口腔径路曲安奈德蝶腭神经节封闭治疗变应性鼻炎（附415例报告）

目的：探讨口腔径路曲安奈德蝶腭神经节封闭治疗变应性鼻炎的效果。方法：变应性鼻炎患者415例，男270例，女145例。用自制封闭针头于口腔径路行曲安奈德蝶腭神经节封闭术。结果：415例中，有效250例，好转63例，总有效率为99．5％。结论：经口腔径路用曲安奈德行蝶腭神经节封闭术是治疗变应性鼻炎的有效疗法。     

Further studies on the chronotherapy of asthma with inhaled steroids: The effect of dosage timing on drug efficacy

Background: Chronotherapy studies with inhaled corticosteroids have shown optimal therapeutic benefit when steroids are administered four times per day (QID) or once daily at 3 PM.Objective: This study evaluated whether more convenient once-daily dosage times (8 AM and 5:30 PM) produce improvement in asthma equivalent to QID.Methods: Efficacy outcome measures included FEV₁, peak expiratory flow rates, bronchial responsiveness, use of β₂-agonists, nocturnal awakenings, and responses to a quality of life questionnaire. Systemic effects were blood eosinophil count, cortisol level, 24-hour urinary cortisol, and evaluation for oral candidiasis and dysphonia.Results: Baseline measurements for all three treatment groups were similar. For morning peak expiratory flow rate, significant improvement was seen for the QID group (p = 0.001) and the 5:30 PM group (p = 0.003), but not the 8 AM group (p = 0.75). For evening peak expiratory flow rate, significant improvement was seen for the QID group (p = 0.005) and the 5:30 PM group (p = 0.01), but not for the 8 AM group (p = 0.47). There were significant improvements in all other outcome variables for each group except PC₂₀. There was a significant improvement in PC₂₀ only in the QID group. The systemic effects of the three regimens were comparable.Conclusion: Dosing of inhaled steroid at 5:30 PM had no increased systemic effects and produced efficacy similar to QID dosing. Dosing at 8 AM did not produce results consistently comparable to QID dosing. Optimal once-daily dosing of inhaled steroid is between 3 PM and 5:30 PM.     

Effect of intranasal fluticasone propionate and triamcinolone acetonide on basal and dynamic measures of hypothalamic–pituitary–adrenal-axis activity in healthy volunteers

BACKGROUND : Most published studies show that intranasal corticosteroids have no effect on the hypothalamic-pituitary-adrenal (HPA) axis, but there have been isolated reports to the contrary, contradicting accumulated knowledge on pharmacokinetics. OBJECTIVE : To re-evaluate the effect of fluticasone propionate aqueous nasal spray (FPANS) and triamcinolone acetonide (TAA) aqueous nasal spray on the HPA axis using an improved study design. METHODS : Twenty-three healthy volunteers were randomized in a double-blind, three-way crossover study. The study comprised a 4-day placebo run-in phase followed by three 4-day treatment periods (placebo, FPANS (200 microg once daily) or TAA aqueous nasal spray (220 microg once daily)), separated by 7-14 days washout intervals. Before the first, and on the last day of each treatment period, 12-h overnight urine was collected to assess cortisol excretion and cortisol creatinine ratio. Approximately 26 h after the last administration of study medication, volunteers underwent stimulation with 0.5 microg adrenocorticotropic hormone (ACTH). Serum cortisol concentrations were measured before and 20 and 30 min after injection. Blood and urine samples were analysed for cortisol by liquid chromatography tandem mass spectrometry. RESULTS : Compared with placebo, EP or TAA had no significant effect on mean overnight (12 h) urinary cortisol excretion, and did not significantly suppress the overnight geometric mean urinary cortisol/creatinine excretion ratio. Values for serum cortisol before and after ACTH simulation showed no significant suppression, although there was a slight blunting of the HPA-axis response following TAA treatment. CONCLUSION : This study confirms that there are no detectable effects on the HPA axis following short-term intranasal FP or TAA at their recommended dosages.     

HPLC法测定尿素-醋酸曲安萘德软膏中醋酸曲安萘德的含量

目的 采用高效液相色谱法测定尿素醋酸曲安萘德软膏中醋酸曲安萘德的含量。方法 Kromasil C₁₈(150mm×4.6mm,5μm)色谱柱;流动相为甲醇水乙醚(62∶38∶2);流量1.0ml·min^-1;检测波长为240nm。采用炔诺酮作内标物质。结果 醋酸曲安萘德在0.16～0.79μg范围内呈线性关系,r=0.9998(n=5),平均回收率为100.7%(n=5),RSD为0.97%。结论 本法简便、准确,可以控制该制剂的质量。     

曲安奈德治疗增生性瘢痕的疗效观察

目的:观察曲安奈德对增生性瘢痕的治疗效果.方法:对63例增生性瘢痕患者采用曲安奈德瘢痕内注射进行治疗.结果:治愈:39例;有效:18例;无效:6例.结论:曲安奈德是治疗增生性瘢痕的有效药物.     

