摘要
目的探讨孟鲁司特钠对儿童支气管哮喘疗效及对呼出气一氧化氮(FeNO)水平的影响。方法随机选择2017年1月-6月住院的儿童支气管哮喘患儿100例,按就诊顺序随机分为对照组和观察组各50例,对照组给予哮喘常规处理,观察组在对照组基础上给予口服孟鲁司特钠咀嚼片每日1次5 mg睡前口服,疗程4周。比较2组第2周时临床疗效及FeNO水平。结果 2组哮喘临床疗效比较,观察组有效率显著高于对照组(χ~2=8.80,P<0.01);治疗前后FeNO比较分析得出,2组治疗后FeNO水平均较治疗前有显著下降(t=5.05,t=8.64,P<0.01),观察组FeNO水平显著低于对照组(t=3.96,P<0.01);结论孟鲁司特咀嚼片可降低哮喘儿童气道FeNO水平,显著提高儿童支气管哮喘疗效。
Objective To observe the effect of montelukast sodium on exhaled nitric oxide(FeNO) levels in children with bronchial asthma. Methods A total of 100 children with bronchial asthma were randomly selected from January 2017 to June 2017, who were randomly divided into the control group and the observation group, with 50 cases in each group. The control group was given routine treatment of asthma, and the observation group was given oral Montelukast Sodium Chewable Tablets 5 mg on the basis of the control group, once daily before going to bed. The course of treatment was 4 weeks; Then the clinical efficacy and FeNO level were compared between the two groups at the second week. Results The clinical efficacy was compared between the two groups, and the efficiency in the observation group was significantly higher than that in the control group(χ~2=8.80, P<0.01). The FeNO level was compared before and after treatment, the levels of FeNO after treatment were significantly lower than those before treatment(t=5.05, t=8.64, P<0.01), and the FeNO level in the observation group was significantly lower than that in the control group(t=3.96, P<0.01). Conclusion Montelukast chewable tablets can significantly improve the efficacy of bronchial asthma in children, which can reduce the FeNO level in airway in children with asthma.
引文
[1] 孟祥珍, 韩月肖, 张方琪, 等. 联合应用白介素-4 突变体及白介素-5 可溶性受体对哮喘小鼠支气管肺泡灌洗液及血清中转化生长因子-β1、活化素-A 水平的影响[J]. 中华肺部疾病杂志: 电子版, 2015, 8(3): 275-278.
[2] 王石磊, 邢丽华. 支气管哮喘诊断与治疗进展[J]. 中华哮喘杂志: 电子版, 2013, 7(3): 50-53.
[3] 马卫宁, 左晓玥, 周小建, 等. 上海松江地区支气管哮喘患儿变态反应原分析[J]. 中华妇幼临床医学杂志: 电子版, 2015, 11(6): 780-785.
[4] 李俊. 孟鲁斯特治疗对支气管哮喘患者肺功能及Th1、Treg 平衡的调节作用[J]. 临床肺科杂志, 2017, 22(1): 105-107.
[5] 王天玥, 尚云晓, 张晗. 呼出气一氧化氮浓度测定在儿童支气管哮喘和咳嗽变异性哮喘中的诊断价值[J]. 中国当代儿科杂志, 2015 , 17(8): 800-805.
[6] 中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南 [J]. 中华哮喘杂志: 电子版, 2008, 2(1): 3-13.
[7] 苟小军, 王淑玲, 孔令万, 等. 儿童哮喘患者中医证型的代谢组学研究. [J]. 中华中医药学刊, 2017, 35(1): 36-40.
[8] 丁莲富, 陈强, 李岚, 等. 舌下特异性免疫治疗过敏性鼻炎/ 过敏性哮喘患儿IL-17 和IL-35 水平的变化及临床疗效 [J]. 中国当代儿科杂志, 2014, 16(12): 1206-1210.
[9] 兰芙蓉, 陈文燕, 王明章, 等. 儿童支气管哮喘患者血清骨桥蛋白和嗜酸细胞趋化因子表达及临床意义[J]. 临床肺科杂志, 2017, 22(5): 877-879.
[10] 尚莉丽, 项李娥. 支气管哮喘急性发作期患儿血清嗜酸性粒细胞阳离子蛋白与IgE的相关性研究[J]. 中国中西医结合儿科学, 2016, 8(1) : 10-12.
[11] 赵扬, 洪爽. 沙丁胺醇联合布地奈德治疗小儿哮喘急性发作的疗效及其对肺功能的影响[J]. 中国妇幼保健, 2017, 32(8): 1668-1671.
[12] 刘心存. 沙丁胺醇联合布地奈德治疗支气管哮喘急性发作的临床疗效分析[J]. 中国继续医学教育, 2017,9( 1) : 161-163.
[13] 李文, 宁君, 申长清, 等. 孟鲁司特及布地奈德对支气管哮喘儿童氧化应激的影响[J]. 临床肺科杂志, 2017, 22(2): 332-346.
[14] 刘艳薇, 董淑红, 谭惠珍, 等. 孟鲁司特钠咀嚼片治疗儿童肺炎支原体感染后持续性咳嗽的疗效及对尿白三烯的影响[J]. 临床肺科杂志, 2017, 22(7) : 1251-1254.
[15] 张惠琴, 张静静, 刘雨东, 等. 肺功能检查及呼出气一氧化氮在儿童支气管哮喘规范化管理中的应用[J]. 中国当代儿科杂志, 2017, 19(3): 419-424.
[16] 潘静, 曾健, 陈敏, 等. 呼出气一氧化氮检测对咳嗽变异性哮喘糖皮质激素减量治疗的价值[J]. 医药导报, 2014, 33(3) : 331-334.
[17] 刘霞, 许文兵, 刘亚男, 等. 呼出气一氧化氮对成人支气管哮喘治疗的指导作用[J]. 中国呼吸与危重监护杂志, 2014, 13(2): 120-124.
[18] 梅湛强, 胡少枝, 罗志杨哮喘患者FeNO水平的影响因素及与气流阻塞的关系[J]. 临床肺科杂志, 2017, 22(6): 1040-1043.
[19] 侯萍, 单丽沈, 蔡栩栩, 等. 哮喘儿童呼出气一氧化氮与肺功能及哮喘控制测试相关性研究[J]. 中国实用儿科杂志, 2014, 29(9): 708-712.
[20] 龚颖, 叶伶, 安霞, 等. 评估呼出气一氧化氮(FeNO)在支气管哮喘管理中的作用[J]. 复旦学报: 医学版, 2013, 40(3) : 349-353.