ABSTRACT
This study aims to evaluate the effectiveness and economic efficiency of Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray in the treatment of chronic rhinosinusitis(CRS). The randomized controlled trial(RCT) of Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray in the treatment of CRS was searched against EMbase, PubMed, Cochrane Library, CNKI, VIP, SinoMed, and Wanfang. The efficacy, nasal mucociliary transport time, and safety of the therapy above in the treatment of CRS were analyzed with single-group rate and Meta-analysis, and the economy and sensitivity were evaluated from the perspective of payer. A total of 9 RCTs were included, including 1 145 patients. Meta-analysis showed that compared with Triamcinolone Acetonide Nasal Spray alone, Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray in the treatment of CRS patients increased the effective rate(RR=1.17, 95%CI[1.11, 1.24], P<0.000 01) and shortened the nasal mucociliary transport time(MD=-3.32, 95%CI[-5.86,-0.78], P=0.01), there was no significant difference in the incidence of adverse reactions between the two groups. The incremental cost-effectiveness analysis showed that the treatment costs of the control group and the observation group were 44.15 yuan and 1 044.96 yuan, respectively. In the Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray treatment group, 75.48 yuan was spent to improve the effective rate of CRS by 1%. The one-way sensitivity analysis indicated the days of treatment, the RR of Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray, the price of unit preparation of Biyuan Tongqiao Granules, and the effective rate of Triamcinolone Acetonide Nasal Spray alone had great influence on the incremental cost-effectiveness ratio. In conclusion, Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray improves the therapeutic effect on CRS. The probabilistic sensitivity analysis showed that when the willingness to pay was greater than 7 920 yuan(less than 0.1 of GDP per capita 8 098 yuan), the combined therapy was economically superior to the control. Due to the limited number of articles published, it is necessary to carry out a real-world clinical trial of Biyuan Tongqiao Gra-nules and Triamcinolone Acetonide Nasal Spray in the treatment of CRS, so as to compare the cost-effectiveness of Biyuan Tongqiao Granules and Triamcinolone Acetonide Nasal Spray.
Subject(s)
Humans , Triamcinolone Acetonide/adverse effects , Nasal Sprays , Cost-Effectiveness Analysis , Sinusitis/drug therapy , Chronic DiseaseABSTRACT
Objective:To observe the efficacy and safety of the M receptor antagonist Bencycloquidium bromide nasal spray in treatment of seasonal allergic rhinitis with runny nose as the main symptom. Methods:From August 2021 to September 2021, 134 patients with seasonal allergic rhinitis were enrolled in the otolaryngology Outpatient Department of Peking University Third Hospital, First Affiliated Hospital of Harbin Medical University and China-Japanese Friendship Hospital of Jilin University, including 71 males and 63 females, with a median age of 38 years. TNSS score and visual analogue scale(VAS) of total nasal symptoms were observed during 2 weeks of treatment with Bencycloquidium bromide nasal spray. Results:TNSS score decreased from (8.89±3.31) on day 0 to (3.71±2.51) on day 14(P<0.001), VAS score of nasal symptoms decreased from (24.86±7.40) on day 0 to (6.84±5.94) on day 14(P<0.001), VAS score of rhinorrhoea decreased from (6.88±2.06) on day 0 to (1.91±1.81) on day 14(P<0.001). Rhinoconjunctivitis quality of life questionnaire(RQLQ) score decreased from (94.63±33.35) on day 0 to (44.95±32.28) on day 14(P<0.001). The incidence of adverse reaction was low and no serious adverse events occurred during the whole experiment. Conclusion:Bencycloquidium bromide nasal spray has significant efficacy and good safety in the treatment of seasonal allergic rhinitis.
Subject(s)
Male , Female , Humans , Adult , Rhinitis, Allergic, Seasonal/drug therapy , Nasal Sprays , Quality of Life , Administration, Intranasal , Rhinorrhea , Double-Blind Method , Treatment Outcome , Rhinitis, Allergic/drug therapyABSTRACT
ABSTRACT: COVID-19 pandemic has infected millions of people around the world. Due to its large accumulation in the nasopharyngeal region and transmission through respiratory fluids, its spread among people is extremely high. Considering the needed time for treatments and vaccine development, the research of preventive methods, such as the use of mouthwash and nasal spray, that could decrease the viral load in the nasopharyngeal region, and thus the spread of SARS-CoV-2, becomes fundamental. The evidence has shown that there are compounds with antiviral capacity that could be used for this purpose, among which are povidone-iodine, hydrogen peroxide, cyclodextrins, and the synthetic drug PUL-042. Currently, there is no clinical evidence that proves the effectiveness of these substances against SARS-CoV-2. Nevertheless, there are ongoing clinical trials to prove it and generate methods that could help to prevent or, at least, decrease its spread among the population and stop this pandemic.
