目的 研究孟鲁斯特联合布地奈德和特布他林治疗哮喘急性发作的临床疗效。方法 选取2012年5月-2014年5月商洛市中心医院收治的支气管哮喘急性发作患者100例,随机分为对照组和治疗组,每组各50例。对照组在对症治疗的基础上给予雾化吸入布地奈德气雾剂,0.5 mg/次,3次/d;同时口服硫酸特布他林片,2.5 mg/次,3次/d。治疗组在对照组基础上口服孟鲁司特钠咀嚼片,10 mg/次,1次/d。两组均连续治疗7 d。观察两组的临床疗效,比较两组症状消失时间、哮喘发作频率、肺功能改善情况。结果 治疗后,对照组和治疗组的总有效率分别为88.0%、98.0%,两组比较差异具有统计学意义(P < 0.05)。治疗组的咳嗽消失时间、湿啰音消失时间、喘息消失时间、哮鸣音消失时间、日间和夜间发作频率具显著短于对照组,两组比较差异具有统计学意义(P < 0.05)。治疗后,两组患者FEV1占预计值的百分比(FEV1%Pred)、用力吸气肺活量(FVC)、呼气流量峰值(PEF)均显著升高,同组治疗前后差异具有统计学意义(P < 0.05);且治疗后治疗组FEV1%Pred、FVC、PEF高于对照组,两组比较差异具有统计学意义(P < 0.05)。结论 孟鲁斯特联合布地奈德和特布他林治疗哮喘急性发作具有较好的临床疗效,可有效改善哮喘急性发作患者的肺功能和临床症状,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of montelukast combined with budesonide and turbutaline in treatment of acute attack of asthma. Methods Patients (100 cases) with acute attack of asthma in Shangluo Central Hospital from May 2012 to May 2015 were randomly divided into control and treatment groups, and each group had 50 cases. The patients in the control group were atomization inhaled with Budesonide Aerosol on the basis of symptomatic treatment, 0.5 mg/time, three times daily, and they were also po administered with Terbutaline Sulphate Tablets, 2.5 mg/time, three times daily. The patients in the treatment group were po administered with Montelukast Sodium Chewable Tablets on the basis of the control group, 10 mg/time, once daily. Two groups were treated for 7 d. After treatment, the efficacy was evaluated, and symptoms disappearing time, frequency of asthma attack, and the improvement of lung function in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 88.0% and 98.0%, respectively, and there were differences between two groups (P < 0.05). After treatment, cough disappeared time, moist rales disappeared time, wheezing disappeared time, wheezing sound disappeared time, attack frequency of daytime and nighttime in the treatment group were shorter than those in the control group, and there were differences between two groups (P < 0.05). After treatment, FEV1%Pred, FVC, and PEF in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, FEV1%Pred, FVC and PEF in the treatment group were higher than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Montelukast combined with budesonide and turbutaline has distinct clinical effect in treatment of acute attack of asthma, and can effectively improve lung function and clinical symptoms of acute asthma patients, which has certain clinical application value.