鼻內(nèi)糖皮質(zhì)激素是治療過敏性鼻炎（AR）最有效的一線藥物之一，其對AR患者的所有鼻部癥狀包括噴嚏、流涕、鼻癢和鼻塞均有顯著改善作用。近年來國內(nèi)外指南為SAR臨床診斷和治療提供了循證醫(yī)學(xué)證據(jù)和指導(dǎo)；鼻內(nèi)糖皮質(zhì)激素作為SAR一線治療得到國內(nèi)外指南的一致推薦，其中布地奈德顯著改善鼻部癥狀、眼部癥狀以及睡眠問題，可作為預(yù)防性治療藥物改善SAR患者癥狀。
Intranasal corticosteroid is one of the most effective first-line drugs for treatment of allergic rhinitis (AR). It can significantly relieve the nasal symptoms of AR patients, including sneezing, running nose, itching and congestion. For years, domestic and overseas guidelines have provided proof and guidance of evidence-based medicine for the clinical diagnosis and treatment of SAR; intranasal corticosteroid, as the first-line treatment of SAR, has been unanimously recommended in domestic and overseas guidelines. Specifically, Budesonide significantly improves nasal symptoms, eye symptoms and sleep problems, and can be used as the preventive drug therapy to improve the symptoms of SAR patients.
對于伴息肉的慢性鼻竇炎（CRSwNP），指南建議原則上先采用至少3個月規(guī)范藥物治療，效果不滿意再進(jìn)行手術(shù)。慢性鼻病具有顯著異質(zhì)性，其中嗜酸性粒細(xì)胞型鼻息肉復(fù)發(fā)率接近99%，且往往伴有系統(tǒng)性炎癥。對于這種分型，更適合使用鼻用糖皮質(zhì)激素進(jìn)行治療，而手術(shù)只是治療中的輔助手段，持續(xù)的抗炎治療是核心。
For CRS with nasal polyps (CRSwNP), the guidelines recommend an at least 3-month standardized drug treatment in principle before operation which is only conducted when there is no satisfactory effect. Chronic rhinopathy features significant heterogeneity. Among them, eosinophilic nasal polyp (ENP) has a recurrence rate approaching 99%, and always features systematic inflammation, which makes it more suitable to be treated with intranasal corticosteroids. In addition, operation is just a supplementary means to treatment, and continuous anti-inflammatory treatment is at the core.
近期的流行病學(xué)和臨床研究提示，空氣污染是影響過敏性鼻炎患病率的重要環(huán)境因素，會加重過敏性鼻炎癥狀，誘導(dǎo)過敏性鼻炎發(fā)生。目前治療空氣污染相關(guān)鼻炎藥物的證據(jù)匱乏，在強(qiáng)生集團(tuán)資助下，6個中心聯(lián)合完成了《布地奈德鼻噴霧劑治療空氣嚴(yán)重污染期間鼻炎的一項IV期隨機(jī)、雙盲、安慰劑對照、多中心研究》，證實布地奈德是目前第一個經(jīng)過臨床研究證實對空氣污染相關(guān)的鼻炎有效的鼻用激素，可顯著改善患者在空氣污染期間的鼻部整體狀況，尤其是鼻癢/噴嚏癥狀。
Recent epidemiologic and clinical researches show that, air pollution is a key environmental factor affecting the prevalence rate of AR, and can worsen the symptoms of AR and induce the occurrence of AR. Currently there is scarce evidence for drugs treating air pollution-related rhinitis. Thanks to the financial aid of Johnson & Johnson, six centers have jointly completed a Phase IV, Randomized, Double-blind, Placebo-controlled and Multi-center Study on Treating Rhinitis with Budesonide Nasal Spray During Severe Air Pollution, confirming that Budesonide is the first effective intranasal corticosteroid for air pollution-related rhinitis verified by clinical research and can evidently improve the general nasal conditions of the patients during air pollution, especially itching/sneezing symptoms.