RESUMEN: La pandemia de COVID-19 ha infectado a millones de personas en el mundo. Su extremadamente alta capacidad de propagación se debe a la gran acumulación en la región nasofaríngea y su transmisión vía fluidos respiratorios.Considerando el tiempo necesario para desarrollar vacunas y tratamientos, se vuelve fundamental la investigación de métodos preventivos como el uso de enjuague bucal y spray nasal, que puedan disminuir la carga viral en la zona nasofaríngea y así también la capacidad de propagación de SARS-CoV-2La evidencia presenta compuestos con capacidad antiviral como la povidona iodada, peróxido de hidrógeno, ciclodextrinas y la droga sintética PUL-042, que podrían ser usados para dicho propósito. Actualmente no existe evidencia clínica que demuestre la efectividad de estas sustancias contra SARS-Cov-2, sin embargo, se están desarrollando estudios clínicos para probarlos y generar métodos que ayuden a disminuir o prevenir su transmisión en la población, y así detener esta pandemia.
Subject(s)
Humans , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Betacoronavirus , Nasal Sprays , Mouthwashes/administration & dosageABSTRACT
ABSTRACT: The COVID-19 pandemic has created challenges that have been dealt with adopting measures such as prolonged or intermittent social distancing, which may even be necessary until 2022. Furthermore, it has been described that a SARS-CoV-2 contagion route corresponds to the inhalation of the virus. Medications via nasal/eye spray and inhalers, therefore, could fulfill the function of inactivating SARS-CoV-2. Due to the abovementioned reasons, we suggest the following hypothesis: The use of Ocular/Nasal/Oral sprays could prevent the infection and the further spread of SARS-CoV-2.
RESUMEN: La pandemia de COVID-19 propone desafíos que han sido manejados con medidas como distanciamiento social prologado o intermitente, el cual podría ser necesario hasta 2022. Se ha descrito que la ruta de contagio de SARS-CoV-2 corresponde a la inhalación del virus. La medicación a través de un spray nasal/ocular podría cumplir la función de inactivar SARS-CoV-2. Por las razones antes presentadas, los autores sugerimos la siguiente hipótesis: El uso de un spray ocultar/nasal/oral previene la infección y replicación de SARS-CoV-2.
Subject(s)
Humans , Coronavirus Infections/prevention & control , Betacoronavirus , Nasal Sprays , Oral SpraysABSTRACT
BACKGROUND@#Currently, there are no drugs that have been proven to be effective against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Because of its broad antiviral activity, interferon (IFN) should be evaluated as a potential therapeutic agent for treatment of coronavirus disease 2019 (COVID-19), especially while COVID-19-specific therapies are still under development.@*METHODS@#Confirmed COVID-19 patients hospitalized in the First Affiliated Hospital, School of Medicine, Zhejiang University in Hangzhou, China, from January 19 to February 19, 2020 were enrolled in a retrospective study. The patients were separated into an IFN group and a control group according to whether they received initial IFN-α2b inhalation treatment after admission. Propensity-score matching was used to balance the confounding factors.@*RESULTS@#A total of 104 confirmed COVID-19 patients, 68 in the IFN group and 36 in the control group, were enrolled. Less hypertension (27.9% vs. 55.6%, P=0.006), dyspnea (8.8% vs. 25.0%, P=0.025), or diarrhea (4.4% vs. 19.4%, P=0.030) was observed in the IFN group. Lower levels of albumin and C-reactive protein and higher level of sodium were observed in the IFN group. Glucocorticoid dosage was lower in the IFN group (median, 40 vs. 80 mg/d, P=0.025). Compared to the control group, fewer patients in the IFN group were ventilated (13.2% vs. 33.3%, P=0.015) and admitted to intensive care unit (ICU) (16.2% vs. 44.4%, P=0.002). There were also fewer critical patients in the IFN group (7.4% vs. 25.0%, P=0.017) upon admission. Although complications during admission process were comparable between groups, the discharge rate (85.3% vs. 66.7%, P=0.027) was higher and the hospitalization time (16 vs. 21 d, P=0.015) was shorter in the IFN group. When other confounding factors were not considered, virus shedding time (10 vs. 13 d, P=0.014) was also shorter in the IFN group. However, when the influence of other factors was eliminated using propensity score matching, virus shedding time was not significantly shorter than that of the control group (12 vs. 15 d, P=0.206).@*CONCLUSIONS@#IFN-α2b spray inhalation did not shorten virus shedding time of SARS-CoV-2 in hospitalized patients.
