Clinical Observation Of Mometasone Furoate Aqueous Nasal Spray Combined With Montelukast Sodium Or Cetirizine Hydrochloride In The Therapy Of Adenoid Hypertrophy In Children

Objective: To research the difference in the efficacy of drug treatment on AH children with or without AR,and to analyze the different opinions of previous research.To verify the effectiveness of nasal corticosteroids and oral leukotriene receptor blockers in the treatment of Adenoid Hypertrophy in children.To further explore whether the combination of antihistamines on the basis of the above two drugs can be more effective in the treatment of children with Adenoid Hypertrophy.Methods: According to include and exclude the standard,150 cases of children with AH were selected to accept the conservative treatment in North Sichuan Medical College Affiliated Hospital,whose clinic time between January 2018 and January 2019.By randomized block method,the children were divided into allergic group(group A,78 cases were diagnosed as AR)and non-anaphylaxis group(group B,72 cases was diagnosed with Non-allergic Rhinitisand and the Allergen-specific IgE test were negative).The allergy group was randomly divided into three treatment groups:single drug group A1(26 cases,Mometasone Furoate Aqueous Nasal Spray);two-drug group A2(26 cases,Mometasone Furoate Aqueous Nasal Spray combined with Montelukast Sodium).three-drug group A3(26 cases,Mometasone Furoate Aqueous Nasal Spray combined with Montelukast Sodium and Cetirizine Hydrochloride).The non-allergic group was also randomly divided into three treatment groups according to the same treatment principles of the allergic group,namely group B1(24 cases),group B2(24 cases)and group B3(24 cases).All the six groups were treated for 12 weeks,and a total of 144 children completed the experiment.The changes of symptom index scoreand adenoid size(FIG.1,FIG.2)of the children in each group before and after treatment were statistically analyzed.SPSS 19.0 statistical software was used for statistical analysis,and the quantitative data were represented by mean standard deviation.The paired data were obtained by T test,and statistical inference was made(p<0.05,indicating that the difference was statistically significant);the data designed for the random block group were obtained by ANOVA(F test),and statistical inference was made(p<0.05,indicating that the difference was statistically significant).Results: The children in the six groups underwent self-paired T test before and after treatment,and the difference in clinical comprehensive score before and after treatment in each group was statistically significant(p<0.05),and the difference in adenoid size(A/N ratio)before and after treatment in each group was statistically significant(p<0.05).For children of AH with or without AR,all three treatment regimens can improve clinical symptoms and reduce adenoid volume.Through data conversion,two-factor ANOVA(i.e.,F test)was performed on the difference of clinical comprehensive score of the six groups of children before and after treatment:1.The difference of comprehensive score before and after treatment was significantly affected by the presence or absence of AR in children of AH(F=12.676,p<0.05).Namely,the clinical symptoms of children with AH and AR were improved significantly before and after treatment;2.The three drug regimens had significant influence on the difference of comprehensive score of children with AH before and after treatment(F=9.394,p<0.05).LSD test was used to compare the three schemes pairwise.By contrasting triple regimen with a single drug(the difference between the mean difference was 1.66,p<0.05),and contrasting triple regimen with two couplet regimen(difference between the mean difference was 0.80,p<0.05),and Contrasting two couplet regimen with single drug(difference between the mean difference was 0.86,p<0.05).The influence of the difference was statistically significant.Namely,three options for the treatment of children with AH all have different degrees of improvement of clinical symptoms before and after.Also through data transformation,two-factor ANOVA was performed for the difference of adenoid size(A/N ratio)before and after treatment in the six groups of children:1.The difference of A/N ratio was significantly affected by the presence or absence of AR(F=8.193,p<0.05).Namely,the clinical symptoms of children with AH and AR were improved significantly before and after treatment;2.The three drug regimens had significant effects on the difference of A/N ratio before and after the treatment of children with AH(F=3.593,p=0.030,p<0.05).By the LSD test for two comparison on three kinds of schemes,Contrasting triple regimen with a single drug(difference between the mean difference was 1.65,p=0.025,p<0.05)and contrasting two couplet regimen with single drug(difference between the mean difference was 1.74,p=0.017,p<0.05).The results showed that there were significant differences in the reduction of adenoid volume between the triple regimen or two couplet regimen contrasted with the single drug regimen,and the differences were statistically significant.However,there was no statistically significant difference in the reduction of adenoid volume between the triple regimen and two couplet regimen(mean difference of the difference was-0.09,p=0.896,p>0.05).Conclusions: For children of AH with or without AR,all three treatment regimens can improve clinical symptoms and reduce adenoid volume.The effectiveness of Momethasone Furoate Nasal Spray and Montelukast Sodium in the treatment of AH children was verified,and the combined treatment had better effect.The combination of Mometasone Furoate Aqueous Nasal Spray and Montelukast Sodium with Cetirizine Drops in the treatment of AH has not been proved to further reduce the adenoid volume of children with AH,but being proved to improve many clinical symptoms of children with AH more effectively.For children of AH with AR.The total therapeutic effect of the three schemes is better than those of AH children without AR.