孟鲁司特钠联合布地奈德治疗89例儿童哮喘的临床研究
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摘要
目的探究孟鲁司特钠联合布地奈德治疗89例儿童哮喘的临床疗效,为儿童哮喘的治疗提供理论依据。方法选取2015年12月—2016年12月于陕西省人民医院治疗的89例哮喘患儿,采用病历资料回顾性分析的方式进行疗效比较,将采用孟鲁司特钠联合布地奈德治疗的48例患儿设为观察组,采用布地奈德治疗的41例患儿设为对照组。连续治疗3个月后比较临床疗效,并比较2组患儿咳嗽、憋喘消失时间,采用酶联免疫吸附试验(ELISA)检测治疗前后血清降钙素原(procalcitonin,PCT)、C-反应蛋白(C-reactive protein,CRP)水平,并检测免疫球蛋白E(Ig E)水平,同时对治疗前后肺功能指标[肺活量(FVC)、1 s用力呼气量(FEV1),FEV1/FVC比值]进行对比,并跟踪随访记录复发率及不良反应发生率。结果观察组治疗总有效率为95.83%,显著高于对照组(85.37%),差异有统计学意义(P<0.05);观察组咳嗽、憋喘消失时间均显著低于对照组,差异有统计学意义(P<0.05);2组治疗前后PCT、CRP、Ig E水平均显著降低,且治疗后观察组显著低于对照组,差异有统计学意义(P<0.05);2组治疗后FVC、FEV1、FEV1/FVC均显著升高,且治疗后观察组显著高于对照组,差异有统计学意义(P<0.05);2组不良反应发生率差异无统计学意义(P>0.05),观察组复发率显著低于对照组,差异有统计学意义(P<0.05)。结论相较于单独使用布地奈德治疗,联合孟鲁司特钠治疗能显著提升儿童哮喘的临床疗效,降低复发率,降低机体炎症反应,提升肺功能。
Objective To explore the clinical efficacy of Montelukast sodium combined with budesonide in the treatment of 89 children with asthma, and to provide data for treatment of asthma in children. Methods This study enrolled 89 children with asthma treated between December 2015 and December 2016 in Shanxi Provinciar Reople's Hospital. The clinical data was retrospectively analyzed to compare the curative effect. 48 of these cases who received Montelukast sodium combined with budesonide treatment were assigned to the observation group, while 41 of these children who received budesonide treatment were selected as the control group. Clinical efficacy was compared after three consecutive months of treatment, so were cough and wheeze extinction time of the two groups. Preoperative and postoperative levels of serum procalcitonin(PCT) and C-reactive protein(CRP) of the two groups were detected through enzyme-linked immunosorbent assay(ELISA), and the immunoglobulin E(IgE) level was determined. At the same time,pulmonary function indexes before and after treatment were compared, and the recurrence and adverse reactions were recorded within the follow-up period. Results The total effective rate of the observation group was 95.83%, which was significantly higher than that of the control group(85.37%), so the difference was of statistical significance(P<0.05). The cough and wheeze extinction time of the observation group was significantly shorter than that of the control group(P<0.05). PCT, CRP, and IgE levelsof the two groups were significantly decreased after treatment, especially in the observation group, and the difference was statistically significant(P<0.05). FVC, FEV1 and FEV1/FVC levels of the two group were significantly increased after treatment, especially in the observation group, and the difference between the two groups was of statistical significance(P<0.05).The incidence of adverse reactions of the two groups was not significantly different(P>0.05), but the recurrence rate of the observation group was significantly lower than that of the control group(P<0.05). Conclusion Compared with budesonide treatment alone, the combined treatment with Montelukast sodium can significantly improve clinical efficacy of asthma in children, reduce recurrence and inflammatory responses, and enhance lung function as well.
Objective To explore the clinical efficacy of Montelukast sodium combined with budesonide in the treatment of 89 children with asthma, and to provide data for treatment of asthma in children. Methods This study enrolled 89 children with asthma treated between December 2015 and December 2016 in Shanxi Provinciar Reople's Hospital. The clinical data was retrospectively analyzed to compare the curative effect. 48 of these cases who received Montelukast sodium combined with budesonide treatment were assigned to the observation group, while 41 of these children who received budesonide treatment were selected as the control group. Clinical efficacy was compared after three consecutive months of treatment, so were cough and wheeze extinction time of the two groups. Preoperative and postoperative levels of serum procalcitonin(PCT) and C-reactive protein(CRP) of the two groups were detected through enzyme-linked immunosorbent assay(ELISA), and the immunoglobulin E(IgE) level was determined. At the same time,pulmonary function indexes before and after treatment were compared, and the recurrence and adverse reactions were recorded within the follow-up period. Results The total effective rate of the observation group was 95.83%, which was significantly higher than that of the control group(85.37%), so the difference was of statistical significance(P<0.05). The cough and wheeze extinction time of the observation group was significantly shorter than that of the control group(P<0.05). PCT, CRP, and IgE levelsof the two groups were significantly decreased after treatment, especially in the observation group, and the difference was statistically significant(P<0.05). FVC, FEV1 and FEV1/FVC levels of the two group were significantly increased after treatment, especially in the observation group, and the difference between the two groups was of statistical significance(P<0.05).The incidence of adverse reactions of the two groups was not significantly different(P>0.05), but the recurrence rate of the observation group was significantly lower than that of the control group(P<0.05). Conclusion Compared with budesonide treatment alone, the combined treatment with Montelukast sodium can significantly improve clinical efficacy of asthma in children, reduce recurrence and inflammatory responses, and enhance lung function as well.
引文
[1]李玲,苟洪波,亚娜,等.孟鲁司特钠联合布地奈德治疗小儿咳嗽变异性哮喘的疗效研究[J].重庆医学,2013(34):4 198-4 199.