Subject(s)
Humans , Albumins/analysis , Antiviral Agents/administration & dosage , Betacoronavirus , C-Reactive Protein/analysis , COVID-19 , Case-Control Studies , China , Coronavirus Infections/drug therapy , Glucocorticoids/pharmacology , Hospitalization , Interferon alpha-2/administration & dosage , Nasal Sprays , Pandemics , Pneumonia, Viral/drug therapy , Propensity Score , Retrospective Studies , SARS-CoV-2 , Sodium/blood , Virus Shedding/drug effects , COVID-19 Drug TreatmentSubject(s)
Humans , Pneumonia, Viral , COVID-19 , Viral Load , Nasal Sprays , Pandemics , SARS-CoV-2 , MouthwashesABSTRACT
Abstract Introduction Eosinophilic chronic rhinosinusitis (ECRS) is characterized by an eosinophilic inflammation driven by Th2-type cytokines. Glucocorticosteroids are the most common first-line treatment for ECRS with nasal polyps. Objective We have evaluated the long-term treatment with double-dose intranasal corticosteroids in refractory ECRS nasal polyps resistant to the conventional dose and assessed the risk of adverse systemic effects Methods Sixteen subjects were enrolled in this study. All subjects had ECRS after endoscopic sinus surgery that resulted in recurrentmild andmoderate nasal polyps and were undergoing a postoperative follow-up application of mometasone furoate at a dose of 2 sprays (100 μg) in each nostril once a day (200 μg). All the patients were prescribed mometasone furoate, administered at a dose of 2 sprays (100 μg) in each nostril twice a day (400 μg) for 6 months. Results The average scores of the symptoms during the regular dose of intranasal steroid treatment were 5.2 ± 2.2, but 6 months after the high-dose application, they had significantly decreased to 2.5 ± 1.4 (p < 0.05). The polyp size showed an average score of 1.38 during the regular dose which was significantly reduced to 0.43 (p < 0.01) by the double dose. Glycated hemoglobin (HbA1c) showed normal ranges in all the patients tested. The cortisol plasma concentration was also normal. Conclusion Doubling the dose of the nasal topical spray mometasone furoate might be recommended for the treatment of recurrent nasal polyps in the postoperative follow-up of intractable ECRS. (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Sinusitis/drug therapy , Rhinitis/drug therapy , Mometasone Furoate/administration & dosage , Mometasone Furoate/adverse effects , Postoperative Care , Sinusitis/surgery , Administration, Intranasal , Rhinitis/surgery , Nasal Polyps/physiopathology , Adrenal Cortex Hormones/administration & dosage , Adrenal Cortex Hormones/adverse effects , Endoscopy , Nasal SpraysABSTRACT
Abstract Introduction: The adherence to medical treatment in allergic rhinitis is poorly evaluated in clinical practice. Objectives: To evaluate adherence to intranasal corticosteroids in the treatment of allergic rhinitis patients. Methods: This prospective study was conducted on adult patients who were admitted to the outpatient clinic of the otolaryngology department tertiary hospital. Patients diagnosed with moderate to severe persistent AR and who had not used any nasal sprays were enrolled in the study. The patients were provided with mometasone furoate nasal sprays. On the 30th day, all participants filled out a questionnaire regarding the factors that may have influenced their adherence to the treatment. Afterwards, each patient filled out the Turkish-language-validated Morisky Medical Adherence Scale (MMAS-8) form. Each factor that may have affected adherence to the prescribed medication was evaluated according to the MMAS-8 score and all variables were analyzed statistically. Results: Fifty-nine adult patients with a mean age of 32.5 years (range 21-52 years) were included in the study. The mean overall MMAS-8 score was 3.64. Two factors were significantly related to low adherence: number of dependent children (p = 0.001) and benefit from the medication (p = 0.001). In addition, patients with higher education levels seemed to be more adherent than the rest of the group. Conclusion: Clinicians must keep in mind the factors related to non-adherence in order to achieve better treatment outcomes. Therefore, based on our results, patients must be informed that medications should be taken properly regardless of the benefit, and the treatment should be scheduled with respect to daily activities, particularly for patients caring for more than two children.
