孟鲁司特与糠酸莫米松鼻喷剂联合治疗儿童变应性鼻炎的近期疗效观察

目的：评价口服孟鲁司特和糠酸莫米松鼻喷剂联合治疗儿童变应性鼻炎的近期疗效，以优化儿童变应性鼻炎的治疗方案。方法：选择2011年4月-2012年4月在潍坊市人民医院耳鼻喉科就诊并确诊为变应性鼻炎的患儿48例，随机分为联合用药组（MM组，24例）和糠酸莫米松组（MS组，24例）。MM组患者给予糠酸莫米松喷鼻（早晨喷鼻1次，每次2喷），孟鲁司特片口服（5mg／次，1次／天，睡前30分口服）；MS组患者给予糠酸莫米松喷鼻（早晨啧鼻2次，每次2啧）。两组的治疗疗程均为3个月，治疗后观察和比较两组患者鼻塞、鼻痒、流清涕、喷嚏等，临床症状及鼻内镜的检查结果。结果：治疗1个月后，两组治疗总有效率的差异无统计学意义（P〉0．05）；治疗3个月后，两组症状评分的改善高于1月朱（P〈0．05）；治疗3个月后，MM组的治疗总有效率显著高于MS组（P〈0．05）。结论：糠酸莫米松与孟鲁司特联合治疗儿童常年性变异性鼻炎的临床疗效优于单用糠酸莫米松治疗，且不良反应少。对于常年性变应性鼻炎患儿的治疗应以序贯性和个体化治疗为原则，最大程度发挥糠酸莫米松与孟鲁司特间的相互协同作用。

Clinical Observation on the Short-term Effects of Oral Montelukast Combined with Mometasone Furoate Nasal Spray in the Treatment of Allergic Rhinitis in Children

Objective： To evaluate the short-term effect of oral montelukast combined with mometasone furoate nasal spray in the treatment of allergic rhinitis in children. Methods： A total of 48 children with PAR identified and diagnosed by Hal Kou Standard were collected in Department of Otorhinolaryngology of Weifang People Hospital from April 2011 to April 2012. The children were divided into 2 groups： combined group （MM group, mometasone furoate nasal spray plus oral montelukast, 24 cases）, mometasone furoate nasal spray group （MS group,24 cases）. MM group was treated by mometasone furoate 2 sprays every morming plus oral montelukast 5 mg half an hour before sleep every day. MS group was treated by mometasone furoate 2 sprays every morning. Both groups were administrated with 3 months. Clinic symptoms, such as nasal congestion, itching, rhinorrhea with sneezing and endoscopic results were chosen as ob- servation indexes. Results： After 1 month of administration, no significant difference of the total effective rate was observed between both groups（P〉0.05 ）. After 3 months of administration, changes of Symptom scores in both groups are higher than that of 1 month of adminis- tration （P〈0.05）. After 3 months of administration, the total effective rate was higher in MM group than that of MS group （P〈0.05）. Conclusion： Oral montelukast combined with mometasone furoate nasal spray was more effective in the treatment of allergic rhinitis in children than mometasone furoate nasal spray and had fewer adverse effects. Sequential and individualized treatment can be used in PAR in order to consummate the synergistic effect of montelukast and mometasone fitroate.