目的 探讨孟鲁司特钠联合布地奈德对哮喘患儿肺功能、呼出气一氧化氮（FeNO）及气道炎症介质的影响。方法 选取2024年2月—2025年2月驻马店市中心医院收治的226例哮喘患儿，根据随机数字表法分为对照组和治疗组，每组各113例。对照组雾化吸入吸入用布地奈德混悬液，2次/d，0.5～1.0 mg/次。治疗组在对照组基础上睡前口服孟鲁司特钠咀嚼片，＜6岁儿童4 mg/次，≥6岁儿童5 mg/次，均为1次/d。两组均连续治疗8周。观察两组患儿临床疗效，比较治疗前后两组患儿临床症状消退时间和住院时间，肺功能指标第1秒用力呼吸量（FEV1）、最大呼气峰流速（PEF）、用力肺活量（FVC），气道炎症介质肿瘤坏死因子-α（TNF-α）、白细胞介素-8（IL-8）、γ干扰素（IFN-γ）水平，及FeNO水平。结果 治疗后，治疗组总有效率明显高于对照组（97.35% vs 89.38%，P＜0.05）。治疗后，治疗组湿啰音消退时间、哮鸣音消退时间、住院时间均短于对照组（P＜0.05）。治疗后，两组FEV1、FVC、PEF比治疗前明显升高（P＜0.05），且治疗组肺功能指标改善情况明显优于对照组（P＜0.05）。治疗后，两组患者TNF-α、IL-8比治疗前明显降低，而IFN-γ明显升高（P＜0.05），且治疗组气道炎症介质改善情况优于对照组（P＜0.05）。治疗后，治疗组干预后4周、8周的FeNO均低于同期对照组（P＜0.05）。结论 孟鲁司特钠联合布地奈德能更有效控制哮喘患儿临床症状，减轻气道炎症，改善肺功能。

Objective Exploring the effects of montelukast sodium combined with budesonide on lung function, exhaled nitric oxide (FeNO), and airway inflammatory mediators in children with asthma. Methods Children (226 cases) with childhood asthma in Zhumadian Central Hospital from February 2024 to February 2025 were divided into control and treatment group by random number table method, and each group had 113 cases. Children in the control group were aerosol inhalation administered with Budesonide Suspension for inhalation, 0.5-1.0 mg/d, twice daily. Children in the treatment group were po administered with Montelukast Sodium Chewable Tablets before bed on the basis of the control group, 4 mg/time for children less than 6 years old, 5 mg/time for children ≥ 6 years old, once daily. Children in two groups were treated for 8 weeks. After treatment, the clinical evaluations were evaluated, and the time of symptom resolution and hospital stay, pulmonary function indexes FEV1, FVC and PEF, airway inflammatory mediators TNF-α, IL-8 and IFN-γ levels, and the FeNO levels in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was significantly higher than that in the control group (97.35% vs 89.38%, P < 0.05). After treatment, the fading time of wet rales, wheezing time, and hospitalization time in the treatment group were shorter than those in the control group (P < 0.05). After treatment, FEV1, FVC and PEF in two groups were significantly higher than before treatment (P < 0.05). The improvement of lung function indicators in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, TNF-α and IL-8 in two groups were significantly lower than before treatment, while IFN-γ was significantly increased (P < 0.05). The improvement of airway inflammatory mediators in the treatment group was better than that in the control group (P < 0.05). After treatment, FeNO in the treatment group was lower than that in the control group at 4 and 8 weeks after intervention (P < 0.05). Conclusion montelukast sodium combined with budesonide can more effectively control clinical symptoms in children with asthma, reduce airway inflammation, and improve lung function.

R974

河南省科技发展计划项目（232102311210）