Resumo Introdução: A adesão ao tratamento clínico de rinite alérgica é mal avaliada na prática clínica. Objetivos: Avaliar a adesão aos corticosteroides intranasais no tratamento de pacientes com rinite alérgica. Método: Este estudo prospectivo foi realizado com pacientes adultos admitidos no ambulatório do setor de otorrinolaringologia de um hospital terciário. Os pacientes diagnosticados com rinite alérgica moderada a persistente grave que não haviam ainda usado spray nasal foram incluídos no estudo. Os pacientes receberam sprays nasais de furoato de mometasona. No 30° dia, todos preencheram um questionário sobre os fatores que podem ter influenciado a sua adesão ao tratamento. Depois disso, cada paciente preencheu o formulário da Escala de Adesão Clínica Morisky validado para a língua turca (MMAS-8). Cada fator que pode ter afetado a adesão à medicação prescrita foi avaliado de acordo com o escore de MMAS-8 e todas as variáveis foram analisadas estatisticamente. Resultados: Foram incluídos no estudo 59 pacientes adultos com média de 32,5 anos (variação de 21-52). O escore total médio de MMAS-8 foi de 3,64. Dois fatores foram significantemente relacionados com a baixa adesão: número de dependentes infantis (p = 0,001) e benefício da medicação (p = 0,001). Além disso, os pacientes com níveis de ensino mais elevados pareceram ser mais adesistas do que o restante do grupo. Conclusão: Os médicos devem estar cientes dos fatores relacionados à falta de adesão, a fim de alcançar melhores resultados do tratamento. Portanto, com base em nossos resultados, os pacientes devem ser informados de que os medicamentos devem ser usados adequadamente independentemente do benefício, e o tratamento deve ser programado com relação às atividades diárias, especialmente para os pacientes que cuidam de mais de dois filhos.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Adrenal Cortex Hormones/therapeutic use , Medication Adherence , Rhinitis, Allergic/drug therapy , Socioeconomic Factors , Administration, Intranasal , Prospective Studies , Surveys and Questionnaires , Treatment Outcome , Nasal Sprays , Tertiary Care CentersABSTRACT
ANTECEDENTES Y OBJETIVO La neuralgia post-herpética es un dolor neuropático generado por el cuadro de Herpes Zóster, producido por el virus de la Varicella. En este contexto, el Departamento de Políticas Farmacéutica y Profesiones Medícas solicita esta síntesis de evidencia con el objetivo de conocer el efecto de extracto y spray oro-mucoso de cannabis para aliviar este dolor. METODOLOGÍA Se formuló una estrategia de búsqueda para ser utilizada en las bases de datos Epistemonikos, Health Systems Evidence, Health Evidence, Cochrane, PubMed, EVIPNet Global, LILACS, Google Scholar, PsycInfo y CINAHL, con el objetivo de identificar revisiones sistemáticas del tema. Se excluyeron estudios realizados en animales, que solo contenían THC (y no CBD), otros canabinoides diferentes a Nabiximols y extracto oral, además, no se consideraron análisis de dependencia de cannabis. RESULTADOS Se utilizan 6 revisiones sistemáticas, de las cuales se obtuvieron los siguientes resultados: -No fue posible calcular significancia estadística, la evidencia encontrada muestra que el aceite de cannabis oral reduciría el dolor percibido (en Escala Numérica del Dolor), en comparación a placebo. -No fue posible agrupar resultados, la evidencia encontrada muestra que Nabiximols (Sativex®) reduciría el dolor en pacientes con dolor neuropático no específico y debido a artritis reumatoide, mientras que no tendría diferencia en pacientes con diabetes. -La evidencia encontrada muestra que el número de personas que reportan una reducción del dolor de al menos un 30%, en pacientes con dolor neuropático no específico y en diabetes, no sería significativamente distinto al comparar Sativex® con Placebo. -La evidencia encontrada muestra que existiría un mayor abandono de los estudios clínicos debido a algún efecto adverso, en pacientes tratados con Sativex® que en pacientes del grupo placebo tratados por dolor neuropático sin especificar. No habría diferencias en pacientes con artritis reumatoide. -La certeza de la evidencia presentada es incierta, puesto que ésta no se ha evaluado en esta síntesis.