[2]李永梅,宋梅,杜昊.布地奈德联合孟鲁司特治疗小儿支气管哮喘疗效观察[J].现代中西医结合杂志,2013,22(32):3 567-3 568.
[3]周素香,齐红梅,李丽萍.孟鲁司特联合布地奈德治疗儿童哮喘临床疗效及对炎症因子的影响[J].临床肺科杂志,2013,18(12):2 266-2 268.
[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(2016年版)[J].中华结核和呼吸杂志,2016,39(9):675-697.
[5]崔嗣庚.孟鲁司特联合布地奈德治疗哮喘急性发作的临床疗效及安全性分析[J].临床肺科杂志,2013,18(1):133-134.
[6]任蕊.布地奈德气雾剂联合孟鲁司特治疗小儿哮喘的临床效果分析[J].中国继续医学教育,2016,8(22):167-168.
[7]陆立东,黄建萍,华敏,等.孟鲁司特钠联合异丙托溴铵和布地奈德在儿童肺感染咳嗽中的应用[J].中国妇幼保健,2013,28(25):4 172-4 174.
[8]张茜.通窍鼻炎颗粒联合孟鲁司特钠、布地奈德治疗变应性鼻炎临床疗效及对炎性因子的影响[J].海南医学院学报,2016,22(11):1 170-1 172.
[9]罗经维,李曾玉.孟鲁司特钠联合布地奈德雾化吸入治疗小儿咳嗽变异性哮喘的临床疗效[J].临床合理用药,2015,8(8C):30-31.
[10]苏丽霞.孟鲁司特钠联合布地奈德雾化吸入治疗儿童感染后咳嗽临床观察[J].北京医学,2015,31(4):366-368.
[11]Rajanandh MG,Nageswari AD,Ilango K.Assessment of montelukast sodium,doxofylline,and tiotropium with budesonide for the treatment of asthma:which is the best among the second-line treatment?a randomized trial[J].Clin Ther,2015,37(2):418-426.
[12]吴兆海,李宏明.孟鲁司特钠联合不同剂量布地奈德治疗毛细支气管炎临床疗效及安全性评价[J].河北医学,2016,22(3):367-369.
[13]于海梅,高捷,钟晓,等.口服孟鲁司特钠联合布地奈德及复方异丙托溴氨雾化治疗儿童支气管哮喘前后单核细胞趋化蛋白-4的变化情况[J].中国药物与临床,2017,17(4):553-556.
[14]黄莉萍,王洁.孟鲁司特钠联合布地奈德以及季节性服用孟鲁司特钠防治儿童哮喘[J].现代中西医结合杂志,2013,22(8):864-865.
[15]殷华克.布地奈德联合孟鲁司特钠治疗小儿咳嗽变异性哮喘的效果观察[J].临床医学工程,2015,22(1):55-56.
[2]李永梅,宋梅,杜昊.布地奈德联合孟鲁司特治疗小儿支气管哮喘疗效观察[J].现代中西医结合杂志,2013,22(32):3 567-3 568.
[3]周素香,齐红梅,李丽萍.孟鲁司特联合布地奈德治疗儿童哮喘临床疗效及对炎症因子的影响[J].临床肺科杂志,2013,18(12):2 266-2 268.
[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(2016年版)[J].中华结核和呼吸杂志,2016,39(9):675-697.
[5]崔嗣庚.孟鲁司特联合布地奈德治疗哮喘急性发作的临床疗效及安全性分析[J].临床肺科杂志,2013,18(1):133-134.
[6]任蕊.布地奈德气雾剂联合孟鲁司特治疗小儿哮喘的临床效果分析[J].中国继续医学教育,2016,8(22):167-168.
[7]陆立东,黄建萍,华敏,等.孟鲁司特钠联合异丙托溴铵和布地奈德在儿童肺感染咳嗽中的应用[J].中国妇幼保健,2013,28(25):4 172-4 174.
[8]张茜.通窍鼻炎颗粒联合孟鲁司特钠、布地奈德治疗变应性鼻炎临床疗效及对炎性因子的影响[J].海南医学院学报,2016,22(11):1 170-1 172.
[9]罗经维,李曾玉.孟鲁司特钠联合布地奈德雾化吸入治疗小儿咳嗽变异性哮喘的临床疗效[J].临床合理用药,2015,8(8C):30-31.
[10]苏丽霞.孟鲁司特钠联合布地奈德雾化吸入治疗儿童感染后咳嗽临床观察[J].北京医学,2015,31(4):366-368.
[11]Rajanandh MG,Nageswari AD,Ilango K.Assessment of montelukast sodium,doxofylline,and tiotropium with budesonide for the treatment of asthma:which is the best among the second-line treatment?a randomized trial[J].Clin Ther,2015,37(2):418-426.
[12]吴兆海,李宏明.孟鲁司特钠联合不同剂量布地奈德治疗毛细支气管炎临床疗效及安全性评价[J].河北医学,2016,22(3):367-369.
[13]于海梅,高捷,钟晓,等.口服孟鲁司特钠联合布地奈德及复方异丙托溴氨雾化治疗儿童支气管哮喘前后单核细胞趋化蛋白-4的变化情况[J].中国药物与临床,2017,17(4):553-556.
[14]黄莉萍,王洁.孟鲁司特钠联合布地奈德以及季节性服用孟鲁司特钠防治儿童哮喘[J].现代中西医结合杂志,2013,22(8):864-865.
[15]殷华克.布地奈德联合孟鲁司特钠治疗小儿咳嗽变异性哮喘的效果观察[J].临床医学工程,2015,22(1):55-56.