目的:尽管COVID-19失语症通常是一过性的,持续嗅觉功能障碍(pOD)的患者可出现难愈性麻痹和嗅觉减退。这项研究评估了慢性COVID-19嗅觉障碍患者的四种推定治疗方法。
方法:经鼻内镜检查后,85名患者(49名女性,58%)患有pOD和治疗难治性的假发被随机分为:(1)超微粉化棕榈酰乙醇胺和木犀草素+嗅觉训练(OT)(umPEALUT组,n=17),(2)α-硫辛酸+OT(ALA组,n=21),(3)umPEALUT+ALA+OT(组合组,n=28),或4)单独嗅觉训练(OT)(对照组,n=23)。嗅觉功能在基线(T0)和6个月(T1)时使用假发问卷和气味阈值的Sniffin\'Sticks测试进行评估。检测,和识别(TDI)。分析包括数字数据的单向方差分析和名义数据的卡方分析。
结果:UPEALUT组的TDI评分改善最大(21.8±9.4至29.7±7.5),其次是联合组(19.6±6.29至27.5±2.7),两者p<0.01。对照组和ALA组无明显变化。与ALA和对照组相比,组合和umPEALUT组的患者TDI评分显着提高(p<0.001)。据报道,联合用药6个月后的瘫痪消退率为96%,65%用于控制,53%为ALA,29%为ALA(p<0.001)。所有治疗方案均耐受良好。
结论:umPEALUT和OT,有或没有ALA,与TDI评分和假发的改善有关,而单独OT或OT与ALA几乎没有获益。
OBJECTIVE: Although COVID-19 anosmia is often transient, patients with persistent olfactory dysfunction (pOD) can experience refractory parosmia and diminished smell. This study evaluated four putative therapies for parosmia in patients with chronic COVID-19 olfactory impairment.
METHODS: After screening nasal endoscopy, 85 patients (49 female, 58%) with pOD and treatment-refractory parosmia were randomized to: (1) ultramicronized palmitoylethanolamide and luteolin + olfactory training (OT) (umPEALUT group, n = 17), (2) alpha-lipoic acid + OT (ALA group, n = 21), (3) umPEALUT + ALA + OT (combination group, n = 28), or 4) olfactory training (OT) alone (control group, n = 23). Olfactory function was assessed at baseline (T0) and 6 months (T1) using a parosmia questionnaire and Sniffin\' Sticks test of odor threshold, detection, and identification (TDI). Analyses included one-way ANOVA for numeric data and Chi-Square analyses for nominal data on parosmia.
RESULTS: The umPEALUT group had the largest improvement in TDI scores (21.8 ± 9.4 to 29.7 ± 7.5) followed by the combination group (19.6 ± 6.29 to 27.5 ± 2.7), both p < 0.01. The control and ALA groups had no significant change. Patients in the combination and umPEALUT groups had significantly improved TDI scores compared to ALA and control groups (p < 0.001). Rates of parosmia resolution after 6 months were reported at 96% for combination, 65% for control, 53% for umPEALUT and 29% for ALA (p < 0.001). All treatment regimens were well-tolerated.
CONCLUSIONS: umPEALUT and OT, with or without ALA, was associated with improvement in TDI scores and parosmia, whereas OT alone or OT with ALA were associated with little benefit.