Subject(s)
Nasal Sprays , Administration, Sublingual , Chile , Medical Marijuana/therapeutic useABSTRACT
OBJECTIVE@#To investigate the clinical efficacy of montelukast plus budesonide nasal spray and desloratadine citrate disodium tablets on moderate and severe persistent allergic rhinitis.@*METHOD@#Senenty patients with moderate and severe persistent allergic rhinitis were devided randomly study group (n = 35) and control group (n = 35). The study group were treated with montelukast sodium tablets combined with budesonide nasal spray and desloratadine citrate disodium tablets for 4 weeks, the control group received budesonide nasal spray and desloratadine citrate disodium tablets for 4 weeks. Comparing visual analogue scale (VAS) scores of nasal symptoms, rhino conjunctivitis quality of life questionnaire (RQLQ) scores and total effective rate in two groups at baseline and after treatment.@*RESULT@#(1) VAS scores of nasal symptoms: the difference of total nasal symptoms VAS scores or single nasal symptom VAS scores from both groups at 2 weeks and 4 weeks after treatment were statistically significant (P < 0.05); (2) RQLQ scores: the difference of RQLQ scores of 2 group's at baseline and 4 weeks after treatment were statistically significant, the difference of RQLQ scores about nasal symptoms in two groups at 4 weeks after treatment were statistically significant (P < 0.05); (3) The total effective rate was 94.29% in study group but 80.00% in control group, the differences were statistically significant (P < 0.05).@*CONCLUSION@#Montelukast plus budesonide nasal spray and desloratadine citrate disodium tablets can work together better on relieving clinical syptoms quickly and promoting the life quality of patients with moderate and severe persistent allergic rhinitis.
Subject(s)
Humans , Acetates , Therapeutic Uses , Budesonide , Therapeutic Uses , Loratadine , Therapeutic Uses , Nasal Sprays , Quinolines , Therapeutic Uses , Rhinitis, Allergic, Perennial , Drug Therapy , Surveys and QuestionnairesABSTRACT
OBJECTIVE@#To observe the efficacy of allergen blocking nasal spray (ABNS) , combined with seawater spray (SS) and myrtol standardized capsules (MSS), in patients with rhinitis sicca.@*METHOD@#Patients diagnosed as rhinitis sicca were randomly divided into 2 groups: ABNS+SS group and SS group. In ABNS+SS group, patients used ABNS and SS four times per day and MSS twice per day. In SS group, patients used the same medicine except ABNS. Both group were observed for 14 days. The visual analog scale (VAS) of dryness, the endoscopy evaluation score (EES) and the tolerability of the spray were compared between the 2 groups.@*RESULT@#There were 30 patients included in each group. The VAS and EES were improved in both groups after 2 weeks' treatment. The improvement of VAS and EES in ABNS+SS group was significantly superior to SS group (VAS: P < 0.01, EES: P < 0.05). There were only 2 patients complaint of slight discomfort when using ABNS, which did not disturb the treatment.@*CONCLUSION@#There is good efficacy of allergen blocking nasal spray (ABNS), combined with seawater spray (SS) and myrtol standardized capsules (MSS), in patients with rhinitis sicca.
Subject(s)
Humans , Allergens , Chronic Disease , Drug Combinations , Endoscopy , Monoterpenes , Therapeutic Uses , Nasal Sprays , Rhinitis , Drug Therapy , Sodium ChlorideABSTRACT
OBJETIVO: Estabelecer os limites superiores para mudanças em VEF1, capacidade vital lenta (CVL), CVF e capacidade inspiratória (CI) após o uso de placebo em pacientes com obstrução ao fluxo aéreo. MÉTODOS: Cento e dois adultos com obstrução ao fluxo aéreo (VEF1 = 62 ± 19% do previsto) foram incluídos neste estudo. Todos os participantes realizaram manobras de CVL e CVF antes e depois do uso de spray de placebo. As mudanças em VEF1, CVL, CVF e CI foram expressas em valores absolutos, porcentagem de variação em relação aos valores basais e porcentagem dos valores previstos, e foram calculados os IC95% e os percentis 95. A análise fatorial foi realizada a fim de determinar como essas alterações se agrupavam. RESULTADOS: Considerando os IC95% e percentis 95 e após o arredondamento dos valores, obtivemos os seguintes limites superiores para resposta significante: VEF1 = 0,20 L, CVF = 0,20 L, CVL = 0,25 L e CI = 0,30 L (em valores absolutos); VEF1 = 12%, CVF = 7%, CVL = 10% e CI = 15% (em porcentagem de variação em relação aos valores basais) e VEF1 = 7%, CVF = 6%, CVL = 7% e CI = 12% (em porcentagem dos valores previstos). CONCLUSÕES: Em pacientes com obstrução ao fluxo aéreo, a CI apresenta maior variabilidade do que a CVF e a CVL. Para a CI, valores maiores que 0,30 L e 15% de variação em relação ao valor basal devem ser considerados significantes. Para CVF, valores maiores que 0,20L e 7% de variação em relação ao valor basal são significantes. Alternativamente, alterações de mais de 0,20 L e 7% do previsto no VEF1 e na CVF devem ser consideradas significantes. Na análise fatorial, os parâmetros espirométricos se agruparam em três dimensões, expressando mudanças no fluxo, volume e hiperinsuflação dinâmica.
