater na-sal irrigation in the treatment of intermittent allergic rhinitis. METHODS:Totally 300 patients with intermittent allergic rhinitis were chosen from the Second Hospital of Hebei Medical University during Jan. 2013-Jun. 2015,and then divided into group A,B,C ac-cording to lottery method,with 100 cases in each group. Group A was given Loratadine tablets 10 mg,po,qd. Group B received nasal irrigation with physiological seawater nasal spray,every morning and evening. Group C was given oral loratadine combined with physiological seawater nasal irrigation. Treatment courses of 3 groups lasted for 28 d. Clinical efficiencies of 3 groups were compared as well as symptom and sign scores,respiration function indexes and inflammatory factor levels before and after treat-ment,and the clinical recurrences were followed up for 12 months. RESULTS:The total response rates of group A,B,C were 80.00%,78.00%,96.00%,respectively,and that of group C was significantly higher than that of group A and B,with statistical significance(P<0.05). Before treatment,there was no statistical significance in symptom and sign scores,respiration function in-dexes and inflammatory factor levels among 3 groups(P>0.05). After treatment,symptom and sign scores,the rates of PEF diur-nal variation,TNF-α,INF-γ and IL-4 in 3 groups were significantly lower than before treatment,and the levels of PEF and IL-12 were significantly higher than before treatment. Above indexes of group C were significantly better than those of group A and B, with statistical significance (P<0.05). Clinical recurrence rates of group A,B,C were 21.00%,23.00%,6.00%,and group C was significantly lower than the group A and B,with statistical significance (P<0.05). There was no statistical significance in above indexes between group A and group B (P>0.05). CONCLUSIONS:Oral loratadine combined with physiological seawater nasal irrigation in treatment of intermittent allergic rhinitis can efficiently relieve the nasal symptoms and signs,improve expiratoryfunction,reduce the inflammatory response levels and be help-ful to reduce the long-term recurrence risk.%目的:探讨氯雷他定口服联合生理性海水鼻腔冲洗治疗间歇性变应性鼻炎(AR)的临床效果及安全性.方法:选取河北医科大学第二医院2013年1月-2015年6月收治的间歇性AR患者共300例,按抽签法分为A、B、C组,各100例.A组患者给予氯雷他定片10 mg,po,qd;B组患者采用生理性海水鼻腔喷雾器进行鼻腔冲洗,早晚各冲洗1次;C组患者给予氯雷他定口服联合生理性海水鼻腔冲洗.3组患者疗程均为28 d.比较3组患者的临床疗效,治疗前后症状体征积分、呼吸功能指标和炎症因子指标水平,以及随访12个月期间的临床复发情况.结果:A、B、C组患者的总有效率分别为80.00%、78.00%、96.00%,C组显著高于A、B组,差异均有统计学意义(P<0.05).治疗前,3组患者的症状体征积分、呼吸功能指标和炎症因子水平比较,差异均无统计学意义(P>0.05);治疗后,3组患者的症状体征积分、最大呼气流速(PEF)昼夜变异率、肿瘤坏死因子α、γ干扰素和白细胞介素(IL)-4水平均显著低于治疗前,PEF和IL-12水平均显著高于治疗前,且C组患者各指标水平均显著优于A、B组,差异均有统计学意义(P<0.05).A、B、C组患者的临床复发率分别为21.00%、23.00%、6.00%,C组显著低于A、B组,差异均有统计学意义(P<0.05).A、B组患者上述所有指标比较,差异均无统计学意义(P>0.05).结论:氯雷他定口服联合生理性海水鼻腔冲洗治疗间歇性AR可有效减轻患者鼻部症状体征,改善患者呼气功能,下调机体炎症反应水平,并有助于降低远期复发风险.
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