本文關(guān)鍵詞：微量元素鋅輔助治療變應(yīng)性鼻炎臨床療效觀察　出處：《寧夏醫(yī)科大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 變應(yīng)性鼻炎 微量元素鋅 療效觀察 電感耦合等離子體原子發(fā)射體光譜法 血清特異性IgE

【摘要】：目的觀察微量元素鋅輔助治療變應(yīng)性鼻炎的臨床療效,從而為變應(yīng)性鼻炎的治療和預(yù)防提供新的方案。 方法收集2010年1～12月在寧夏醫(yī)科大學(xué)總醫(yī)院變態(tài)反應(yīng)性疾病診療中心就診的資料完整的變應(yīng)性鼻炎且合并微量元素鋅缺乏患者90例，隨機(jī)分為三組，每組各為30例，實(shí)驗(yàn)組:給予丙酸氟替卡松鼻噴劑（葛蘭素史克公司）噴鼻+鋅咀嚼片（湯臣倍健股份有限公司）口服;對(duì)照組①:給予丙酸氟替卡松鼻噴劑噴鼻;對(duì)照組②:給予丙酸氟替卡松鼻噴劑噴鼻+鹽酸氮卓斯汀片（貴州云峰藥業(yè))口服。三組療程均為一月。于治療前、后分次抽取各組研究對(duì)象靜脈血3ml-5ml⑴采用電感耦合等離子體原子發(fā)射光譜（ICP-AES）法測定治療前、后各組血清中微量元素Zn、Cu、Ni、Se含量，利用配對(duì)樣本t檢驗(yàn)比較各組治療前后微量元素含量有無差別⑵采用歐蒙印跡法檢測治療前、后各組血清常見變應(yīng)原特異性IgE種類及分級(jí)變化情況,利用卡方檢驗(yàn)對(duì)各組結(jié)果進(jìn)行比較。采用癥狀體征計(jì)分標(biāo)準(zhǔn)對(duì)各組治療前后療效進(jìn)行評(píng)定，同時(shí)對(duì)各組治療后不良反應(yīng)進(jìn)行評(píng)估。所有數(shù)據(jù)均應(yīng)用軟件SPSS16.0進(jìn)行統(tǒng)計(jì)分析。 結(jié)果1.實(shí)驗(yàn)組、對(duì)照組①及對(duì)照組②治療后總有效率分別為93%、60%、96%。實(shí)驗(yàn)組與對(duì)照組②療效顯著，兩者之間無統(tǒng)計(jì)學(xué)差異。實(shí)驗(yàn)組與對(duì)照組①療效比較有顯著性差異。在鼻塞、鼻癢、每日擤鼻次數(shù)、噴嚏及體征改善方面，實(shí)驗(yàn)組與對(duì)照組②效果基本等同，且明顯優(yōu)于對(duì)照組①，P＜0.05，表明微量元素鋅結(jié)合鼻用糖皮質(zhì)激素能明顯改善AR的癥狀及體征，臨床療效顯著。2.治療后實(shí)驗(yàn)組、對(duì)照組①及對(duì)照組②在鼻出血、鼻腔干燥、胃腸道不適等不良反應(yīng)方面無顯著性差異（P＞0.05）,實(shí)驗(yàn)組、對(duì)照組①分別與對(duì)照組②比較在嗜睡、口干方面存在顯著性差異（P＜0.05），表明微量元素鋅輔助治療AR安全性較高。3.治療前、后三組常見變應(yīng)原（如樹組合2、艾蒿、塵螨組合、淡水魚組合1）血清中特異性IgE分級(jí)及種類，，實(shí)驗(yàn)組與對(duì)照組②有明顯統(tǒng)計(jì)學(xué)差異（P＜0.05），實(shí)驗(yàn)組與對(duì)照組①比較無統(tǒng)計(jì)學(xué)差異（P＞0.05）表明實(shí)驗(yàn)組與對(duì)照組②能明顯降低血清特異性IgE種類及分級(jí)。4.治療前三組血清中Zn、Cu、Ni、Se含量無統(tǒng)計(jì)學(xué)差異（P＞0.05），治療后三組血清中Zn含量有不同程度升高，且以實(shí)驗(yàn)組升高最為顯著，治療后三組血清Cu含量有不同程度下降，具有統(tǒng)計(jì)學(xué)差異（P＜0.05）表明血清鋅含量升高與AR療效改善密切相關(guān)。 結(jié)論1.本課題通過對(duì)比研究證實(shí)微量元素鋅輔助治療變應(yīng)性鼻炎療效明顯，并且不良反應(yīng)少，安全性較高，值得在臨床推廣。2.微量元素鋅輔助治療變應(yīng)性鼻炎能明顯減低血清特異性IgE分級(jí)及種類，且血鋅含量升高與AR療效改善密切相關(guān)。3.微量元素鋅輔助治療變應(yīng)性鼻炎，療效判定與患者年齡、民族、性別、分類無關(guān)，與是否合并哮喘關(guān)系不甚清楚，今后需進(jìn)一步開展此方面的研究。
[Abstract]:Objective to observe the clinical efficacy of trace element zinc in the treatment of allergic rhinitis and to provide a new scheme for the treatment and prevention of allergic rhinitis. Methods 90 patients with allergic rhinitis and trace element zinc deficiency were collected from 2010 to December in the diagnosis and treatment center of allergic diseases in the General Hospital of Ningxia Medical University. Three groups were randomly divided into three groups, 30 cases in each group. The experimental group was given fluticasone propionate nasal spray (GlaxoSmithKline) orally; Control group 1: fluticasone propionate nasal spray; Control group 2: fluticasone propionate nasal spray was administered orally with azoxetine hydrochloride tablets (Guizhou Yunfeng Pharmaceutical Industry). The course of treatment in the three groups was January. The venous blood levels of 3ml-5ml1 were measured by ICP-AESS-ICP-AESmethod before and after treatment. The content of NiSe was compared by paired t-test before and after treatment. 