OBJECTIVE: To establish the upper limits for changes in FEV1, slow vital capacity (SVC), FVC, and inspiratory capacity (IC) after placebo administration in patients with airflow obstruction. METHODS: One hundred and two adults with airflow obstruction (FEV1 = 62 ± 19% of predicted) were included in the study. All of the participants performed SVC and FVC maneuvers before and after the administration of placebo spray. The changes in FEV1, SVC, FVC, and IC were expressed as absolute values, percentage of change from baseline values, and percentage of predicted values, 95% CIs and 95th percentiles being calculated. Factor analysis was performed in order to determine how those changes clustered. RESULTS: Considering the 95% CIs and 95th percentiles and after rounding the values, we found that the upper limits for a significant response were as follows: FEV1 = 0.20 L, FVC = 0.20 L, SVC = 0.25 L, and IC = 0.30 L (expressed as absolute values); FEV1 = 12%, FVC = 7%, SVC = 10%, and IC = 15% (expressed as percentage of change from baseline values); and FEV1 = 7%, FVC = 6%, SVC = 7%, and IC = 12% (expressed as percentage of predicted values). CONCLUSIONS: In patients with airflow obstruction, IC varies more widely than do FVC and SVC. For IC, values greater than 0.30 L and 15% of change from the baseline value can be considered significant. For FVC, values greater than 0.20 L and 7% of change from the baseline value are significant. Alternatively, changes exceeding 0.20 L and 7% of the predicted value can be considered significant for FEV1 and FVC. On factor analysis, spirometric parameters clustered into three dimensions, expressing changes in flows, volumes, and dynamic hyperinflation.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Bronchodilator Agents/administration & dosage , Lung Diseases, Obstructive/drug therapy , Placebos/pharmacology , Vital Capacity/drug effects , Bronchodilator Agents/therapeutic use , Factor Analysis, Statistical , Forced Expiratory Volume/drug effects , Inspiratory Capacity/drug effects , Lung Diseases, Obstructive/physiopathology , Nasal Sprays , Placebos/administration & dosage , Spirometry , Statistics, NonparametricABSTRACT
Various therapeutic options such as calcitonin have been suggested for patients with low bone density, despite uncertain efficacy in most patients. C-telopeptide of type I collagen [CTX] is a new bone marker used for the assessment of bone resorption. The aim of this study was to evaluate the therapeutic effects of nasal spray calcitonin in women with osteopenia via serum CTX and other laboratory tests. We conducted a self controlled clinical trial in 2009 on 105 women of menopausal age diagnosed in Baqiyatallah Hospital Clinic with osteopenia based on a bone mineral density score of 1.5 SD lower than peak bone mass. The patients were assigned to receive nasal spray calcitonin [200 IU/day], calcium [1000 mg/day] and Vit-D [400 IU/day] for 6 months. Serum CTX and other laboratory parameters were measured before and after the treatment. The data were analyzed by SPSS, version 17, using t-tests and a P<0.05 was considered statistically significant. Fifty-two patients completed the study and the mean CTX level decreased significantly from 3.10 +/- 2.03 to 2.61 +/- 1.82 pmol/lit [P<0.001], but total serum levels of PTH, Ca, AST, ALT and Alkaline Ph decreased insignificantly. It seems that nasal spray of calcitonin is significantly effective in preventing disease progression and treatment of low bone density by inhibiting bone tissue resorption indicated by CTX although further studies with larger samples sizes and inclusion of control groups are warranted
Subject(s)
Humans , Female , Metalloendopeptidases/blood , Bone Diseases, Metabolic/drug therapy , Menopause , Nasal Sprays , Treatment Outcome , Calcitonin/administration & dosageABSTRACT
