舍雷肽酶腸溶片對(duì)慢性鼻竇炎疾病腫脹的療效及安全性評(píng)估

鄭晶瓊　虞義建　潘兆虎

[摘要] 目的 探討舍雷肽酶腸溶片治療慢性鼻竇炎疾病腫脹的臨床療效及安全性。 方法 納入172例慢性鼻竇炎患者，均具有完整的臨床資料，收集時(shí)間為2014年10月～2016年10月。按照就診順序進(jìn)行分組，分為對(duì)照組（85例）和觀察組（87例），分別給予克拉霉素治療和克拉霉素聯(lián)合舍雷肽酶腸溶片治療。觀察兩組治療前后的臨床癥狀和體征評(píng)分及生活質(zhì)量評(píng)分，判定療效并記錄不良反應(yīng)情況。 結(jié)果 治療后兩組患者的臨床癥狀和體征評(píng)分與本組治療前進(jìn)行比較，均出現(xiàn)顯著下降，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），且治療后觀察組評(píng)分顯著低于對(duì)照組，組間比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；觀察組顯效50例，有效31例，總有效率為93.10%，顯著高于對(duì)照組的82.35%（P<0.05）；治療前與治療后不同時(shí)間分別對(duì)兩組患者進(jìn)行鼻腔鼻竇結(jié)局測(cè)量20條（SNOT-20）評(píng)分比較，與本組治療前比較，治療后1個(gè)月、2個(gè)月、3個(gè)月評(píng)分均出現(xiàn)顯著的下降（P<0.05），且治療后不同時(shí)間點(diǎn)觀察組評(píng)分顯著低于對(duì)照組，組間比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；研究過程中兩組患者均未出現(xiàn)不良反應(yīng)。 結(jié)論 對(duì)慢性鼻竇炎患者實(shí)施舍雷肽酶腸溶片治療可以有效改善患者的臨床腫脹等癥狀，提高治療效果以及患者的生活質(zhì)量，且無不良反應(yīng)，是一種安全有效的治療方案。

[關(guān)鍵詞] 慢性鼻竇炎；舍雷肽酶腸溶片；腫脹；安全性

[中圖分類號(hào)] R765.4 [文獻(xiàn)標(biāo)識(shí)碼] B [文章編號(hào)] 1673-9701（2017）12-0084-04

[Abstract] Objective To investigate the clinical efficacy and safety of serrapeptase enteric-coated tablets on swelling of chronic sinusitis. Methods A total of 172 patients with chronic sinusitis were included in the treatment， and all had complete clinical data collected from October 2014 to October 2016. The patients were divided into control group（n=85） and observation group（n=87）， according to the order of treatment. The control group was treated with clarithromycin and the observation group was given clarithromycin combined with serrapeptase enteric-coated tablets. The clinical symptoms and signs scores and quality of life scores in the two groups before and after treatment were observed to determine the efficacy and record adverse reactions. Results The scores of clinical symptoms and signs in patients of the two groups after treatment were significantly lower than those before treatment， and there was statistically significant difference（P<0.05）. There was statistical difference in the scores between the two groups after treatment（P<0.05）. And the scores of the observation group were significantly lower than those of the control group. By determining the efficacy， 50 cases were cured， 31 cases were effective in the control group， and the total effective rate was 93.10%， which was significantly higher than that of the control group 82.35%（P<0.05）. The sino-nasal outcome test-20 was measured respectively in the patients of two groups before treatment and at different time after treatment， and it was found that the score at 1 month， 2 months， 3 months after treatment significantly decreased compared with that of this group before treatment（P<0.05）. And there were also statistical differences between groups at different time after treatment（P<0.05）. The score of the observation group was significantly lower than that of the control group. There were no adverse reactions in both groups during the course of the study. Conclusion The serrapeptase enteric-coated tablets in the treatment of patients with chronic sinusitiscan can effectively improve the clinical symptoms such as swelling and improve the treatment effect and the quality of life of patients with no adverse reactions， which is a safe and effective treatment program.

[Key words] Chronic sinusitis； Serrapeptase enteric-coated tablets； Swelling； Safety

慢性鼻竇炎是常見的耳鼻喉科慢性疾病，病程較長(zhǎng)，患者長(zhǎng)期存在鼻塞、流鼻涕、鼻涕倒流、呼吸困難、嗅覺減退、頭痛、咳嗽等癥狀，使患者注意力無法集中、記憶力減退及睡眠不足，嚴(yán)重影響到患者的日常生活和工作，常規(guī)治療大多采用克拉霉素等抗生素類藥物[1]。舍雷肽酶是一種酶類制劑，為沙雷氏菌屬細(xì)菌所產(chǎn)生的蛋白分解酶口服制劑，具有多重作用，可以發(fā)揮出很強(qiáng)的抗炎、消腫、祛痰功效[2]。本院自2014年起嘗試對(duì)慢性鼻竇炎疾病腫脹患者實(shí)施舍雷肽酶腸溶片治療。經(jīng)過一段時(shí)期的臨床應(yīng)用與療效觀察，效果顯著，現(xiàn)報(bào)道如下。

1 資料與方法

1.1 一般資料

研究納入172例慢性鼻竇炎患者，其中男92例，女80例；年齡最小19歲，最大51歲，平均（34.81±10.15 ）歲。資料收集時(shí)間為2014年10月～2016年10月。均為本院收治的住院患者，均具有完整的臨床資料。……