2 before and after treatment, the content of trace elements was detected by OMBI. After the serum allergen specific IgE types and grading changes, chi-square test was used to compare the results of each group. The symptoms and signs of scoring criteria were used to evaluate the efficacy of each group before and after treatment. At the same time, the adverse reactions of each group were evaluated. All the data were analyzed by software SPSS16.0. Results 1. The total effective rate of experimental group, control group 1 and control group 2 after treatment was 930.60 and 96, respectively. The effect of experimental group and control group 2 was significant. 2. There was no statistical difference between the two groups. There was a significant difference between the experimental group and the control group. The effect of the experimental group and the control group 2 was basically the same as that of the control group in the aspects of nasal congestion, nasal itching, number of times of blowing nose daily, sneezing and improvement of physical signs. The results showed that the trace element zinc combined with nasal glucocorticoid could significantly improve the symptoms and signs of AR. Control group 1 and control group 2 had no significant difference in adverse reactions such as epistaxis, dry nasal cavity and gastrointestinal discomfort (P > 0.05). There was significant difference in dry mouth (P < 0.05), indicating that the safety of trace element zinc in the treatment of AR was higher. 3. Before treatment, common allergens (such as tree combination 2, Artemisia argyi, dust mite) were found in the latter three groups. There was significant difference between the experimental group and the control group (P < 0.05). There was no significant difference (P > 0.05) between the experimental group and the control group (P > 0.05). The results showed that the type and grading of serum specific IgE in the experimental group and the control group were significantly decreased. There was no statistical difference in the content of nitianse (P > 0.05). After treatment, the serum Zn content in the three groups increased to some extent, especially in the experimental group. After treatment, the serum Cu content in the three groups decreased to some extent, with statistical difference (P < 0.05). The results showed that the increase of serum zinc content was closely related to the improvement of AR curative effect. This subject through comparative study confirmed that trace element zinc adjuvant treatment of allergic rhinitis curative effect is obvious, and the adverse reaction is less, the safety is higher. 2. It is worth popularizing in clinic. The trace element zinc adjuvant treatment of allergic rhinitis can obviously reduce the serum specific IgE grade and type. The increase of blood zinc content is closely related to the improvement of AR curative effect .3.Trace element zinc adjuvant therapy for allergic rhinitis, the curative effect is not related to the age, nationality, sex and classification of the patients. The relationship between asthma and asthma is unclear, and further research is needed in the future.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R765.21

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