聚焦超声与药物治疗常年性变应性鼻炎的临床效果观察

摘要

Objective To make a comparison between clinical therapeutic effect of high-intensity focused ultrasound (HIFU) and pharmacotherapy on perennial allergic rhinitis (PAR) patients and to discuss the validity and superiority of HIFU on PAR.Methods The experiment data were randomly selected from 152 patients who had PAR,and they were divided into two groups under their own will.There are 72 patients in HIFU group and 80 patients in pharmacotherapy grouP.For the HIFU group,they were treated with HIFU assisted by nasal endoscope,with the bilateral inferior turbinate,the front of middle turbinate,agger nasi and the anterosuperior part of nasal septum scanned.As for the pharmacotherapy group,they were treated with conventional nasal spray hormone medicine and antihistamine medicine.There are 23 cases of HIFU group patients who voluntarily accept the sacchar.in test before and after the treatment,which is to detect the transmission function of nasal mucus cilia,the result of which will be further compared with normal group(non AR group).Results The curative effect of the pharmacotherapy group was higher than that of HIFU group at 1 weeks(P＜0.01).There was no significant difference between the 2 groups.After 6 months of treatment and treatment for 1 years,the effect of focused ultrasound group was better than that of drug treatment group(P＜0.05 or ＜0.01).Following 1 year,HIFU group had 16 cases(22.2％),the pharmacotherapy group had 34 cases(42.5％),the recurrencerate of pharmacotherapy lower than of HIFU group,2 groups was statistically significant difference on recurrence rate(P＜0.01).HIFU group began to gradually reduce the signs and symptoms score after 1 week,but the score increased again after 1 year.The symptoms and signs scores of pharmacotherapy group began to gradually reduce after 1 week,but on the 6 month,the scores began to rise,there was no statistically significant difference between the 2 group(P＞0.05).Two groups between point and group interaction point have statistically significant (P＜0.01).The nasal cilia transmission time in HIFU is longer than the normal group before treatment(P＜0.01),but after 1 month and 1 year HIFU group on the nasal cilia transmission time is shorter than pre-treatment (P＜0.01).And after 1 year the nasal cilia transmission time was longer than that in 1 month(P＜0.01).Conclusion HIFU has better curative effect comparing with conventional pharmacotherapy and is worthy of clinical promotion.%目的 比较聚焦超声与药物治疗常年性变应性鼻炎患者的临床效果,并观察聚焦超声治疗常年性变应性鼻炎的有效性及优越性.方法 选取常年性变应性鼻炎患者152例按治疗意愿分为2组,聚焦超声组72例,药物治疗组80例.聚焦超声组行鼻内镜下聚焦超声治疗,扫描部位为双侧下鼻甲、中鼻甲前部、鼻丘及鼻中隔前上部;药物治疗组采用常规鼻喷激素及抗组胺药物治疗.对患者治疗前后鼻部症状和体征进行评分并评定疗效.聚焦超声组中23例患者治疗前后自愿接受糖精试验,测定鼻黏膜黏液纤毛传输功能,并与正常组(非变应性鼻炎者)进行比较.结果 药物治疗组治疗1周时疗效优于聚焦超声组(P＜0.01),治疗1个月时2组疗效差异无统计学意义(P＞0.05),治疗6个月和治疗1年时聚焦超声组疗效优于药物治疗组(P＜0.05或＜0.01).术后随访1年,聚焦超声组复发16例(22.2％),药物治疗组复发34例(42.5％),聚焦超声组复发率低于药物治疗组,差异有统计学意义(P＜0.01).聚焦超声组治疗后1周开始症状体征评分逐渐降低,治疗后1年开始升高,药物治疗组症状体征评分也从治疗1周开始逐渐降低,治疗后6个月开始升高,2组间差异无统计学意义(P＞0.05),2组时点间以及组间·时点间交互作用差异均有统计学意义(P＜0.01).聚焦超声组鼻纤毛传输时间长于正常组(P＜0.01),治疗后1个月和1年聚焦超声组鼻纤毛传输时间短于治疗前(P＜0.01),治疗后1年鼻纤毛传输时间长于治疗1个月(P＜0.01).结论 聚焦超声较药物治疗疗效好,复发率低,值得临床推广.