一个随机的双盲研究,比较皮质类固醇灌和鼻喷雾,以减少CRSwNP中的息肉大小
Chakapan Promsopa1, Thanapa Quannuy1, Suchet Chinpairoj1
1Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
The Laryngoscope
|May 7, 2025
概括
皮质类固醇灌显著减少了鼻息肉大小,比鼻内皮质类固醇喷雾更有效地在患有鼻息肉慢性鼻炎 (CRSwNP) 的患者中. 这两种治疗都是安全的,没有观察到HPA轴抑制.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 过敏和免疫学 过敏和免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 具有鼻息肉的慢性鼻炎 (CRSwNP) 显著影响生活质量.
- 目前的治疗方法旨在减少多重体负担并改善鼻症状.
- 不同的皮质类固醇输送方法的疗效和安全性需要进一步研究.
研究的目的:
- 为了比较皮质类固醇灌 (CSI) 与鼻内皮质类固醇喷雾 (INCS) 在管理CRSwNP方面的有效性.
- 评估这些治疗对鼻息肉大小,鼻腔症状和下丘脑-垂体-上腺 (HPA) 轴功能的影响.
- 评估非手术CRSwNP患者的治疗结果.
主要方法:
- 这是一项随机对照试验,涉及24名非手术CRSwNP患者.
- 第1组接受了布德索尼德灌 (CSI) 加上安慰剂喷雾.
- 第二组接受了盐水灌加布德索尼德喷雾 (INCS).
- 结果包括聚合物分类 (mLKS),症状得分 (VAS-TNSS,SNOT-22) 和12周的血清皮质醇水平.
主要成果:
- 皮质类固醇灌 (CSI) 在12周后 (p < 0.001) 与鼻内皮质类固醇喷雾 (INCS) 相比,显示了聚大小的统计显著减少 (mLKS得分).
- 虽然CSI在mLKS得分中显示出更大的改善,但在两组之间的整体鼻腔症状得分 (VAS-TNSS,SNOT-22) 中没有显著差异.
- 血清皮质醇水平在两组治疗中都保持在正常范围内,这表明没有抑制HPA轴.
结论:
- 与鼻内皮质类固醇喷雾相比,皮质类固醇灌是减少非手术CRSwNP患者鼻息肉大小的更有效的治疗方法.
- 两种CSI和INCS似乎都是安全的,没有观察到对HPA轴功能的不良影响.
- 进一步的研究可能会探索CSI在CRSwNP管理中的长期疗效和患者报告的结果.
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