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目的探讨小剂量红霉素治疗联发小儿支气管哮喘(BA)的难治性变应性鼻炎(AR)的疗效及用药安全性。方法 3～14岁鼻炎-哮喘联发的门诊患儿173例。其中BA控制满意或基本满意,但AR治疗2个疗程无效的难治性AR78例,配合随访至研究结束者76例。以此76例作为研究对象,分为观察组和对照组,对照组继续常规治疗,予以更换不同的第二代抗组胺药口服,必要时辅以鼻用糖皮质激素;观察组在常规治疗的基础上,加用红霉素肠溶胶囊10mg·kg-1.d-1,分3次口服,疗程为1个月。2组患儿均继续按规范方案治疗BA。结果观察组显效、无效及总有效率与对照组比较差异有统计学意义(χ2=12.629、8.412、8.412,Pa<0.005)。2组不良反应比较,观察组发生食欲亢进显著高于对照组(χ2=8.324,P<0.005),其他不良反应,如不规则腹痛、腹泻、食欲不振等比较差异均无统计学意义(Pa>0.05)。治疗前和治疗1个月后,肝功能监测(包括ALT、AST、清蛋白、球蛋白)未发现异常。结论小剂量红霉素治疗难治性AR疗效可靠,安全性较好。但仅限于难治性病例,并严格掌握好适应证。
Objective To investigate the curative effect and medication safety of refractory allergic rhinitis (AR) treated with low dose erythromycin in children with bronchial asthma (BA). Methods A total of 173 outpatients with rhinitis and asthma were enrolled in this study. Among them, BA control was satisfactory or basically satisfactory, but 78 AR cases refractory to AR were not followed up until the end of the study. The 76 patients were divided into the observation group and the control group. The control group continued routine treatment, and the second generation antihistamines were replaced orally, if necessary, supplemented with nasal glucocorticoid. In the observation group, Based on the addition of erythromycin enteric-coated capsules 10mg · kg-1.d-1, 3 times orally, treatment for 1 month. 2 groups of children continue to be treated according to the standard program BA. Results There was significant difference between the observation group and the control group (χ2 = 12.629, 8.412, 8.412, Pa <0.005). There was no significant difference in other adverse reactions such as irregular abdominal pain, diarrhea, loss of appetite, etc. (P> 0.05). There was no significant difference in adverse reactions between the two groups (P> 0.05) 0.05). Liver function tests (including ALT, AST, albumin, globulin) were not found to be abnormal before and 1 month after treatment. Conclusion Low-dose erythromycin in refractory AR is reliable and safe. But only for refractory cases, and strictly control the indications.