[分享]孟鲁司特加西替立嗪可预防季节性变应性鼻炎
发布于 2004-03-10 · 浏览 1604 · IP 湖北湖北
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研究人员发现，在花粉季节来临前开始联用抗组胺药和抗白三烯药，可有效预防变应性鼻炎（AR）的症状和减少鼻粘膜的过敏性炎症。
尽管组胺引起了AR的症状如鼻溢、喷嚏和眼、鼻痒感，但白三烯也有一定作用，它增加了鼻腔的气道阻力和血管通透性。有证据表明在花粉季节到来前使用按组胺药，可预防出现AR的症状。但对预防性使用抗白三烯类药的资料还很缺乏。
波兰罗兹大学的库罗斯基（Marek L. Kurowski）和同事进行了一项双盲、平行、安慰剂对照研究，以检查口服抗组胺药（西特立嗪）或/和抗白三烯药（孟鲁司特）预防性用于AR的效果。60位18-35岁有季节性AR史的病人被随机分为在花粉季节来临前6周或开始用安慰剂，或西特立嗪，或孟鲁司特，或联用后两药。4人因为症状加重退出，7人失去随访，1人服用了非处方的抗组胺药。研究终点为花粉季中的鼻炎联合症状分、炎症细胞计数、嗜酸性细胞阳离子蛋白（ECP）和鼻冲洗液（NFL）中的肥大细胞类胰蛋白酶（MCT）水平。
结果表明，联合治疗显著减少了发病季节中的症状分，延迟了症状出现的时间，显著降低了平均嗜酸细胞计数。而且，ECP在治疗12周后也显著下降。但嗜碱细胞计数和MCT水平无差异。详见《变应性》杂志（Allergy 2004 Mar;59:3:280-8）上“孟鲁司特加西替立嗪预防性治疗季节性变应性鼻炎：对临床症状和鼻过敏性炎症的影响”一文。
Montelukast plus cetirizine in the prophylactic treatment of seasonal allergic rhinitis: influence on clinical symptoms and nasal allergic inflammation.
Background: The aim of our study was to investigate effects of 6-week pretreatment of seasonal allergic rhinitis (AR) with cetirizine, and montelukast, alone and in combination. Antihistamine/antileukotriene treatment is effective in AR. Antihistamines may prevent AR symptoms while prophylactic activity of antileukotrienes remains unclear.
Methods: Sixty AR patients, aged 18-35 years, were randomized to receive placebo, montelukast only, cetirizine only, or montelukast plus cetirizine, 6 weeks prior and 6 weeks after the beginning of grass pollen season. Mean self-recorded in-season symptom scores and mean weekly all-symptom scores were analyzed. In 31 patients, nasal lavages were performed before treatment, and at the end of the study, i.e. 12 weeks after the treatment initiation. Eosinophil and basophil counts, eosinophil cationic protein (ECP), and mast cell tryptase (MCT) levels were evaluated in lavage samples.
Results: Combined montelukast/cetirizine pretreatment significantly reduced in-season symptom score for sneezing, eye itching, nasal itching, rhinorrhea, and congestion. Montelukast plus cetirizine were more effective than cetirizine alone in preventing eye itching, rhinorrhea, and nasal itching. Moreover, combined pretreatment with montelukast and cetirizine delayed appearance of AR symptoms. Eosinophil nasal lavage fluid counts were significantly increased during pollen season in placebo and montelukast-only groups. No differences were observed in basophil counts. The in-season ECP level was significantly increased in all groups except montelukast-plus-cetirizine group. In-season MCT levels were not increased.
Conclusion: Combined antihistamine and antileukotriene treatment started 6 weeks before the pollen season is effective in preventing AR symptoms and reduces allergic inflammation in nasal mucosa during natural allergen exposure.
Allergy. 2004 Mar;59(3):280-8.
尽管组胺引起了AR的症状如鼻溢、喷嚏和眼、鼻痒感，但白三烯也有一定作用，它增加了鼻腔的气道阻力和血管通透性。有证据表明在花粉季节到来前使用按组胺药，可预防出现AR的症状。但对预防性使用抗白三烯类药的资料还很缺乏。
波兰罗兹大学的库罗斯基（Marek L. Kurowski）和同事进行了一项双盲、平行、安慰剂对照研究，以检查口服抗组胺药（西特立嗪）或/和抗白三烯药（孟鲁司特）预防性用于AR的效果。60位18-35岁有季节性AR史的病人被随机分为在花粉季节来临前6周或开始用安慰剂，或西特立嗪，或孟鲁司特，或联用后两药。4人因为症状加重退出，7人失去随访，1人服用了非处方的抗组胺药。研究终点为花粉季中的鼻炎联合症状分、炎症细胞计数、嗜酸性细胞阳离子蛋白（ECP）和鼻冲洗液（NFL）中的肥大细胞类胰蛋白酶（MCT）水平。
结果表明，联合治疗显著减少了发病季节中的症状分，延迟了症状出现的时间，显著降低了平均嗜酸细胞计数。而且，ECP在治疗12周后也显著下降。但嗜碱细胞计数和MCT水平无差异。详见《变应性》杂志（Allergy 2004 Mar;59:3:280-8）上“孟鲁司特加西替立嗪预防性治疗季节性变应性鼻炎：对临床症状和鼻过敏性炎症的影响”一文。
Montelukast plus cetirizine in the prophylactic treatment of seasonal allergic rhinitis: influence on clinical symptoms and nasal allergic inflammation.
Background: The aim of our study was to investigate effects of 6-week pretreatment of seasonal allergic rhinitis (AR) with cetirizine, and montelukast, alone and in combination. Antihistamine/antileukotriene treatment is effective in AR. Antihistamines may prevent AR symptoms while prophylactic activity of antileukotrienes remains unclear.
Methods: Sixty AR patients, aged 18-35 years, were randomized to receive placebo, montelukast only, cetirizine only, or montelukast plus cetirizine, 6 weeks prior and 6 weeks after the beginning of grass pollen season. Mean self-recorded in-season symptom scores and mean weekly all-symptom scores were analyzed. In 31 patients, nasal lavages were performed before treatment, and at the end of the study, i.e. 12 weeks after the treatment initiation. Eosinophil and basophil counts, eosinophil cationic protein (ECP), and mast cell tryptase (MCT) levels were evaluated in lavage samples.
Results: Combined montelukast/cetirizine pretreatment significantly reduced in-season symptom score for sneezing, eye itching, nasal itching, rhinorrhea, and congestion. Montelukast plus cetirizine were more effective than cetirizine alone in preventing eye itching, rhinorrhea, and nasal itching. Moreover, combined pretreatment with montelukast and cetirizine delayed appearance of AR symptoms. Eosinophil nasal lavage fluid counts were significantly increased during pollen season in placebo and montelukast-only groups. No differences were observed in basophil counts. The in-season ECP level was significantly increased in all groups except montelukast-plus-cetirizine group. In-season MCT levels were not increased.
Conclusion: Combined antihistamine and antileukotriene treatment started 6 weeks before the pollen season is effective in preventing AR symptoms and reduces allergic inflammation in nasal mucosa during natural allergen exposure.
Allergy. 2004 Mar;59(3):280-8.
最后编辑于 2022-10-09 · 浏览 1604
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