高效液相色谱法测定曲安奈德乳膏的含量

目的建立曲安奈德乳膏的含量测定方法。方法采用高效液相色谱法测定曲安奈德乳膏的含量,色谱柱为Nova-Park C18柱(4.0mm×300mm,4μm),流动相为甲醇-乙醚-水(68∶2∶30),流速为1mL.min-1,检测波长为240nm。结果曲安奈德浓度在6.8~108.8mg.L-1浓度内与其峰面积呈良好的线性关系(r=0.9996)。回收率为101.45%,RSD为0.50%。结论本法简便,准确,灵敏度高,重现性好,可用于曲安奈德乳膏的含量测定。     

多磺酸黏多糖乳膏联合曲安奈德益康唑乳膏治疗成人慢性湿疹45例

目的 观察多磺酸黏多糖乳膏与曲安奈德益康唑乳膏联合应用治疗成人慢性湿疹的临床效果.方法 选取90例成人慢性湿疹患者作为研究对象,采用随机数字表法分为两组,每组45例,其中对照组采用曲安奈德益康唑乳膏治疗,观察组在对照组治疗的基础上,联合多磺酸黏多糖乳膏治疗,观察并比较两组患者经过用药后的临床效果及随访恢复情况.结果 观察组总有效率(91.11%)明显高于对照组(60.00%),差异有统计学意义(P<0.05);观察组患者临床各指标积分(4.81 ±1.01)分明显优于对照组(10.61 ±2.60)分,差异有统计学意义(P <0.05);观察组患者透明质酸酶合成的增长率(639.15 ± 140.43)%明显高于对照组(48.98 ±14.26)%,差异有统计学意义(P<0.05);治疗后,观察组患者皮肤水份情况(46.15 ± 14.32)%明显优于对照组(40.02 ±11.56)%,差异有统计学意义(P<0.05).结论 在曲安奈德益康唑乳膏治疗的基础上,联合多磺酸黏多糖乳膏对成人慢性湿疹的治疗具有积极作用,提高临床总有效率,有效改善自觉瘙痒程度、皮损厚度和皮肤软硬度及颜色恢复等方面的临床状况,患者皮肤水份得以维持,为受损皮肤的组织再生提供了保障,值得临床广泛应用.     

局部注射曲安奈德及积雪苷治疗病理性瘢痕的临床疗效分析

目的应用盐酸曲安奈德注射液治疗病理性瘢痕的临床疗效及观察其不良反应。方法120例病理性患者（其中增生性瘢痕（hypertrophic）62例,瘢痕疙瘩（keloid）58例）分别采用曲安奈德注射液局部注射和积雪苷注射剂局部注射治疗的方法,对两者的临床疗效进行配对比较。结果治疗组的总体疗效明显优于对照组,两组间具有明显差异（P〈0．05）,在治疗组方面,曲安奈德组的疗效〉积雪苷组的疗效（P〈0．05）。结论对于病理性瘢痕患者,此两种药物局部注射治疗均为确切有效的方法,在单一使用其中药物进行治疗时,曲安奈德的效果优于积雪苷。     

三联疗法治疗阴囊湿疹疗效观察

目的观察三联疗法治疗阴囊湿疹的疗效。方法将入选患者随机分为两组,治疗组（45例）予润燥止痒胶囊2.0g,3次/d,口服;联合马应龙麝香痔疮膏,外用,2次/d和曲安奈德益康唑乳膏,外用,2次/d;对照组（43例）：仅曲安奈德益康唑乳膏,外用,2次/d。两组均治疗2周。结果治疗组有效率为75.56%;对照组有效率为32.56%。两组比较差异有统计学意义（P〈0.05）。结论三联疗法治疗阴囊湿疹疗效显著,不良反应少。     

玻璃酸钠联合曲安奈德关节腔内注射治疗膝骨性关节炎的疗效观察

目的：观察玻璃酸钠联合曲安奈德关节腔内注射治疗骨性膝关节炎的疗效。方法：将101例患者随机分为4组,联合治疗组选择30例骨性膝关节炎患者,关节腔内联合注射玻璃酸钠和曲安奈德,玻璃酸钠每周1次,共5次,曲安奈德第1周和第3周注射,共2次。曲安奈德组仅关节腔内注入曲安奈德。玻璃酸钠组仅关节腔内注射玻璃酸钠。对照组仅关节腔内注射0.9%氯化钠溶液。观察和比较治疗前、治疗后1个月和治疗后6个月膝关节功能评分结果。结果：治疗后1个月和治疗后6个月膝关节功能评分显著好转,并疗效优于单用玻璃酸钠或曲安奈德（P〈0.05）。结论：玻璃酸钠联合曲安奈德关节腔内注射可以明显改善骨性膝关节炎的临床症状,远期效果较好,而且副作用少。