丙酸倍氯米松或布地奈德联合特布他林治疗轻、中度哮喘患儿急性发作的疗效比较
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摘要
目的对比研究病情处于急性发作期的轻中度哮喘患儿采用硫酸特布他林联合布地奈德和硫酸特布他林联合丙酸倍氯米松两种不同方案进行治疗的临床效果。方法选我院2016年4月～2018年4月收治的104例急性发作轻中度哮喘患儿,以随机分组法,分成对照组和治疗组,每组52例。对照组采用硫酸特布他林联合布地奈德方案进行治疗;治疗组采用硫酸特布他林联合丙酸倍氯米松方案进行治疗。对比两组哮喘症状消失时间和住院治疗总时间、药物不良反应情况、治疗总有效率、治疗前后呼吸功能相关指标水平、家长对治疗方案和达到效果的满意度。用SPSS18.0处理数据,计数资料采用χ~2检验,计量资料采用t检验并以(x±s)的形式表示,P <0.05为差异有统计学意义。结果治疗组患儿哮喘症状消失时间和住院治疗总时间短于对照组;药物不良反应仅有3例,少于对照组的10例;治疗总有效率达到90.39%,优于对照组的63.46%;治疗前后呼吸功能相关指标水平的改善幅度大于对照组;家长对治疗方案和达到效果的满意度达到94.23%,高于对照组的80.77%。组间数据对应比较差异有统计学意义(P <0.05)。结论病情处于急性发作期的轻中度哮喘患儿采用硫酸特布他林联合丙酸倍氯米松进行治疗的临床效果明显优于联合布地奈德,可以在短时间内迅速改善患儿呼吸功能,使症状尽快得到控制,减少药物相关不良反应,缩短用药时间,使治疗效果和家长满意度提高。
Objective To compare the clinical effects of terbutaline sulphate combined with budesonide and terbutaline sulfate and beclomethasone propionate in the treatment of children with mild and moderate asthma in acute attack stage. Methods One hundred and four children with acute mild and moderate asthma treated in our hospital from April 2016 to April 2018 were selected and randomly divided into control group and treatment group, with 52 cases in each group. The control group was treated with terbutaline sulphate combined with budionide, and the treatment group was treated with terbutaline sulfate combined with beclomethasone propionate. The disappearance time of asthma symptoms and the total time of hospitalization, adverse drug reaction, total effective rate, the level of respiratory function before and after treatment, the parents' satisfaction with the treatment plan and the effect were compared in the two groups. Data were processed by SPSS18.0, χ~2 test of count data, t test of measurement data and expression in(±s), P < 0.05, the difference was statistically significant. Results The time of disappearance of asthma symptoms and the total time of hospitalization in the treatment group were shorter than those in the control group; Only 3 cases of adverse drug reactions in the treatment group, which were less than 10 cases in the control group; The total effective rate in the treatment group was 90.39%, which was superior to 63.46% in the control group; The improvement of the level of respiratory function related indexes in the treatment group before and after treatment was greater than that of the control group; And the parents' satisfaction rate of the scheme and effect reached 94.23%, which was higher than 80.77% of the control group. There was a significant difference in data correspondence between groups(P < 0.05). Conclusion The clinical effect of terbutaline sulfate combined with beclomethasone in patients with acute attack stage is better than that of budesonide. It can quickly improve the respiratory function of children in a short time, make the symptoms be controlled as soon as possible, reduce the adverse drug reaction and shorten the drug use, improve parents' satisfaction and treatment effect.
Objective To compare the clinical effects of terbutaline sulphate combined with budesonide and terbutaline sulfate and beclomethasone propionate in the treatment of children with mild and moderate asthma in acute attack stage. Methods One hundred and four children with acute mild and moderate asthma treated in our hospital from April 2016 to April 2018 were selected and randomly divided into control group and treatment group, with 52 cases in each group. The control group was treated with terbutaline sulphate combined with budionide, and the treatment group was treated with terbutaline sulfate combined with beclomethasone propionate. The disappearance time of asthma symptoms and the total time of hospitalization, adverse drug reaction, total effective rate, the level of respiratory function before and after treatment, the parents' satisfaction with the treatment plan and the effect were compared in the two groups. Data were processed by SPSS18.0, χ~2 test of count data, t test of measurement data and expression in(±s), P < 0.05, the difference was statistically significant. Results The time of disappearance of asthma symptoms and the total time of hospitalization in the treatment group were shorter than those in the control group; Only 3 cases of adverse drug reactions in the treatment group, which were less than 10 cases in the control group; The total effective rate in the treatment group was 90.39%, which was superior to 63.46% in the control group; The improvement of the level of respiratory function related indexes in the treatment group before and after treatment was greater than that of the control group; And the parents' satisfaction rate of the scheme and effect reached 94.23%, which was higher than 80.77% of the control group. There was a significant difference in data correspondence between groups(P < 0.05). Conclusion The clinical effect of terbutaline sulfate combined with beclomethasone in patients with acute attack stage is better than that of budesonide. It can quickly improve the respiratory function of children in a short time, make the symptoms be controlled as soon as possible, reduce the adverse drug reaction and shorten the drug use, improve parents' satisfaction and treatment effect.
引文
[1]柳英丽,张宛夏,孙巧玲,等.孟鲁司特钠治疗病毒诱发儿童哮喘56例疗效观察[J].中国中西医结合儿科学,2013,5(2):129-130.
