不同剂量布地奈德雾化吸入治疗哮喘急性发作患儿疗效
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摘要
目的探讨不同剂量布地奈德雾化吸入治疗小儿哮喘急性发作的临床疗效,为临床用药剂量选择提供参考。方法选取自2016年6月至2018年9月收治的90例哮喘急性发作患儿为研究对象,采用单盲随机分组法分为常规组与观察组,每组各45例。两组患儿均接受吸氧、抗感染、补液、止咳祛痰等常规对症治疗,常规组患儿给予常规剂量0.5 mg/次布地奈德混悬液雾化吸入,观察组患儿给予大剂量1.0 mg/次布地奈德混悬液雾化吸入。观察两组患儿治疗前后哮喘症状评分、肺功能指标变化及不良反应发生情况。结果治疗3、7 d时,两组患儿气促、喘息、咳嗽及肺内哮鸣音评分均较治疗前明显下降,晨起第1秒用力呼吸容积(FEV1)、呼吸峰值流速(PEF)均较治疗前明显升高,差异有统计学意义(P<0.05)。治疗3 d时,观察组患儿气促、喘息、咳嗽及肺内哮鸣音评分均低于常规组,FEV1、PEF显著高于常规组,差异有统计学意义(P<0.05)。治疗7 d时,两组患儿哮喘症状评分、肺功能指标比较,差异无统计学意义(P>0.05)。两组患儿治疗依从性较好,未出现严重不适症状。观察组出现胸痛1例、咽部疼痛2例,不良反应发生率为6.7%(3/45);常规组出现口干2例、咽部疼痛2例,不良反应发生率为8.9%(4/45),两组间不良反应发生率比较,差异无统计学意义(P>0.05)。结论布地奈德雾化吸入治疗小儿哮喘急性发作存在明显量效关系,大剂量(1.0 mg/次)雾化吸入对缓解哮喘症状、改善肺功能和减轻患儿生理痛苦的效果更佳。
Objective To investigate the clinical effect of different doses of Budesonide in the treatment of acute asthma attack in children.Methods A retrospective study was performed on 90 cases of patients with acute asthma attack who were admitted from June 2016 to September 2018.A single blind randomized method was used to divide the patients into the conventional group and the observation group,with 45 cases in each group.Children in both groups received conventional symptomatic treatment including oxygen inhalation,anti-infection,fluid supplementation,cough relieving and expectorant.Children in the conventional group were given a conventional dose of 0.5 mg/time Budesonide suspension atomized inhalation,while children in the observation group were given a large dose of 1.0 mg/time Budesonide suspension atomized inhalation.The changes of asthma symptom score,pulmonary function index and adverse reactions before and after treatment were observed.Results After 3 and 7 days of treatment,the scores of wheezing,cough and intrapulmonary asthma in the two groups were significantly reduced than those before treatment,and forced expiratory volume in one second(FEV1) and peak expiratory flow(PEF) were significantly increased compared with those before treatment,with statistically significant differences(P<0.05).On the third day of treatment,the scores of wheezing,cough and intrapulmonary asthma in the observation group were all lower than those in the routine group,and FEV1 and PEF were significantly higher than those in the routine group(P< 0.05).At 7 days of treatment,there was no statistically significant difference in asthma symptom scores and lung function indicators between the two groups(P>0.05).The two groups of children had good treatment compliance and no severe discomfort symptoms.In the observation group,1 patient had chest pain and 2 patients had pharyngeal pain,and the incidence of adverse reactions was 6.7%(3/45).There were 2 cases of dry mouth and 2 cases of pharyngeal pain occurred in the routine group,and the incidence of adverse reactions was 8.9%(4/45).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion There is a significant dose-effect relationship between Budesonide aerosol inhalation and acute attack of asthma in children.High dose(1.0 mg/time) aerosol inhalation is better in alleviating asthma symptoms,improving pulmonary function and alleviating physiological pain in children.
Objective To investigate the clinical effect of different doses of Budesonide in the treatment of acute asthma attack in children.Methods A retrospective study was performed on 90 cases of patients with acute asthma attack who were admitted from June 2016 to September 2018.A single blind randomized method was used to divide the patients into the conventional group and the observation group,with 45 cases in each group.Children in both groups received conventional symptomatic treatment including oxygen inhalation,anti-infection,fluid supplementation,cough relieving and expectorant.Children in the conventional group were given a conventional dose of 0.5 mg/time Budesonide suspension atomized inhalation,while children in the observation group were given a large dose of 1.0 mg/time Budesonide suspension atomized inhalation.The changes of asthma symptom score,pulmonary function index and adverse reactions before and after treatment were observed.Results After 3 and 7 days of treatment,the scores of wheezing,cough and intrapulmonary asthma in the two groups were significantly reduced than those before treatment,and forced expiratory volume in one second(FEV1) and peak expiratory flow(PEF) were significantly increased compared with those before treatment,with statistically significant differences(P<0.05).On the third day of treatment,the scores of wheezing,cough and intrapulmonary asthma in the observation group were all lower than those in the routine group,and FEV1 and PEF were significantly higher than those in the routine group(P< 0.05).At 7 days of treatment,there was no statistically significant difference in asthma symptom scores and lung function indicators between the two groups(P>0.05).The two groups of children had good treatment compliance and no severe discomfort symptoms.In the observation group,1 patient had chest pain and 2 patients had pharyngeal pain,and the incidence of adverse reactions was 6.7%(3/45).There were 2 cases of dry mouth and 2 cases of pharyngeal pain occurred in the routine group,and the incidence of adverse reactions was 8.9%(4/45).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion There is a significant dose-effect relationship between Budesonide aerosol inhalation and acute attack of asthma in children.High dose(1.0 mg/time) aerosol inhalation is better in alleviating asthma symptoms,improving pulmonary function and alleviating physiological pain in children.