<p><b>OBJECTIVE</b>To study the mechanism of action and the therapeutic efficacy of treating patients with perennial allergic rhinitis by Qumin Tongbi Nasal Spraying Agent (QTNSA).</p><p><b>METHODS</b>One hundred and three patients with perennial allergic rhinitis were randomly assigned to two groups. Of them, 57 patients in the treatment group were treated with QTNSA and 46 patients in the control group were treated with Veconase. Seven days were taken as one therapeutic course, two courses in total. The therapeutic efficacy and the serum levels of interleukin-4 (IL-4), IL-8, immunoglobulin E (IgE) and nasal airway resistance (NAR), symptoms and signs integrals before and after treatment were observed in the two groups.</p><p><b>RESULTS</b>There was no statistical significance between the treatment group and the control group in the markedly effective rate (61.40% vs. 63. 04%) and the total effective rate (87.72% vs. 89.13%). After treatment symptoms and signs integrals of the two groups were significantly improved when compared with before treatment (P < 0.01). There was no significant difference between the two groups after treatment (P > 0.05). The serum levels of IL-4, IL-8, IgE, and NAR were significantly higher in the two groups than those of the normal group. They significantly decreased after treatment in the two groups, showing statistical difference (P < 0.01). There was no statistical difference between the treatment group and the control group (P > 0.05).</p><p><b>CONCLUSIONS</b>QTNSA could effectively treat perennial allergic rhinitis. It could obviously lower serum levels of IL-4, IL-8, IgE, and NAR in patients with perennial allergic rhinitis.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Drugs, Chinese Herbal , Therapeutic Uses , Immunoglobulin E , Blood , Interleukin-4 , Blood , Interleukin-8 , Blood , Nasal Sprays , Phytotherapy , Rhinitis, Allergic, Perennial , Blood , Drug TherapyABSTRACT
<p><b>OBJECTIVE</b>To evaluate the outcome of mometasone furoate nasal spray (MFNS) used for 3 months on non-allergic rhinitis (NAR).</p><p><b>METHODS</b>In this multicenter study, NAR patients were enrolled from eight hospitals and received MFNS 200 microgram once daily for 3 months. The patients were followed-up for three times (at baseline, month 1 and month 3) to record the symptom scores and nasal endoscopic appearances. At the same time, the adverse events frequency was recorded and analyzed.</p><p><b>RESULTS</b>A total of 188 NAR cases were enrolled in the study. The total nasal symptom score assessment descended significantly at month 1 (1.70 ± 0.75) and month 3 (0.95 ± 0.79) visits versus at baseline (2.67 ± 0.68, Z value were from -11.603 to -10.491, all P < 0.01). The individual symptoms, including nasal stuffiness, nasal discharge, nasal stuffiness-related dizziness or headache, hyposmia, sleep quality, daily life activity, work or study efficiency, mental status, and whole body fatigue, also showed less scores at month 1 and month 3 visits versus at baseline (Z value were from -11.313 to -6.802, all P < 0.01). At the same time, nasal mucosal appearances assessed by endoscopy had lower scores at month 1 (1.40 ± 0.62) and month 3 (0.75 ± 0.71) visits versus at baseline (2.27 ± 0.73, Z value were from -11.484 to -10.002, all P < 0.01). Additionally, adverse events were only observed in 5.3% cases with light rhinorrhagia and nasal dryness. No other side effect was found.</p><p><b>CONCLUSIONS</b>A 3-months administration of intranasal mometasone can effectively and safely improve NAR patients' clinical symptom and nasal mucosal appearances.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Anti-Allergic Agents , Therapeutic Uses , Mometasone Furoate , Nasal Sprays , Pregnadienediols , Therapeutic Uses , Rhinitis , Classification , Drug Therapy , Treatment OutcomeABSTRACT
OBJECTIVE@#To evaluate the recent clinical efficiency of nebulized Pulmicort respimat after FESS.@*METHOD@#Forty-four patients with chronic sinusitis who received FESS, 21 cases were treated with aerosol therapy: Pulmicort respimat , the other 23 cases were treated with Budesonide aqueous nasal spray. All the patients were asked for return at the day 14. Efficacy was evaluated by measurement of nasal symptom scores and sign scores at day 2 and day 14, the biopsy of the membrane on the gap of sinus maxillary were taken to count the eosinophil cell and neutrophil cell in per hundred inflammation cells under microscope and analyze the statistic of the symptom scores, sign scores, efficiency, percentage of the eosinophil cell and the neutrophil cell between two groups at day 14.@*RESULT@#There was no significant differences on the total score between two groups at the day 2, while the therapy group was remarkably lower than that in the control group at the day 14 (P 0.05). The percentage of the eosinophil was no significant differences between two groups (P > 0.05), while the percentage of the neutrophil was lower in the therapy group (P < 0.01).