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[摘要]
目的 比较布地奈德福莫特罗粉吸入剂与孟鲁司特钠治疗儿童咳嗽变异性哮喘的疗效。方法 以2012年1月-2016年5月西安交通大学第二附属医院儿科收治的100例咳嗽变异性哮喘患儿为研究对象,根据随机数字表法分为观察组和对照组,每组50例。观察组患儿给予布地奈德福莫特罗粉吸入剂治疗,对照组患儿给予孟鲁司特钠治疗。比较两组治疗后临床疗效、咳嗽积分、肺功能[一秒用力呼气量(FEV1)、用力肺活量(FVC)、最大呼气峰流速(PEF),计算FEV1/FVC、PEF/预计值*100%(PEF pred%)]、血清中肿瘤坏死因子-α(TNF-α)、血液总IgE及全血嗜酸性粒细胞计数(EOS),不良反应及半年复发率。结果 观察组的总有效率为80.00%,显著高于对照组的64.00%,差异有统计学意义(P<0.05)。治疗后,两组的咳嗽积分较治疗前显著降低,FEV1、FEV1/FVC及PEF pred%均较治疗前显著升高,同组治疗前后比较差异有统计学意义(P<0.05);且观察组治疗后的咳嗽积分显著低于对照组,FEV1/FVC及PEF pred%显著高于对照组,差异有统计学意义(P<0.05)。治疗后,两组的TNF-α、总IgE及EOS均较治疗前显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且观察组的TNF-α、总IgE及EOS显著低于对照组,差异有统计学意义(P<0.05)。两组的总不良反应发生率和治疗后半年内复发率比较,差异均无统计学意义。结论 布地奈德福莫特罗粉吸入剂治疗儿童咳嗽变异性哮喘的临床疗效显著优于孟鲁司特钠,对患儿的咳嗽、肺功能、血清TNF-α、总IgE及EOS的改善效果更佳。
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[Abstract]
Objective To investigate the clinical effect of Budesonide Formoterol Powder Inhaler and Montelukast Sodium Chewable Tablets in cough variant asthma in children. Methods 100 cases of children with cough variant asthma in Second Affiliated Hospital of Xi'an Jiaotong University from January 2012 to May 2016 were divided into observation group and control group, 50 cases in each group. Children in the observation group were treated with Budesonide Formoterol Powder Inhaler, and in control group were treated with Montelukast Sodium Chewable Tablets. The cough symptoms, lung function, including a second forced expiratory volume (FEV1) and forced vital capacity (FVC), the largest out front velocity of flow (PEF), calculate the FEV1/FVC, PEF/*100% expected value (PEF Pred%), clinical efficacy, serum tumor necrosis factor-α (TNF-α), a blood total IgE and whole blood eosinophil count (EOS), adverse reactions and half year relapse were compared. Results The clinical effet of the observation group were significantly higher than that of the control group (P < 0.05). After treatment, the cough score of the two groups was significantly lower than that before treatment, FEV1, FEV1/FVC and PEF pred% were significantly higher than before treatment, the difference was statistically significant (P < 0.05). The cough score of observation group after treatment was significantly lower than the control group, FEV1/FVC and PEF pred% was significantly higher than that of the control group, the difference was statistically significant (P < 0.05). TNF-α, total IgE and EOS in the two groups were significantly lower than those before treatment, the difference was statistically significant (P < 0.05). The TNF-α, total IgE and EOS in the observation group were significantly lower than those in the control group, the difference was statistically significant (P < 0.05). There was no significant difference between the two groups in the incidence of adverse reactions and recurrence rate within six months after treatment. Conclusion Budesonide Formoterol Powder Inhaler has remarkable clinical effect in cough variant asthma.
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