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首页> 外文期刊>The Journal of Allergy and Clinical Immunology >Comparison of a nasal glucocorticoid, antileukotriene, and a combination of antileukotriene and antihistamine in the treatment of seasonal allergic rhinitis.
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Comparison of a nasal glucocorticoid, antileukotriene, and a combination of antileukotriene and antihistamine in the treatment of seasonal allergic rhinitis.

机译：鼻用糖皮质激素，抗白三烯以及抗白三烯和抗组胺药联合治疗季节性变应性鼻炎的比较。

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BACKGROUND: Allergic rhinitis requires active intervention for symptom relief. A combination of antileukotriene and antihistamine drugs has been suggested to provide additive treatment benefits for patients with allergic rhinitis. OBJECTIVE: We evaluated how such a combination treatment would affect symptoms and local mucosal eosinophilia in comparison with a nasal glucocorticoid. METHODS: In a double-blind, randomized study 62 patients with grass pollen-induced allergic rhinitis received a nasal glucocorticoid (fluticasone propionate aqueous nasal spray [FPANS], 200 microg/d), an antileukotriene (montelukast, 10 mg/d), a combination of montelukast with an antihistamine (loratadine, 10 mg/d), or placebo throughout the season. Cromoglycate eyedrops and a limited amount of loratadine were allowed as rescue medication for severe symptoms. Patients recorded their symptoms for nasal blockage, itching, rhinorrhea, and sneezing. Before and during the season, nasal biopsy specimens were obtained from patients for evaluation of local eosinophilic inflammation. RESULTS: During the peak season, both FPANS and combined montelukast-loratadine were significantly more effective than placebo and montelukast alone for daytime symptom prevention. For nighttime symptoms, FPANS was significantly more effective compared with all other treatments, whereas combined montelukast-loratadine and montelukast alone did not provide significant symptom prevention compared with placebo. The pollen-induced increase in the numbers of epithelial eosinophils was significantly lower for FPANS-treated patients compared with that seen in all other treatment groups. CONCLUSION: In patients with seasonal allergic rhinitis, intranasal glucocorticoids are more effective than an antileukotriene drug or combined antileukotriene-antihistamine for the reduction of pollen-induced nasal eosinophilic inflammation and for control of nasal symptoms.
机译：背景：过敏性鼻炎需要积极干预才能缓解症状。已建议将抗白三烯和抗组胺药结合使用，为过敏性鼻炎患者提供加成治疗益处。目的：我们评估了与鼻糖皮质激素相比，这种联合治疗对症状和局部粘膜嗜酸性粒细胞增多的影响。方法：在一项双盲，随机研究中，62例草花粉诱发的过敏性鼻炎患者接受了鼻糖皮质激素（丙酸氟替卡松鼻腔喷洒液[FPANS]，200微克/天），抗白三烯（孟鲁司特，10毫克/天），整个季节中孟鲁司特与抗组胺药（氯雷他定，10 mg / d）的组合或安慰剂。允许使用cromoglycate眼药水和少量氯雷他定作为严重症状的急救药物。患者记录了鼻塞，瘙痒，鼻漏和打喷嚏的症状。在该季节之前和期间，从患者获得鼻活检标本，以评估局部嗜酸性粒细胞炎症。结果：在高峰季节，FPANS和孟鲁司特-氯雷他定联合使用对白天症状的预防效果明显优于安慰剂和孟鲁司特。对于夜间症状，与所有其他治疗方法相比，FPANS显着更有效，而与安慰剂相比，孟鲁司特-氯雷他定和孟鲁司特的联合单独使用不能提供显着的症状预防。与所有其他治疗组相比，FPANS治疗的患者中花粉诱导的上皮嗜酸性粒细胞数量增加显着降低。结论：在季节性过敏性鼻炎患者中，鼻内糖皮质激素比抗白三烯药物或抗白三烯-抗组胺药联合使用在减少花粉诱导的鼻嗜酸性粒细胞炎症和控制鼻症状方面更有效。

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