目的 探讨止咳丸联合孟鲁司特钠治疗咳嗽变异性哮喘的临床效果。方法 选取2015年2月-2018年4月西安交通大学第二附属医院收治的咳嗽变异性哮喘患者118例，随机分成对照组（59例）和治疗组（59例）。对照组睡前口服孟鲁司特钠片，1片/次，1次/d。治疗组在对照组基础上口服止咳丸，6丸/次，2次/d。两组均连续治疗8周。观察两组患者临床疗效，同时比较治疗前后两组患者咳嗽症状评分、肺功能指标、气道高反应相关指标和炎症标志物水平。结果 治疗后，对照组和治疗组临床有效率分别为84.7%和96.6%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组日间、夜间咳嗽症状评分及其总分均显著下降（P<0.05），且治疗组患者咳嗽症状评分明显低于对照组患者（P<0.05）。治疗后，两组肺功能各项参数第1秒用力呼气容积（FEV1）、呼气峰流速（PEF）和最大呼气中段流量（MMEF）值均显著升高（P<0.05），且治疗组患者FEV1、PEF和MMEF值明显高于对照组患者（P<0.05）。治疗后，两组PEF昼夜变异率、FEV1较基线下降20%时累积吸入激发药物的剂量（PD20-FEV1）均显著低于治疗前（P<0.05），且治疗组患者PEF昼夜变异率、PD20-FEV1明显低于对照组患者（P<0.05）。治疗后，两组呼出气一氧化氮（FeNO）水平、外周血嗜酸粒细胞比例（EOS%）值及血清白三烯（LT）B4浓度均显著降低（P<0.05），且治疗组患者这些炎症标志物水平明显低于对照组（P<0.05）。结论 止咳丸联合孟鲁司特钠治疗咳嗽变异性哮喘可明显减轻患者咳嗽症状，改善肺功能，降低气道高反应性，整体疗效显著。

Objective To investigate the clinical effect of Zhike Pills combined with montelukast sodium in treatment of cough variant asthma. Methods Patients (118 cases) with cough variant asthma in the Second Affiliated Hospital of Xi'an Jiaotong University from February 2015 to April 2018 were randomly divided into control (59 cases) and treatment (59 cases) groups. Patients in the control group were po administered with Montelukast Sodium Tablets before bed, 1 tablet/time, once daily. Patients in the treatment group were po administered with Zhike Pills on the basis of the control group, 6 pills/time, twice daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, and the cough symptoms scores, the pulmonary function indexes, the indexes of airway hyperresponsiveness, and the levels of inflammatory markers in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 84.7% and 96.6%, respectively, and there were differences between two groups (P < 0.05). After treatment, the diurnal and night cough symptom scores and the total scores in two groups were significantly decreased (P < 0.05), and these scores in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the FEV1, PEF, and MMEF value in two groups was significantly increased (P < 0.05), and the indicators in the treatment group were significantly higher than those in the control group (P < 0.05). After treatment, the PEF of variation rate of day and night, PD20-FEV1 in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the FeNO, EOS% of peripheral blood, and serum LTB4 concentration in two groups were significantly decreased (P<0.05), and the levels of inflammatory markers in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Zhike Pills combined with montelukast sodium in treatment of cough variant asthma can significantly reduce cough symptoms of patients, improve lung function, reduce airway hyperresponsiveness, and has significant overall curative effect.

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