红霉素、布地奈德联合重组人干扰素1b治疗小儿闭塞性细支气管炎的临床研究
|
摘要
目的探讨红霉素、布地奈德联合重组人干扰素α1b治疗小儿闭塞性细支气管炎(BO)的临床效果及安全性。方法选取2012年1月～2016年6月河北省保定市第二中心医院收治的82例BO患儿,按照随机数字表法将其分为对照组(n=41)和观察组(n=41)。对照组给予小剂量红霉素联合布地奈德治疗,观察组给予小剂量红霉素、布地奈德联合重组人干扰素α1b治疗,两组均治疗7 d。观察并比较两组临床疗效、喘憋消失时间、咳嗽消失时间、气促消失时间、肺部啰音消失时间、治疗前后呼吸频率(RR)、潮气量(VT)、呼吸时间比(Ti/Te)、血清γ干扰素(IFN-γ)、白细胞介素-4(IL-4)水平及不良反应情况。结果观察组的临床总有效率明显高于对照组,差异有统计学意义(P <0.05)。观察组的喘憋消失时间、咳嗽消失时间、气促消失时间及肺部啰音消失时间均明显短于对照组,差异有统计学意义(P <0.05)。两组治疗后RR、Ti/Te、血清IFN-γ水平较治疗前降低,VT、血清IL-4水平较治疗前升高,且观察组治疗后RR、VT、Ti/Te及血清IFN-γ、IL-4水平的改善幅度大于对照组治疗后(P <0.05)。两组治疗过程中均未出现严重的不良反应。结论红霉素、布地奈德联合重组人干扰素α1b治疗小儿BO的临床效果显著,能够明显改善临床症状,改善肺功能和炎性反应,且安全性较好。
Objective To investigate the clinical effect and safety of Erythromycin and Budesonide combined with recombinant human interferon α1 b in the treatment of pediatric bronchiolitis obliteratus(BO). Methods From January2012 to June 2016, 82 children with BO in the Second Center Hospital of Baoding were selected, and they were divided into the control group(n = 41) and observation group(n = 41) according to the random number table method. The control group were given low dose of Erythromycin combined with Budesonide, and the observation group was treated with low dose of Erythromycin combined with Budesonide and recombinant human interferon α1 b, the two groups were treated for 7 days. The clinical efficacy, wheezing and holding disappeared time, cough disappeared time, shortness of breath disappeared time, lung rale disappeared time, respiratory rate(RR), tidal volume(VT), respiratory time ratio(Ti/Te), serum gamma interferon(IFN-γ), interleukin-4(IL-4) levels and adverse reactions were observed and compared between the two groups. Results The total clinical effective rate of the observation group was significantly higher than that of the control group, and the difference was statistically significant(P < 0.05). The disappearance times of wheezing and holding, cough, shortness of breath and lung rale in the observation group were significantly shorter than that in the control group(P < 0.05). After treatment, the RR,Ti/Te and serum IFN-γ levels in the two groups were lower than that before treatment, and the VT and serum IL-4 levels were higher than that before treatment. The RR, VT, Ti/Te and serum IFN-γ and IL-4 levels in the observation group were significantly improved than those in the control group(P < 0.05). No serious adverse reactions occurred during the treatment in both groups. Conclusion Erythromycin, Budesonide combined with recombinant human interferon α1 b in the treatment of pediatric BO has a significant clinical effect, can significantly improve the clinical symptoms, improve pulmonary function and inflammatory response, and better safety.
Objective To investigate the clinical effect and safety of Erythromycin and Budesonide combined with recombinant human interferon α1 b in the treatment of pediatric bronchiolitis obliteratus(BO). Methods From January2012 to June 2016, 82 children with BO in the Second Center Hospital of Baoding were selected, and they were divided into the control group(n = 41) and observation group(n = 41) according to the random number table method. The control group were given low dose of Erythromycin combined with Budesonide, and the observation group was treated with low dose of Erythromycin combined with Budesonide and recombinant human interferon α1 b, the two groups were treated for 7 days. The clinical efficacy, wheezing and holding disappeared time, cough disappeared time, shortness of breath disappeared time, lung rale disappeared time, respiratory rate(RR), tidal volume(VT), respiratory time ratio(Ti/Te), serum gamma interferon(IFN-γ), interleukin-4(IL-4) levels and adverse reactions were observed and compared between the two groups. Results The total clinical effective rate of the observation group was significantly higher than that of the control group, and the difference was statistically significant(P < 0.05). The disappearance times of wheezing and holding, cough, shortness of breath and lung rale in the observation group were significantly shorter than that in the control group(P < 0.05). After treatment, the RR,Ti/Te and serum IFN-γ levels in the two groups were lower than that before treatment, and the VT and serum IL-4 levels were higher than that before treatment. The RR, VT, Ti/Te and serum IFN-γ and IL-4 levels in the observation group were significantly improved than those in the control group(P < 0.05). No serious adverse reactions occurred during the treatment in both groups. Conclusion Erythromycin, Budesonide combined with recombinant human interferon α1 b in the treatment of pediatric BO has a significant clinical effect, can significantly improve the clinical symptoms, improve pulmonary function and inflammatory response, and better safety.