引文
[1] 中华医学会呼吸病学分会哮喘学组.支气管哮喘患者自我管理中国专家共识[J].中华结核和呼吸杂志,2018,41(3):171-178.
[2] 朱丽丽,张海邻,李昌崇.糖皮质激素抗支气管哮喘治疗的药物基因组学研究进展[J].国际呼吸杂志,2017,37(1):51-56.
[3] 中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南(2016年版)[J].中华儿科杂志,2016,54(3):167-181.
[4] 张志惠,张瑞,盖小荣.清热利湿法对支气管哮喘患儿症状及气道功能作用研究[J].西南国防医药,2017,27(1):81-84.
[5] 金世杰,饶花平,罗力妍,等.影响儿童支气管哮喘发病的危险因素研究[J].中国医师杂志,2017,19(12):1898-1900.
[6] 黄传君,赵方正,陈方方,等.吸入性糖皮质激素能有效控制支气管哮喘气道炎症[J].中华结核和呼吸杂志,2018,41(11):912.
[7] 杨敏,李林瑞,孟燕妮,等.布地奈德辅助治疗小儿支气管哮喘对T淋巴细胞亚群及相关细胞因子的影响[J].疑难病杂志,2018,17(3):255-258.
[8] 朱元璐,黄琴,余忠红.复方异丙托溴铵联合不同剂量布地奈德混悬液雾化吸入治疗儿童变异性哮喘的临床研究[J].解放军医药杂志,2019,31(1):65-68,84.
[9] 刘伟峰,赵春玲,田继红,等.小剂量布地奈德联合孟鲁司特治疗小儿支气管哮喘的效果及安全性分析[J].河南医学研究,2017,26(16):2941-2943.
[10] 杨俊莉,陈智敏,郑耀健.不同剂量布地奈德混悬液雾化吸入治疗儿童哮喘急性发作疗效及安全性比较[J].贵州医药,2015,39(10):883-884.
[11] 尹硕淼,陈远彬,郑燕婵,等.不同肺功能检查方式在支气管哮喘指南中的诊断价值比较[J].中国全科医学,2018,21(32):8-11.
[12] 官灵宏.儿童哮喘急性发作应用不同剂量布地奈德雾化吸入的临床疗效对比[J].中国现代医生,2017,55(26):89-91.
[13] 吴小雄,林先茂.不同剂量布地奈德混悬液雾化吸入治疗小儿哮喘急性发作的疗效及安全性对比[J].中国地方病防治杂志,2017,32(7):96-97.
[14] 代静.儿童哮喘急性发作应用不同剂量布地奈德雾化吸入的临床疗效对比[J].医学理论与实践,2018,31(3):412-413.
[15] 杨涛,刘丽.不同剂量布地奈德混悬液雾化吸入治疗小儿哮喘急性发作的对比分析[J].中国继续医学教育,2018,23(9):118-120.
[2] 朱丽丽,张海邻,李昌崇.糖皮质激素抗支气管哮喘治疗的药物基因组学研究进展[J].国际呼吸杂志,2017,37(1):51-56.
[3] 中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南(2016年版)[J].中华儿科杂志,2016,54(3):167-181.
[4] 张志惠,张瑞,盖小荣.清热利湿法对支气管哮喘患儿症状及气道功能作用研究[J].西南国防医药,2017,27(1):81-84.
[5] 金世杰,饶花平,罗力妍,等.影响儿童支气管哮喘发病的危险因素研究[J].中国医师杂志,2017,19(12):1898-1900.
[6] 黄传君,赵方正,陈方方,等.吸入性糖皮质激素能有效控制支气管哮喘气道炎症[J].中华结核和呼吸杂志,2018,41(11):912.
[7] 杨敏,李林瑞,孟燕妮,等.布地奈德辅助治疗小儿支气管哮喘对T淋巴细胞亚群及相关细胞因子的影响[J].疑难病杂志,2018,17(3):255-258.
[8] 朱元璐,黄琴,余忠红.复方异丙托溴铵联合不同剂量布地奈德混悬液雾化吸入治疗儿童变异性哮喘的临床研究[J].解放军医药杂志,2019,31(1):65-68,84.
[9] 刘伟峰,赵春玲,田继红,等.小剂量布地奈德联合孟鲁司特治疗小儿支气管哮喘的效果及安全性分析[J].河南医学研究,2017,26(16):2941-2943.
[10] 杨俊莉,陈智敏,郑耀健.不同剂量布地奈德混悬液雾化吸入治疗儿童哮喘急性发作疗效及安全性比较[J].贵州医药,2015,39(10):883-884.
[11] 尹硕淼,陈远彬,郑燕婵,等.不同肺功能检查方式在支气管哮喘指南中的诊断价值比较[J].中国全科医学,2018,21(32):8-11.
[12] 官灵宏.儿童哮喘急性发作应用不同剂量布地奈德雾化吸入的临床疗效对比[J].中国现代医生,2017,55(26):89-91.
[13] 吴小雄,林先茂.不同剂量布地奈德混悬液雾化吸入治疗小儿哮喘急性发作的疗效及安全性对比[J].中国地方病防治杂志,2017,32(7):96-97.
[14] 代静.儿童哮喘急性发作应用不同剂量布地奈德雾化吸入的临床疗效对比[J].医学理论与实践,2018,31(3):412-413.
[15] 杨涛,刘丽.不同剂量布地奈德混悬液雾化吸入治疗小儿哮喘急性发作的对比分析[J].中国继续医学教育,2018,23(9):118-120.