孟鲁司特钠联合丙卡特罗治疗小儿慢性咳嗽的疗效观察及其对IgE水平的影响

Clinical efficacy of montelukast sodium and procaterol for treating the children with chronic cough and its impact on serum immunoglobulin E

目的探讨孟鲁司特钠联合丙卡特罗治疗小儿慢性咳嗽的临床疗效及对血清IgE水平的影响。方法80例慢性咳嗽患儿按照随机数字表法分为治疗组和对照组，每组40例。对照组在常规治疗的基础上给予丙卡特罗治疗，治疗组在对照组治疗的基础上给予孟鲁司特钠治疗，连续治疗1个月。观察治疗后两组主要临床症状和体征改善情况，检测血清IgE水平，评价临床疗效，观察不良反应。结果治疗组临床疗效总有效率为95．0％（38／40），显著高于对照组的67．5％（27／40），两组比较差异有统计学意义（r=9．928，P〈0．01）。治疗组咳嗽缓解和消失时间分别为（24．41±8．14）d和（41．27±14．74）d，均短于对照组的（47．27±15．76）d和（57．78±20．64）d，差异有统计学意义（t=8．153、4．118，P〈0．05）。治疗后，治疗组和对照组血清IgE水平与治疗前比较均显著下降[（295．27±105．45）μg/L 比（594．48±198．16）μg/L，（427．78±152．78）μg/L／L比（567．21±189．07）μg/Lg／L，t=8．430、3．628，P〈0．05]，且治疗组治疗后血清IgE水平显著低于对照组（t=4．515，P〈0．05）。两组均无严重不良反应发生。结论血清IgE在小儿慢性咳嗽的发病中起着很重要的作用，孟鲁司特钠联合丙卡特罗治疗小儿慢性咳嗽是一种安全、有效的治疗方法，值得临床推广应用。

Objective To investigate the clinical efficacy of montelukast sodium and procaterol for treating the children with chronic cough and its impact on serum immunoglobulin E （IgE）. Methods Eighty cases of children with chronic cough were divided into treatment group and control group by random digits table method with 40 cases each. The control group was given procaterol treatment on the basis of conventional treatment, and the treatment group was added montelukast sodium on the basis of treatment of control group. Treatment course was 1 month. Before and after treatment, the clinical symptoms and signs in the two groups were observed, the serum IgE level was detected, the clinical efficacy was evaluated,and the adverse reaction was observed. Results The total effective rate in the treatment group was 95.0% （38/40）, the control group was 67.5% （27/40）, and the difference was significant （ X2 = 9.928,P 〈 0.01 ）. The time of cough mitigation and disappearance in the treatment group was （24.41 ＋ 8.14） d and （41.27 ~ 14.74） d, which was lower than that in the control group [（47.27 ~ 15.76） d and （57.78 ±20.64） d],and the difference was significant （t = 8.153,4.118, P 〈 0.05 ）. After treatment, the serum IgE level in the treatment group and control group significantly decreased [ （295.27 ± 105.45）it g/L vs. （594.48 ± 198.16）μg/L, （427.78± 152.78 ） μg/L vs. （567.21 ± 189.07 ） μg/L, t = 8.430, 3.628, P 〈 0.05 ], and the difference was significant between them （t = 4.515 ,P 〈 0.05）. There were no serious adverse reactions in two groups.Conclusions The serum IgE may play an important role in the incidence of children with chronic cough, and montelukast sodium and procaterol for treating the children with chronic cough is safe, effective and worthy of clinical application.