[2]全国儿科哮喘协作组,中国疾病预防控制中心环境与健康相关产品安全所.第三次中国城市儿童哮喘流行病学调查[J].中华儿科杂志,2013,51(10):729-735.
[3]朱桂芳,甄兴军,李建春.博利康尼联合酮替芬治疗小儿咳嗽变异性哮喘[J].中国实用医刊,2014,7(15):123-124.
[4]中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南(支气管哮喘的定义、诊断、治疗和管理方案)[J].柳州医学,2012,25(3):171-179.
[5]张良.干扰素联合布地奈德治疗小儿哮喘的疗效分析[J].深圳中西医结合杂志,2014,24(11):85-86.
[6]郭梅,符州.吸入性糖皮质激素与孟鲁司特治疗儿童哮喘疗效的Meta分析[J].重庆医学,2014,43(21):2730-2733.
[7]陈利霞,易绘,宋红梅.不同雾化吸入方法对支气管哮喘患儿的疗效观察[J].中国民族民间医药,2015,24(14):102-103.
[8]姚如婕,刘沉涛,黄榕,等.布地奈德雾化治疗对哮喘小鼠糖皮质激素受体及核因子-κB表达的影响[J].中国当代儿科杂志,2015,17(1):86-89.
[9]陈爱欢,陈荣昌,湛洁谊,等.雾化吸入高剂量糖皮质激素对儿童中重度支气管哮喘急性发作的疗效[J].中华结核和呼吸杂志,2012,35(4):269-274.
[10]陈乐,苏雯,俞善昌,等.雾化吸入丙酸倍氯米松混悬液治疗儿童轻中度哮喘急性发作有效性及安全性研究[J].中国实用儿科杂志,2015,30(8):601-604.
[11]张玲,李虎,万俊,等.三种雾化吸入方案治疗婴幼儿急性喘息疗效比较[J].儿科药学杂志,2015,21(3):15-17.
[12]冯艳梅.布地奈德与阿奇霉素联合特布他林对小儿肺炎支原体肺炎细胞因子水平及Th1/Th2指标的影响[J].中国实用医刊,2017,44(9):97-100.
[13]赵蓓,童人杰,张春芬,等.布地奈德、阿奇霉素联合特布他林治疗小儿急性支气管炎的临床观察[J].中国药房,2016,27(18):2519-2521.
[14]吴玉丽,赵晓莉,王游.阿奇霉素、β2受体兴奋剂联合糖皮质激素吸入治疗支原体感染引发小儿哮喘的临床效果研究[J].临床和实验医学杂志,2016,15(19):1880-1883.
[15]裴新昕.阿奇霉素、特布他林、孟鲁司特联用对咳嗽变异性哮喘合并感染患儿气道功能及感染程度的影响[J].海南医学院学报,2016,22(18):2167-2170.
[2]全国儿科哮喘协作组,中国疾病预防控制中心环境与健康相关产品安全所.第三次中国城市儿童哮喘流行病学调查[J].中华儿科杂志,2013,51(10):729-735.
[3]朱桂芳,甄兴军,李建春.博利康尼联合酮替芬治疗小儿咳嗽变异性哮喘[J].中国实用医刊,2014,7(15):123-124.
[4]中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南(支气管哮喘的定义、诊断、治疗和管理方案)[J].柳州医学,2012,25(3):171-179.
[5]张良.干扰素联合布地奈德治疗小儿哮喘的疗效分析[J].深圳中西医结合杂志,2014,24(11):85-86.
[6]郭梅,符州.吸入性糖皮质激素与孟鲁司特治疗儿童哮喘疗效的Meta分析[J].重庆医学,2014,43(21):2730-2733.
[7]陈利霞,易绘,宋红梅.不同雾化吸入方法对支气管哮喘患儿的疗效观察[J].中国民族民间医药,2015,24(14):102-103.
[8]姚如婕,刘沉涛,黄榕,等.布地奈德雾化治疗对哮喘小鼠糖皮质激素受体及核因子-κB表达的影响[J].中国当代儿科杂志,2015,17(1):86-89.
[9]陈爱欢,陈荣昌,湛洁谊,等.雾化吸入高剂量糖皮质激素对儿童中重度支气管哮喘急性发作的疗效[J].中华结核和呼吸杂志,2012,35(4):269-274.
[10]陈乐,苏雯,俞善昌,等.雾化吸入丙酸倍氯米松混悬液治疗儿童轻中度哮喘急性发作有效性及安全性研究[J].中国实用儿科杂志,2015,30(8):601-604.
[11]张玲,李虎,万俊,等.三种雾化吸入方案治疗婴幼儿急性喘息疗效比较[J].儿科药学杂志,2015,21(3):15-17.
[12]冯艳梅.布地奈德与阿奇霉素联合特布他林对小儿肺炎支原体肺炎细胞因子水平及Th1/Th2指标的影响[J].中国实用医刊,2017,44(9):97-100.
[13]赵蓓,童人杰,张春芬,等.布地奈德、阿奇霉素联合特布他林治疗小儿急性支气管炎的临床观察[J].中国药房,2016,27(18):2519-2521.
[14]吴玉丽,赵晓莉,王游.阿奇霉素、β2受体兴奋剂联合糖皮质激素吸入治疗支原体感染引发小儿哮喘的临床效果研究[J].临床和实验医学杂志,2016,15(19):1880-1883.
[15]裴新昕.阿奇霉素、特布他林、孟鲁司特联用对咳嗽变异性哮喘合并感染患儿气道功能及感染程度的影响[J].海南医学院学报,2016,22(18):2167-2170.