目的 探討桉檸蒎腸溶軟膠囊聯(lián)合糠酸莫米松治療慢性鼻炎的臨床效果。方法 選取2017年1月-2018年8月西安醫(yī)學(xué)院第二附屬醫(yī)院收治的134例慢性鼻炎患者，隨機分成對照組（n=67）和治療組（n=67）。對照組給予糠酸莫米松鼻噴霧劑，鼻腔給藥，每側(cè)鼻孔2撳/次，1次/d。治療組患者在對照組基礎(chǔ)上口服桉檸蒎腸溶軟膠囊，1粒/次，2次/d，于餐前0.5 h用涼開水整粒吞服。兩組均連續(xù)治療4周。比較兩組臨床療效、治療前后鼻部主要癥狀評分、鼻腔鼻竇結(jié)局測試-20（SNOT-20）評分、DIP內(nèi)鏡評分、總鼻阻力（TNR）值、鼻聲反射參數(shù)[鼻腔最小橫截面積（NMCA）、0~5 cm鼻腔容積（0~5 cm NCV）]值及鼻灌洗液炎癥細(xì)胞計數(shù)變化及隨訪復(fù)發(fā)率。結(jié)果 治療組總有效率為95.5%顯著高于對照組83.6%（P<0.05）。兩組治療后鼻塞評分、鼻涕評分及SNOT-20總分均顯著低于治療前（P<0.05），且治療組下降更顯著（P<0.05）。與治療前對比，兩組治療后DIP內(nèi)鏡評分系統(tǒng)中各項（炎癥、分泌物、息肉/水腫）評分及其總分均顯著降低（P<0.05）；但治療后，治療組以上DIP內(nèi)鏡評分均較對照組同期顯著更低（P<0.05）。兩組治療后TNR較治療前均顯著減?。?i>P<0.05），NMCA和0~5 cm NCV則均顯著增大（P<0.05）；且治療組上述參數(shù)的改善效果均更顯著（P<0.05）。兩組治療后鼻灌洗液EOS和LYM計數(shù)均顯著低于治療前（P<0.05），而治療組鼻灌洗液以上炎癥細(xì)胞計數(shù)均顯著更少（P<0.05）。隨訪6個月，治療組復(fù)發(fā)率3.0%顯著低于對照組14.9%（P<0.05）。結(jié)論 桉檸蒎腸溶軟膠囊聯(lián)合糠酸莫米松治療慢性鼻炎的整體療效顯著，能明顯緩解患者鼻部癥狀和體征，改善鼻腔通氣功能，減輕鼻腔炎癥反應(yīng)，降低復(fù)發(fā)風(fēng)險，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical effect of Eucalyptus Carabinieri Enteric Soft Capsule combined with mometasone furoate in treatment of chronic rhinitis. Methods 134 Patients with chronic rhinitis admitted to Second Affiliated Hospital of Xi'an Medical University from January 2017 to August 2018 were randomly divided into control group (n=67) and treatment group (n=67). The control group was treated by Mometasone Furoate Nasal Spray, 2 snouts/time for each nostril, once daily. The treatment group was po administered with Eucalyptus Carabinieri Enteric Soft Capsule with cold boiled water 0.5 h before meal on the basis of the control group, one tablet/time, twice daily. All patients were treated for 4 weeks. The clinical effects of the two groups were compared. The nasal main symptom score, nasal sinus outcome test -20(SNOT-20) score, DIP endoscopy score, total nasal resistance (TNR) value, nasal acoustic reflex parameters[nasal minimum cross-sectional area (NMCA), nasal volume of 0-5 cm (0-5 cm NCV)] value, changes in inflammatory cell count in nasal lavage fluid and follow-up recurrence rate were compared before and after treatment. Results The total effective rate of the treatment group was 95.5%, significantly higher than that of the control group 83.6%, P<0.05. After treatment, nasal congestion score, nasal mucus score and SNOT-20 total score in both groups were significantly lower than before treatment (P<0.05), and the decline was more significant in the treatment group (P<0.05). Compared with before treatment, scores of various items (inflammation, secretions, polyps/edema) in the DIP endoscopic scoring system and their total scores were significantly reduced after treatment in both groups (P<0.05). However, after treatment, all the DIP endoscopic scores in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, TNR of both groups was significantly reduced compared with that before treatment (P<0.05), while NMCA and NCV of 0-5 cm were significantly increased (P<0.05). The improvement effect of the above parameters in the treatment group was more significant (P<0.05). After treatment, the EOS and LYM counts of nasal lavage fluid in both groups were significantly lower than before treatment (P<0.05), while the inflammatory cell counts above nasal lavage fluid in the treatment group were significantly lower (P<0.05). Follow-up for 6 months showed that the recurrence rate of 3.0% in the treatment group was significantly lower than that of 14.9% in the control group (P<0.05). Conclusion Eucalyptus Carabinieri Enteric Soft Capsule combined with mometasone furoate has overall effect in treatment of chronic rhinitis, and can significantly relieve patients' nasal symptoms and signs, and also can improve nasal ventilation, reduce nasal inflammation and the risk of recurrence, which has a certain clinical application value.

R976