鼻盐水冲洗法可以降低鼻窦炎的症状及严重度


  Oct. 13, 2003 (纽奥良)-研究人员在今年的美国家庭医生学会的科学集会上宣布,每日以高张盐水溶液经鼻冲洗不仅能减低鼻窦炎症状的严重度,更能降低急性恶化的发生及抗生素治疗的需求。
  
  美国麦迪逊威斯康辛大学家庭医学部的David Rabago医师和同事发表的一项研究结果,将76位慢性鼻窦炎病患随机分配到以135cc的高张盐液经鼻冲洗的治疗或是分配到照例以症状治疗的控制群,这项研究持续了六个月。
  
  Rabago医师告诉会议出席者,与控制组相比,介入治疗的病患表示其生活质量,鼻窦炎症状的减轻,抗生素使用的减少,和鼻喷剂使用的减少都有明显的改善,Rabago医师解释,在鼻子里灌水并非正常引力运动的流向,但是对于这些病患似乎有效。
  
  在最初阶段的研究完成后,54位病患,包括第一阶段研究的控制组,持续使用鼻腔冲洗且继续追踪4、8及12个月,没有病患中途退出,且所有后续追踪者的生活质量皆持续改善。
  
  在第二阶段,65%的病患在症状发生才使用鼻腔冲洗及35%的病患每日使用,将近10%的病人表示有轻微的鼻灼热,但是有96%的病患对这项方法表示满意并表示将持续使用,Rabago医师用「热衷」来描述这些病患。
  
  静脉窦感染的病患降低了72%,药物治疗使用则减少了58%、69%的呼吸能力获得改进,和52%的病患在生活质量获得改善,Rabago医师表示,几乎被治疗的每一个人都因此而获益。
  
  西雅图Queen Anne Family Medicine 及华盛顿大学FAAFP 的Bruce Gardner医师同意上述看法,他告诉Medscape,他将鼻腔盐水冲洗视为治疗鼻窦炎不可或缺的一部分,特别是慢性鼻窦炎。
  
  但是他表示某些病患不能将这项方法合并到健康照护疗法,他指出,你所需要是正面的结果,在使用一项技术时,例如鼻盐水冲洗法,需要学习曲线,有时你就是无法成功,但是它真的减少了其它药物治疗的需求。

Saline Nasal Irrigation Reduce

By
Medscape Medical News

Martha Kerr

Oct. 13, 2003 (New Orleans) — Daily nasal irrigation with a hypertonic saline solution reduces not only the severity of symptoms in sinusitis, but the occurrence of acute exacerbations and the need for antibiotic therapy, researchers announced here at this year's scientific assembly of the American Academy of Family Physicians.

David Rabago, MD, from the Department of Family Medicine at the University of Wisconsin, Madison, and colleagues presented results of a study of 76 patients with chronic sinusitis randomized to a regimen of daily nasal lavage with 135 cc of hypertonic saline solution (52 patients) or to a control group that managed symptoms as usual (24 patients). The study lasted for six months.

Patients in the intervention arm reported a significant improvement in quality of life, reduction in symptoms of sinusitis, reduction in antibiotic use, and a reduction in use of nasal sprays compared with control patients, Dr. Rabago told meeting attendees.

"Pouring water in your nose is not what you normally gravitate towards," Dr. Rabago commented, "but it seems to work for these patients."

After the initial phase of the study was completed, 54 patients, including control patients from phase 1 of the study, continued to use nasal lavage and were followed at 4, 8, and 12 months. There was no patient dropout, Dr. Rabago reported, and quality-of-life improvements were maintained throughout follow-up.

In phase 2, 65% of patients used nasal lavage when symptomatic and 35% used it on a daily basis. Approximately 10% of patients reported mild nasal burning, but 96% of subjects reported satisfaction with the technique and said they will continue to use it. Dr. Rabago described the patients as "enthusiastic."

Patients reported a 72% reduction in sinus infections, a 58% decrease in medication use, a 69% improvement in ability to breathe, and a 52% improvement in quality of life.

"Almost everyone you treat can benefit from this," Dr. Rabago said.

Bruce Gardner, MD, FAAFP, from Queen Anne Family Medicine and the University of Washington in Seattle, concurs. He told Medscape that he considers nasal saline lavage "an integral part of treating sinusitis, especially chronic sinusitis."

But he said that some patients are unable to integrate the technique into their healthcare regimen. "What you need is a positive result" when using a technique like saline irrigation of the nasal passages, Dr. Gardner said. "It is a technique that involves a learning curve and sometimes you just can't get past that...but it really does cut down on the need for other medications."

AAFP 2003 Scientific Assembly: Family Practice Research Presentations. Presented Oct. 4, 2003.

Reviewed by Gary D. Vogin, MD

Martha Kerr is a freelance writer for Medscape.

    
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