目的 观察扎鲁司特联合沙丁胺醇治疗儿童支气管哮喘的临床疗效。方法 选取2013年4月—2014年10月中国海洋石油南海西部医院收治的支气管哮喘患儿105例,随机分为对照组(51例)和治疗组(54例)。对照组将0.5 mL吸入用硫酸沙丁胺醇溶液用生理盐水稀释至2.5 mL,氧气驱动雾化吸入,氧流量为6～8 L/min,吸入时间为3～5 min/次,3次/d。治疗组在对照组的基础上口服扎鲁司特片,1片/次,2次/d。两组均连续治疗15 d。观察两组的临床疗效,同时比较两组患儿治疗前后的外周血肿瘤坏死因子(TNF-α)、白介素6(IL-6)、免疫球蛋白E(IgE)、一秒用力呼气容积(FEV₁)/用力肺活量(FVC)、呼气峰流量(PEF)的变化。结果 治疗后,对照组和治疗组的总有效率分别为72.55%、92.59%,两组比较差异有统计学意义(P <0.05)。治疗后,两组患儿TNF-α、IL-6、IgE水平均较治疗前显著降低,FEV₁/FVC、PEF显著升高,同组治疗前后差异有统计学意义(P <0.05);且治疗组这些观察指标的改善程度优于对照组,两组比较差异具有统计学意义(P <0.05)。结论 扎鲁司特联合沙丁胺醇治疗儿童支气管哮喘具有较好的临床疗效,可抑制炎症因子的表达,改善患儿肺功能,具有一定的临床推广应用价值。

Objective To explore the clinical effects of zafirlukast combined with salbutamol in treatment of bronchial asthma of children. Methods Patients (105 cases) with bronchial asthma in the China Offshore Oil Nanhai Westen Hospital from April 2013 to October 2014 were randomly divided into control (n= 51) and treatment (n= 54) groups. Patients in control group were oxygen atomization inhaled with Salbutamol Sulfate Inhalation Solution 0.5 mL which was diluted to 2.5 mL with physiological saline, and the oxygen flow rate was 6 — 8 L/min, while the suction time was 3 — 5 min/time, three times daily. Patients in treatment group were po administered with Zafirlukast Tablets, 1 tablet/time, twice daily. Two groups were treated for 15 d. After treatment, the efficacy was evaluated, and the changes of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), immunoglobulin E (IgE), forced expiratory volume in one second (FEV₁)/ forced vital capacity (FVC), and peak expiratory flow (PEF) in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 72.55% and 92.59%, respectively, and there were differences between two groups (P < 0.05). After treatment, TNF-α, IL-6 and IgE in two groups were significantly reduced, while FEV₁/FVC and PEF in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And these indicators in treatment group improved better than those in the control group, with significant differences between two groups (P < 0.05). Conclusion Zafirlukast combined with salbutamol has good clinical effect in treatment of bronchial asthma of children, can inhibit the expression of inflammatory cytokines, and can improve lung function, which has a certain clinical application value.