目的：比较左西替利嗪和孟鲁司特钠对中-重度持续性儿童变应性鼻炎( AR)患者症状评分和生活质量评分的改善作用,探讨儿童AR的个体化药物治疗方案。方法将157例年龄6~14岁的中-重度持续性AR患儿,随机分为左西替利嗪(LEVO)组77例与孟鲁司特(MONT)组80例。 LEVO组每晚口服左西替利嗪片5mg,MONT组每晚口服孟鲁司特钠片5mg。应用鼻炎症状评分体系进行评价,评分越低症状越轻。结果治疗2周,两组症状总评分差异无统计学意义(F=1．157,P>0．05),但均较基线差异有统计学意义(F=0．404和0．485,P<0．01),流涕症状LEVO组改善优于MONT组(F=0．744,P<0．05),鼻塞症状MONT组改善优于LEVO组(F=0．819,P=0．013<0．05)；治疗4周,两组症状总评分差异无统计学意义(F=1．240,P>0．05),但较基线(F=0．158和0．203,P均<0．01)和2周前差异有统计学意(F=0．391和0．419,P<0．01),鼻塞症状MONT组改善极优于LEVO组(F=0．304,P=0．001<0．01)。结论对于鼻塞症状明显的患儿,可以选择孟鲁司特钠作为初始治疗药物；对于流涕症状明显的患儿,可以选择盐酸左西替利嗪作为初始治疗药物。%Objective To compare the effects of Levocetirizine and Montelukast on persistent allergic rhinitis ( AR ) in children and explore individualized therapy for child AR. Methods 157 children(6~14 years)with moderate to severe persistent AR were evenly randomized into two groups treated by Levocetirizine( LEVO, 77 patients) or Montelukast( MONT, 80 patients) . The effects of two groups were compared in terms of rhinitis symptoms. Results Treatment after two weeks, the total symptom score between the two groups was not statistically significant(F=1. 157, P> 0. 05)compared with the baseline, but there was a significant difference(F=0. 404 and 0. 485, P<0. 01), runny nose symptoms improved in LEVO group than in MONT group (F=0. 744, P<0. 05), MONT group improved nasal symptoms than LEVO group(F=0. 819, P=0. 013<0. 05);4 weeks after treatment, total symptom score between the two groups was not statistically significant(F=1. 240, P> 0. 05), but lower than the baseline(F=0. 158 and 0. 203, P<0. 01), and two weeks later(F=0. 391 and 0. 419, P <0. 01), there was a significant difference in improvement in nasal symptoms MONT group which very superior than LEVO group(F=0. 304, P=0. 001<0. 01). Conclusion For the nasal symptoms in children, we can choose Montelukast as initial therapy; for the runny nose symptoms in children, we can select the Levocetirizine as initial therapy.
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