目的 探讨分析孟鲁司特联合布地奈德治疗咳嗽变异性哮喘（CVA）的临床疗效，及其对患儿肺功能和血清转化生长因子β1水平的影响。方法 选取2013年8月-2016年6月在西安市中心医院接受治疗的117例CVA患儿为研究对象，随机分为对照组59例和观察组58例。对照组患者给予雾化吸入布地奈德治疗，观察组在对照组的基础上给予孟鲁司特钠咀嚼片治疗，均治疗2个月。观察治疗前后两组患儿肺功能指标包括肺活量（VC）、1 s用力呼吸容积（FEV1）、FEV1/用力肺活量（FVC）、最大呼气峰流速（PEF）/预计值的百分比（PEF pred%），以及血清转化生长因子β1（TGF-β1）和炎症因子包括血清免疫球蛋白E（IgE）、血浆白细胞介素8（IL-8）、人肿瘤坏死因子-α（TNF-α），以及临床症状积分的变化。结果 治疗2个月后，两组的症状积分均有显著降低，治疗前后比较差异有统计学意义（P<0.05）；且观察组患儿症状评分显著低于对照组，差异具有统计学意义（P<0.05）。两组患儿的VC无明显变化，而FEV1、FEV1/FVC以及PEF pred%较治疗前均有显著升高，治疗前后比较差异有统计学意义（P<0.05）；且观察组的该3种指标显著高于对照组，两组比较差异具有统计学意义（P<0.05）。两组的TGF-β1较治疗前有显著升高，IgE、IL-8、TNF-α明显降低，同组治疗前后比较差异有统计学意义（P<0.05），且观察组的TGF-β1显著低于对照组，IgE、IL-8、TNF-α明显高于对照组，比较差异具有统计学意义（P<0.05）。结论 孟鲁司特联合布地奈德吸入治疗咳嗽变异性哮喘的临床疗效显著，可有效改善患儿的肺功能以及TGF-β1水平，抑制炎症因子水平。

Objective To investigate the clinical efficacy of budesonide combined with montelukast on treatment of children with cough variant asthma, and its influence on lung function and transforming growth factor-β1. Methods One hundred and seventeen children with cough variant asthma inXi’an Central Hospital from August 2013 to June 2016 were divided into control group and observation group. Fifty-nine children in control group were treated with aerosol budesonide, while 58 children in observation group were treated with montelukast based on control group. The lung function index including VC, FEV1, FEV1/FVC, and PEF pred%, TGF-β1, inflammatory factors including IgE, IL-8, TNF-α, and clinical symptom score in both groups were detected and analyzed before and after treatment. Results After two months of treatment, clinical symptom score in each group obviously decreased, and that in observation group was significantly lower than that of control group (P<0.05). The FEV1, FEV1/FVC, and PEF pred% of two groups showed remarkable increase, and those in observation group were much higher than those of control group (P<0.05), while no conspicuous changes were detected in VC. Additionally, TGF-β1 of each group increased markedly, and that in observation group was much higher, while IgE, IL-8, and TNF-α in two groups showed obvious decrease, andthose in observation group were significantly lower than those of control group (P<0.05). Conclusion Budesonide combined with montelukast had a great ability on treatment of children with cough variant asthma, and could significantly improve the lung function and levels of TGF-β1, and inhibit the levels of inflammatory factors.