引文
[1]张詹明,李昌崇.儿童闭塞性细支气管炎研究进展[J].温州医科大学学报,2018,48(8):618-621.
[2]唐艳姣,黄寒,钟礼立.儿童闭塞性细支气管炎研究进展[J].临床儿科杂志,2018,36(7):563-568.
[3]李学梅.小剂量红霉素辅助治疗小儿毛细支气管炎的临床效果[J].影像研究与医学应用,2018,2(18):215-216.
[4]刘后存.特布他林联合布地奈德雾化吸入治疗儿童感染后闭塞性细支气管炎疗效观察[J].新乡医学院学报,2017,34(10):943-945.
[5]毛庆东.重组人干扰素α2b氧驱雾化吸入佐治毛细支气管炎疗效及安全性观察[J].中国临床药理学与治疗学,2018,23(8):927-931.
[6]胡亚美,江载芳.诸福棠实用儿科学[M].7版.北京:人民卫生出版社,2002:668-692.
[7]王卫平.儿科学[M].北京:人民卫生出版社,2013:100-112.
[8]李丽丽.儿童闭塞性细支气管炎的病因病机及中医药治疗研究进展[J].医疗装备,2018,31(14):199-200.
[9]唐辉英,宋萍,付丹.闭塞性细支气管炎患儿的临床特点和肺部CT特征分析[J].中国当代医药,2018,25(20):69-71,78.
[10]丁淑玉,李亚伟,杨新丽,等.小儿纤维支气管镜联合小剂量红霉素和糖皮质激素治疗小儿闭塞性细支气管炎的疗效观察[J].临床医药文献电子杂志,2017,4(8):1458-1460.
[11]马苗苗,王斌锋,杨永红,等.小剂量红霉素辅助治疗小儿毛细支气管炎的临床效果[J].广西医学,2018,40(2):143-144.
[12]王育.对比红霉素与阿奇霉素治疗肺炎支原体感染的临床效果[J].中外医学研究,2017,15(31):27-28.
[13]钱晋.沙丁胺醇、布地奈德雾化吸入治疗毛细支气管炎疗效观察[J].中国现代药物应用,2016,10(6):129-130.
[14]李红菊,杜淑珍,李红菊,等.布地奈德联合特布他林对哮喘急性期的治疗效果观察[J].中国医药,2017,12(3):347-351.
[15]陈国松.孟鲁司特钠联合布地奈德治疗小儿咳嗽变异性哮喘的效果[J].中外医学研究,2017,15(36):177-179.
[16]黄亚平,牛文泽,黄卫良,等.重组干扰素α2b联合布地奈德、异丙托溴铵雾化治疗小儿毛细支气管炎疗效观察[J].解放军医学院学报,2018,39(8):688-690,722.
[17]康利娜,成芳,安红,等.雾化吸入重组人干扰素α1b治疗小儿毛细支气管炎的临床观察[J].中国药房,2016,27(6):758-760.
[18]王翠.布地奈德联合重组人干扰素α-2b雾化吸入对毛细支气管炎患儿症状改善及康复进程的影响[J].北方药学,2018,15(8):71-72.
[19]宁亚灵,杨月敏,成佳文.重组人干扰素α1b联合丙酸氟替卡松治疗毛细支气管炎的临床研究[J].现代药物与临床,2018,33(8):1974-1977.
[20]张爱明.阿奇霉素静脉滴注联合布地奈德雾化吸入治疗儿童闭塞性细支气管炎临床观察[J].儿科药学杂志,2017,23(6):15-18.
[21]马雪萍.布地奈德联合重组人干扰素α-2b雾化吸入治疗小儿毛细支气管炎的临床疗效分析[J].中国实用医药,2017,12(24):123-124.
[22]魏忠明.重组人干扰素α2b雾化吸入治疗毛细支气管炎疗效观察[J].中国社区医师,2017,33(23):20-21.
[23]杨婷,饶花平,金世杰,等.特布他林联合布地奈德雾化吸入治疗小儿感染后闭塞性细支气管炎临床观察[J].儿科药学杂志,2016,22(7):19-21.
[24]徐东,许华平,胡俊杰,等.雾化吸入重组人干扰素α-2b治疗婴幼儿毛细支气管炎的多中心研究[J].中国妇幼保健,2016,31(22):4770-4771.
[25]余杜生.红霉素联合阿奇霉素序贯疗法与阿奇霉素序贯疗法治疗小儿支原体肺炎的疗效及安全性对比[J].中国医药科学,2017,7(20):75-78.
[26]周金君.红霉素联合人静脉推注免疫球蛋白治疗35例毛细支气管炎临床分析[J].吉林医学,2013,34(36):7660.
