克拉霉素强化治疗用于慢性鼻窦炎患者的临床观察
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篇名: 克拉霉素强化治疗用于慢性鼻窦炎患者的临床观察
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摘要: 目的:探讨克拉霉素强化治疗用于慢性鼻窦炎患者的疗效、安全性及对血清炎性细胞因子的影响。方法:186例慢性鼻窦炎患者随机分为对照1组(62例)、对照2组(62例)和观察组(62例)。对照1组患者口服阿莫西林克拉维酸钾片(7 ∶ 1)0.457 g,每日3次;对照2组患者口服克拉霉素分散片0.25 g,每日1次;观察组患者口服克拉霉素分散片第1周0.5 g,每日2次,第2周0.25 g,每日2次。各组患者疗程均为2周。观察各组患者的临床疗效和治疗前后各临床症状评分、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、超敏C反应蛋白(hs-CRP)水平及不良反应发生情况。结果:总有效率观察组(93.55%)>对照2组(80.65%)>对照1组(65.51%),差异均有统计学意义(P<0.05)。治疗前,各组患者各临床症状评分、TNF-α、IL-6、hs-CRP水平比较,差异均无统计学意义(P>0.05);治疗后,各组患者各临床症状评分、TNF-α、IL-6、hs-CRP水平均显著低于同组治疗前,且观察组<对照2组<对照1组,差异均有统计学意义(P<0.05)。观察组、对照2组患者不良反应发生率均显著低于对照1组,差异均有统计学意义(P<0.05),但观察组与对照2组间比较,差异无统计学意义(P>0.05)。结论:克拉霉素强化治疗用于慢性鼻窦炎的疗效显著,可改善患者的临床症状,降低血清炎性细胞因子水平,且未增加不良反应的发生。
ABSTRACT: OBJECTIVE: To investigate therapeutic efficacy and safety of clarithromycin intensive therapy on patients with chronic rhinosinusitis and its effects on serum inflammatory cytokines. METHODS: A total of 186 patients with chronic rhinosinusitis were randomly divided into control group 1 (62 cases), control group 2 (62 cases) and observation group (62 cases). Control group 1 was given Amoxicillin and clavulanate potassium tablet (7 ∶ 1) 0.457 g, 3 times a day. Control group 2 was given Clarithromycin dispersible tablet 0.25 g orally, once a day. Observation group was given Clarithromycin dispersible tablet 0.5 g orally on the first week, twice a day, 0.25 g at the second week, twice a day. Both groups were treated for 2 weeks. Clinical efficacies of 3 groups were observed. Clinical symptom score, TNF-α, IL-6 and hs-CRP before and after treatment as well as the occurrence of ADR were observed. RESULTS: Total response rate was in descending order: observation group (93.55%)>control group 2 (80.65%)>control group 1(65.51%), with statistical significance (P<0.05). Before treatment, there was no statistical significance in clinical symptom score, the levels of TNF-α, IL-6 and hs-CRP among 3 groups (P>0.05). After treatment, clinical symptom score, the levels of TNF-α, IL-6 and hs-CRP were significantly lower than before treatment; those indexes of 3 groups were in ascending order: observation group<control group 2<control group 1, with statistical significance (P<0.05). The incidence of ADR in observation group and control groups were significantly lower than control group 1, with statistical significance (P<0.05). There was no statistical significance between observation group and control group 2 (P>0.05). CONCLUSIONS: Clarithromycin intensive therapy shows significant therapeutic efficacy for chronic rhinosinusitis, improves clinical symptoms of patients and reduces the level of serum inflammatory factor without increasing the occurrence of ADR.
期刊: 2017年第28卷第30期
作者: 李震,张瑞桐,苏光春,王莹,周成,刘永刚
AUTHORS: LI Zhen,ZHANG Ruitong,SU Guangchun,WANG Ying,ZHOU Cheng,LIU Yonggang
关键字: 慢性鼻窦炎;克拉霉素;强化治疗;炎性细胞因子;疗效;安全性
KEYWORDS: Chronic rhinosinusitis; Clarithromycin; Intensive therapy; Inflammatory cytokines; Therapeutic efficacy; Safety
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