@*CONCLUSION@#Pulmicort respimat and Budesonide are the same type hormones, butPulmicort respimat is a fine granule mixed liquid, with PARI SINUS nasal spray, it can arrive at the whole cavity of the sinus maxillary and be absorbed faster and in a larger space. We consider that nebulized Pulmicort respimat after FESS can relieve the acute inflammation and oedema, it can also reduce the complication of the surgery. The recent clinical efficiency of the Pulmicort respimat is much better than other aqueous nasal spray.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Administration, Inhalation , Administration, Intranasal , Budesonide , Chronic Disease , Endoscopy , Methods , Intraoperative Period , Nasal Sprays , Sinusitis , General SurgeryABSTRACT
Mometasone furoate (MF) aqueous nasal spray has been shown to be effective and well-tolerated in the treatment of perennial allergic rhinitis (PAR). All of the sudies, however, have been conducted in Canada, UK, and Europe. Therefore, a bridging study is warranted in view of the different climatic conditions in tropical countries. To evaluate the clinical efficacy and tolerability of MF aqueous nasal spray in the treatment of PAR in a tropical country. This study was an open, non comparative, 4-week 3-centre trial in outpatients of 12 to 60 years with moderate to severe PAR of at least 2 years duration. Patients were allergic to at least one major PAR allergen, confirmed by skin prick test. They had total nasal symptom score (TNSS) of ≥ 6 and nasal congestion score (NCS) of ≥ 2 on ≥ 3 diary time points prior to baseline visit and at both screening and baseline visits. Eligible patients received MF aqueous nasal spray at baseline visit, and administered 200 µg mometasone every morning for 4 weeks. The primary clinical efficacy parameter was the mean percentage reduction of TNSS from baseline. Of 100 eligible patients, all completed this 4-week trial. The patient-evaluated TNSS (sum of the Last 3 mornings) decreased signiftcantly from baseline with a mean reduction of 60.9 % (p < 0.0001,) at week-2 and 73.6 % (p < 0.0001) at week-4. The mean reductions in physician-rated TNSS (61.7 % at week-2 and 77.8 % at week-4) were higher than those in the previous studies (43 % and 51 % at week-2, 52 % and 54 % at week-4). Similar trends were observed for nasal congestion score (NCS), other individual symptoms, total symptoms, and clinical efficacy rates. Evening symptoms were reduced similarly as morning symptoms There was no withdrawal due to adverse event. MF aqueous nasal spray, at a dose of 200 µg once daily in the morning for the treatment of moderate to severe PAR in a tropical country, was clinically effective with 24-hour control of PAR symptoms, and was well tolerated.
Subject(s)
Rhinitis, Allergic, Perennial , Nasal Sprays , Anti-Allergic AgentsABSTRACT
BACKGROUND AND OBJECTIVES: Benzalkonium Chloride (BZC) is one of the most often used preservatives that has strong germicidal effect. Not only is it used for nasal drops, but also for eye drops and cosmetics. However, there have been many reports that lesions such as dermatitis and conjunctivitis are considered the results of irritation induced by BZC. We evaluated the histological changes after long-term administration of BZC on rat nasal respiratory mucosa. MATERIAL AND METHODS: We divided 40 BZC treated animals into 4 groups. First group received low-concentrated BZC solution which is commonly used for nasal sprays. Second group received high-concentrated BZC solution which is reported to induce dermatitis in human. Third and Fourth group received steroid mixed in the BZC solutions of low and high concentrations, respectively. Control group was administrated with normal saline. After 1, 2, and 4 weeks of topical administration in each group, the symptomatic and histological changes with H&E stain were observed. RESULTS: Sneezing and nose rubbing with forelegs were observed in all subgroups on the 5th day of treatment. The BZC induced lesions, including glandular formation, inflammatory cell infiltration, and edematous changes. The symptomatic and histological changes were pronounced when the duration of BZC administration was increased. Similar results were observed in groups that received steroid mixed in the BZC solution. CONCLUSION: We found that even low concentration of BZC preservative can cause nasal lesions. Thus, there is a strong need to develope a preservative that can be used safely.