[27]方炜.布地奈德联合阿奇霉素治疗小儿肺炎支原体感染的临床效果分析[J].中国现代医生,2017,55(4):68-70.
[2]唐艳姣,黄寒,钟礼立.儿童闭塞性细支气管炎研究进展[J].临床儿科杂志,2018,36(7):563-568.
[3]李学梅.小剂量红霉素辅助治疗小儿毛细支气管炎的临床效果[J].影像研究与医学应用,2018,2(18):215-216.
[4]刘后存.特布他林联合布地奈德雾化吸入治疗儿童感染后闭塞性细支气管炎疗效观察[J].新乡医学院学报,2017,34(10):943-945.
[5]毛庆东.重组人干扰素α2b氧驱雾化吸入佐治毛细支气管炎疗效及安全性观察[J].中国临床药理学与治疗学,2018,23(8):927-931.
[6]胡亚美,江载芳.诸福棠实用儿科学[M].7版.北京:人民卫生出版社,2002:668-692.
[7]王卫平.儿科学[M].北京:人民卫生出版社,2013:100-112.
[8]李丽丽.儿童闭塞性细支气管炎的病因病机及中医药治疗研究进展[J].医疗装备,2018,31(14):199-200.
[9]唐辉英,宋萍,付丹.闭塞性细支气管炎患儿的临床特点和肺部CT特征分析[J].中国当代医药,2018,25(20):69-71,78.
[10]丁淑玉,李亚伟,杨新丽,等.小儿纤维支气管镜联合小剂量红霉素和糖皮质激素治疗小儿闭塞性细支气管炎的疗效观察[J].临床医药文献电子杂志,2017,4(8):1458-1460.
[11]马苗苗,王斌锋,杨永红,等.小剂量红霉素辅助治疗小儿毛细支气管炎的临床效果[J].广西医学,2018,40(2):143-144.
[12]王育.对比红霉素与阿奇霉素治疗肺炎支原体感染的临床效果[J].中外医学研究,2017,15(31):27-28.
[13]钱晋.沙丁胺醇、布地奈德雾化吸入治疗毛细支气管炎疗效观察[J].中国现代药物应用,2016,10(6):129-130.
[14]李红菊,杜淑珍,李红菊,等.布地奈德联合特布他林对哮喘急性期的治疗效果观察[J].中国医药,2017,12(3):347-351.
[15]陈国松.孟鲁司特钠联合布地奈德治疗小儿咳嗽变异性哮喘的效果[J].中外医学研究,2017,15(36):177-179.
[16]黄亚平,牛文泽,黄卫良,等.重组干扰素α2b联合布地奈德、异丙托溴铵雾化治疗小儿毛细支气管炎疗效观察[J].解放军医学院学报,2018,39(8):688-690,722.
[17]康利娜,成芳,安红,等.雾化吸入重组人干扰素α1b治疗小儿毛细支气管炎的临床观察[J].中国药房,2016,27(6):758-760.
[18]王翠.布地奈德联合重组人干扰素α-2b雾化吸入对毛细支气管炎患儿症状改善及康复进程的影响[J].北方药学,2018,15(8):71-72.
[19]宁亚灵,杨月敏,成佳文.重组人干扰素α1b联合丙酸氟替卡松治疗毛细支气管炎的临床研究[J].现代药物与临床,2018,33(8):1974-1977.
[20]张爱明.阿奇霉素静脉滴注联合布地奈德雾化吸入治疗儿童闭塞性细支气管炎临床观察[J].儿科药学杂志,2017,23(6):15-18.
[21]马雪萍.布地奈德联合重组人干扰素α-2b雾化吸入治疗小儿毛细支气管炎的临床疗效分析[J].中国实用医药,2017,12(24):123-124.
[22]魏忠明.重组人干扰素α2b雾化吸入治疗毛细支气管炎疗效观察[J].中国社区医师,2017,33(23):20-21.
[23]杨婷,饶花平,金世杰,等.特布他林联合布地奈德雾化吸入治疗小儿感染后闭塞性细支气管炎临床观察[J].儿科药学杂志,2016,22(7):19-21.
[24]徐东,许华平,胡俊杰,等.雾化吸入重组人干扰素α-2b治疗婴幼儿毛细支气管炎的多中心研究[J].中国妇幼保健,2016,31(22):4770-4771.
[25]余杜生.红霉素联合阿奇霉素序贯疗法与阿奇霉素序贯疗法治疗小儿支原体肺炎的疗效及安全性对比[J].中国医药科学,2017,7(20):75-78.
[26]周金君.红霉素联合人静脉推注免疫球蛋白治疗35例毛细支气管炎临床分析[J].吉林医学,2013,34(36):7660.
[27]方炜.布地奈德联合阿奇霉素治疗小儿肺炎支原体感染的临床效果分析[J].中国现代医生,2017,55(4):68-70.