Efficacy Of Different Second-generation Antihistamines Combined With Fluticasone Propionate Nasal Spray In Moderate-to-severe Seasonal Allergic Rhinitis

Objective: By comparing different second-generation antihistamines combined with fluticasone propionate nasal spray in the treatment of moderate-to-severe seasonal allergic rhinitis(SAR),to find a safe and efficient method to control SAR symptoms and improve the quality of life of patients.Methods: We selected 120 patients who met the diagnostic criteria of moderate-to-severe SAR from June 1 to October 31 in the Department of Otolaryngology Head and Neck Surgery,Yanan University Affiliated Hospital of 2021,2021.120 patients were randomly divided into 3 groups: Group A was given oral azelastine combined with Fluticasone propionate nasal spray;Group B was given oral desloratadine combined with fluticasone propionate nasal spray;Group C received azelastine nasal spray in combination with fluticasone propionate nasal spray.All patients in 3 groups were treated continuously for 4 weeks,the Nasal symptom score,Uni-VAS score,Nasal Minimum Cross-sectional Area(NMCA),Total Nasal Resistance(TNR),Rhinoconjunctivitis Quality of Life Questionnaire(RQLQ),adverse reactions and clinical efficacy were compared before and after treatment.Results: A total of 113 patients were followed up after treatment.The results are as follows:1.Nasal and eye symptom scores After treatment,the scores of nasal itching,sneezing,runny nose,eye itching and tearing in Group A were significantly lower than those before treatment(p < 0.05),and the scores of nasal obstruction were significantly lower than those before treatment,there was no significant difference(P > 0.05).The scores of nasal itching,sneezing,runny nose,nasal obstruction,eye itching and tearing in Group B and Group C were significantly lower than those before treatment(p < 0.05).The scores of nasal symptom in Group A and group B were significantly higher than that in Group C(p < 0.05).2.Uni-VAS scores After treatment,the Uni-VAS scores in Group A,Group B and Group C were significantly lower than those before treatment(p < 0.05);the Uni-VAS scores in Group A and group B were higher than those in Group C,the difference was statistically significant(p < 0.05).3.NMCA,TNR measurements After treatment,NMCA in Group A had no significant difference(p > 0.05),and TNR was lower than that before treatment(p < 0.05).NMCA and TNR in Group B and C were significantly lower than those before treatment(p < 0.05).The results of NMCA and TNR in Group A and group B were significantly higher than that in Group C(p <0.05).4.RQLQ scores After treatment,the RQLQ scores of Group A,Group B and group C decreased significantly(p < 0.05).The scores of daily activities,sleep and non-nose/eye symptoms in the three groups were significantly lower than those before treatment(p < 0.05).The RQLQ scores in Group A and group B were significantly higher than those in Group C(p< 0.05).5.Adverse events A total of 11 patients with adverse reactions,after the end of treatment were spontaneous remission.The incidence of ADR was 15.79% in Group A,7.89% in Group B and 5.41% in Group C.There was no significant difference in the incidence of adverse reactions among the three groups(P > 0.05).6.Clinical efficacy After treatment: the total effective rate was 76.32% in group A,84.21% in group B and 91.89% in Group C.There was significant difference between the three groups(P >0.05).The total effective rate in Group C was significantly higher than that in Group A and group B(p < 0.05).Conclusion:1.Different second-generation antihistamines combined with fluticasone propionate nasal spray can relieve nasal and eye discomfort,improve nasal ventilation and improve quality of life in patients with moderate-to-severe SAR,the clinical effect is good.2.Nasal second-generation antihistamines combined with fluticasone propionate nasal spray were significantly better than oral second-generation antihistamines combined with fluticasone propionate nasal spray.