流感和急性呼吸道病毒感染季节性流行期间的鼻腔冲洗

V. Svistushkin, Z. Mokoyan, D. I. Sagova
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摘要

鼻腔冲洗是治疗各种鼻科疾病患者的最常见建议之一。用生理盐水冲洗鼻腔的方法最早见于古印度阿育吠陀的文献中,如今在各种现代局部用药的情况下,这种方法依然适用。鼻腔冲洗是治疗和预防急性呼吸道病毒感染的一种安全有效的方法。在急性呼吸道病毒感染和流感发病率季节性上升期间,预防性使用鼻腔生理盐水尤为重要。鼻腔冲洗可降低粘液的粘度,促进粘液和固定在粘液中的病原体更快地排出体外。此外,使用等渗盐水可提高粘液纤毛清除的效率,降低局部炎症介质和细胞因子的浓度。急性上呼吸道感染(包括普通感冒和急性鼻炎)是一种常见疾病,会引起明显的不适感,在急性呼吸道病毒感染发病率上升期间是造成暂时性残疾的常见原因。尽管急性上呼吸道感染的治疗在大多数情况下只涉及对症治疗,但退烧药的使用、充足的液体摄入、局部排毒和冲洗疗法经常被用作这类患者的辅助治疗。同时,从循证医学的角度来评估鼻腔灌洗在临床实践中的有效性也相当困难。本综述旨在分析评估鼻腔冲洗治疗各种病症有效性的现代临床研究和专题综述,并更详细地分析这种方法在治疗急性上呼吸道感染患者以及在急性上呼吸道感染发病率上升的流行季节作为预防措施的有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Nasal irrigation during seasonal epidemics of influenza and acute respiratory viral infections
Nasal irrigation is one of the most common recommendations for the treatment of patients with a wide variety of rhinologic diseases. First described in ancient Indian Ayurvedic papers, rinsing the nasal cavity with saline solutions remains relevant today with all the variety of available modern medications for local use. Nasal irrigation is a safe and effective method for the treatment and prevention of acute respiratory viral infections. The preventive use of nasal saline is especially important during the seasonal rise in the incidence of acute respiratory viral infections and influenza. Nasal irrigation reduces the viscosity of mucus and promotes its faster elimination along with pathogens fixed in it. Moreover, the use of isotonic saline solutions increases the effectiveness of the mucociliary clearance and reduces the concentration of local inflammatory mediators and cytokines. Acute upper respiratory tract infections, including common cold and acute rhinosinusitis, are common diseases that cause significant discomfort and are a common cause of temporary disability during periods of increased incidence of acute respiratory viral infections. Despite the fact that treatment of acute upper respiratory tract infections in most cases involves only symptomatic therapy the use of antipyretic drugs, sufficient fluid intake, local elimination and irrigation therapy is often used as adjuvant therapy in this group of patients. At the same time, it is quite difficult to assess the effectiveness of nasal lavage in clinical practice from the standpoint of evidence-based medicine. The purpose of this review is to analyze modern clinical studies and topical reviews assessing the effectiveness of nasal irrigation for various pathologies with a more detailed analysis of the effectiveness of this method for the treatment of patients with acute upper respiratory tract infections and as a preventive measure during the season of epidemic rise in the incidence of acute upper respiratory tract infections.
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