Influence of endotype-oriented pharmacotherapy of chronic rhinosinusitis with nasal polyposis on quality of life indices

Q4 Medicine

Otorhinolaryngology Clinics Pub Date : 2023-04-10 DOI:10.37219/2528-8253-2023-1-38

I. Koshel, Yaroslav R. Maksymenko

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引用次数: 0

Abstract

Chronic rhinosinusitis (CRS) is a clinical syndrome including several clinical phenotypes and endotypes with differences in pathophysiology. CRS with nasal polyposis (NP) is the most severe CRS phenotype associated with a significant influence on the patients’ quality of life. Peculiarities of the endotype of CRS with NP justify the use of aminocapronic acid (ACA) not only for preoperative preparation, but also as a means of pharmacotherapy. Aim: assessment of the dynamics of the life quality of patients with CRS with NP, with the addit ional prescription of aminocapronic acid in comparison with standard therapy according to clinical recommendations. Material and methods: The study included 120 outpatients, divided into two groups: the main (n=60) and control (n= 60) ones. Patients were prescribed basic treatment (irrigation therapy with saline solutions and mometasone furoate), and in the main group additionally aminocapronic acid (ACA). The evaluation of the treatment effectiveness was based on the analysis of the dynamics of clinical symptoms: decreased sense of smell, sleep disturbances, reduced work capacity, as well as the total number of points according to SNOT-22 at V2 (5±1), V3 (10±1), V4 (20±1) and V5 (30±1) compared to V0. Indications for surgical treatment were determined at V3. Results: The use of aminocapronic acid in CRS with NP promotes significant decrease of the severity of the main clinical symptoms and improvement of the quality of patients’ life in the main group at V2 and V3 compared to the control group. This provided a statistically significant increase at 25% in the number of patients who were performed conservative treatment further (p<0.05). After the removal of the operated patients, the groups statistically did not differ significantly in terms of the dynamics of life quality indices at V4 and V5 (p>0.05). Differences in the results of treatment are attributed to the clinical effects of ACA, since the group characteristics of the patients were comparable. Conclusions: the use of ACA in addition to the basic therapy for patients with CRS with NP, contributes to a reliable improvement of life quality indices compared to patients of the control group; reliable positive dynamics of life quality allows a 25% increase in the patients who continue to be performed pharmacotherapy.

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内源性药物治疗慢性鼻窦炎伴鼻息肉病对生活质量指标的影响

慢性鼻窦炎(CRS)是一种包括多种临床表型和病理生理差异的临床综合征。CRS合并鼻息肉病(NP)是最严重的CRS表型，对患者的生活质量有显著影响。伴有NP的CRS内型的特殊性证明了氨基己酸(ACA)不仅用于术前准备，而且作为药物治疗的一种手段。目的:评价CRS合并NP患者根据临床推荐加用氨基戊酸与标准治疗的生活质量动态变化。材料与方法:本研究纳入120例门诊患者，分为主组(n=60)和对照组(n=60)。患者给予基础治疗(生理盐水和糠酸莫米松冲洗治疗)，主组加用氨基己酸(ACA)。治疗效果的评价是基于临床症状的动态分析:嗅觉下降、睡眠障碍、工作能力下降，以及根据SNOT-22在V2(5±1)、V3(10±1)、V4(20±1)和V5(30±1)的总积分与V0相比。手术治疗指征在V3确定。结果:与对照组相比，在NP合并CRS中使用氨基戊酸可显著降低主组在V2和V3期的主要临床症状的严重程度，改善患者的生活质量。进一步进行保守治疗的患者数量增加了25%，具有统计学意义(p0.05)。治疗结果的差异归因于ACA的临床效果，因为患者的组特征具有可比性。结论:CRS合并NP患者在基础治疗的基础上应用ACA，与对照组患者相比，生活质量指标有可靠的改善;可靠的积极动态生活质量使继续进行药物治疗的患者增加25%。

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来源期刊

Otorhinolaryngology Clinics Medicine-Otorhinolaryngology

CiteScore

0.10

自引率

0.00%

发文量

期刊介绍： Otorhinolaryngology Clinics: An International Journal is an International periodical devoted at exploring connections between clinical experience and world literature, and understanding of various pathologies and diseases related to the ear, nose and throat. Issues of recent advancements and research related to disease, illness, health and medical science are examined through various evidence-based clinical research studies. This journal proposes to serve as a collection of clinical notes, with an international perspective, along with the recent advances for postgraduates and consultants. The readership for this journal would include a wide variety of healthcare professionals, such as otolaryngologists, head and neck surgeons, ENT nurses as well as scholars and academicians in the field of medicine, trauma, surgery, etc. This journal aims to encourage the analysis of clinical data from various centers all over the world using standardized protocols to develop an international consensual perspective on the management of disorders related to the field of otorhinolaryngology. Recently, we have introduced "Case Reports", "How I Do It" and "Original Research" categories in the process of expanding the scope of the journal. Thisis a peer-reviewed journal of which three issues would be published each year. Each future issue will cover a different topic of special interest in the field of otorhinolaryngology and head and neck surgery. This issue is the first of its kind dedicated to "anesthesia in otorhinolaryngology" and contains a compilation of articles by experienced anesthesiologists dealing with a large volume of ENT and related surgeries. In each issue, the editors give their perspective based on the submitted articles. All non invited articles are peer-reviewed. Peer-revieweing helps in providing unbiased, independent, critical assessment of the results of the research study in question including the scientific process.