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目的:探讨氟哌噻吨美利曲辛联合特异性免疫治疗(SIT)治疗变应性鼻炎(AR)伴焦虑(抑郁)状态患者的疗效。方法:选取2014-10-2015-09期间收治的99例中重度持续AR伴焦虑及抑郁患者,随机分成2组(实验组45例,对照组44例),所有患者给予标准化尘螨变应原疫苗SIT,疗程1年,实验组在此基础上再予氟哌噻吨美利曲辛口服(1片/d),疗程4个月。观察治疗前、治疗4个月和1年后的鼻部症状评分、迷你鼻结膜炎生活质量问卷(MiniRQLQ)、用药评分、焦虑状态量表(SAS)、抑郁状态量表(SDS)评分及临床疗效。同时收集2组发生的不良反应。结果:与治疗前比较,治疗4个月和1年后2组鼻部症状评分、MiniRQLQ各项评分、用药评分、SAS及SDS积分均降低,均差异有统计学意义(P<0.05);与对照组比较,在治疗4个月后实验组鼻部症状评分、MiniRQLQ各项评分、用药评分、SAS和SDS评分以及在治疗1年后的用药评分、SAS和SDS评分均降低(P<0.05);在治疗1年后,2组鼻部症状评分和MiniRQLQ各项评分、临床总有效率差异无统计学意义(P>0.05)。治疗4个月后,实验组总有效率为84.4%,对照组为56.8%;治疗1年后,实验组显效率为57.8%,对照组为22.7%;均差异有统计学意义(均P<0.05);治疗过程中共出现13例轻度不良反应,实验组8例(17.7%)和对照组5例(11.4%),差异无统计学意义(P>0.05)。结论:对于中重度AR伴焦虑抑郁状态患者,应用氟哌噻吨美利曲辛联合SIT能够进一步改善其临床症状、生活质量和精神状态,可提高临床疗效且安全可靠。
Objective: To investigate the efficacy of flupenthixol combined with melitracen combined with specific immunotherapy (SIT) in the treatment of patients with allergic rhinitis (AR) accompanied by anxiety (depression). Methods: Ninety-nine patients with moderate-to-severe persistent AR with anxiety and depression who were treated during 2014-10-2015-09 were randomly divided into two groups (45 in experimental group and 44 in control group). All patients were given standardized dust mite allergen Vaccine SIT, 1-year course of treatment, the experimental group on the basis of flupentixol MTX oral (1 / d), the course of 4 months. Nasal symptom scores, MiniRQLQ, medication scores, anxiety status scale (SAS), depression status scale (SDS) scores and clinical symptoms before treatment, 4 months and 1 year after treatment were observed. Efficacy. Adverse reactions were also collected in 2 groups. Results: Compared with those before treatment, the nasal symptom score, MiniRQLQ score, medication score, SAS and SDS scores were lower in both groups at 4 and 1 year after treatment, the difference was statistically significant (P <0.05); and The nasal symptom scores, MiniRQLQ scores, medication scores, SAS and SDS scores of the experimental group and the medication scores after 1 year of treatment, SAS and SDS scores decreased (P <0.05) 4 months after treatment in the control group, ; After 1 year of treatment, there was no significant difference in the total effective rate between two groups of nasal symptom scores and MiniRQLQ scores (P> 0.05). After 4 months of treatment, the total effective rate was 84.4% in the experimental group and 56.8% in the control group. After 1 year of treatment, the markedly effective rate was 57.8% in the experimental group and 22.7% in the control group (all P < 0.05). Thirteen mild adverse reactions occurred in the treatment group. There were 8 cases (17.7%) in the experimental group and 5 cases (11.4%) in the control group, with no significant difference (P> 0.05). Conclusion: For patients with moderate-severe AR accompanied by anxiety and depression, the application of flupentixol and melitracen in combination with SIT can further improve its clinical symptoms, quality of life and mental state, which can improve the clinical efficacy and be safe and reliable.