孟鲁司特联合布地奈德治疗支气管哮喘急性发作期患儿的效果及对免疫和肺功能的影响

Effect of Montelukast Combined with Budesonide in the Treatment of Children with Acute Attack of Bronchial Asthma and Its Influence on Immune Function and Lung Function

目的探讨孟鲁司特联合布地奈德治疗支气管哮喘急性发作期患儿的临床效果及对免疫功能和肺功能的影响。方法选取2018年7月—2019年8月收治的110例支气管哮喘急性发作期患儿,根据治疗方法的不同分为观察组58例和对照组52例。对照组在常规治疗基础上加用布地奈德治疗,观察组在对照组基础上联合孟鲁司特治疗,2组疗程均为2周。比较2组的临床疗效,治疗前后的免疫功能指标以及第1秒用力呼气容积(FEV 1)、最大呼气峰流速(PEF)、用力肺活量(FVC)、25%肺活量呼气流速(FEF 25)水平,并观察治疗期间不良反应发生情况。结果观察组的治疗总有效率高于对照组(P<0.01)。治疗后,2组IgA、IgG、IgM、CD3+、CD4+、CD4+/CD8+、FEV 1、FVC、PEF、FEF 25水平均高于治疗前,IgE和CD8+水平低于治疗前,且观察组IgA、IgG、IgM、CD3+、CD4+、CD4+/CD8+、FEV 1、FVC、PEF、FEF 25升高程度和IgE、CD8+降低程度均大于对照组(P<0.05或P<0.01)。2组治疗期间总不良反应发生率比较差异无统计学意义(P>0.05)。结论孟鲁司特联合布地奈德治疗支气管哮喘急性发作期患儿,可显著提高临床效果,有效缓解临床症状,降低气道高反应性,改善患儿免疫功能及肺功能,且安全性良好。

Objective To investigate the effect of Montelukast Combined with Budesonide in the treatment of children with acute attack of bronchial asthma and its influence on immune function and lung function.Methods A total of 110 children with acute attack of bronchial asthma admitted from July 2018 to August 2019 were selected and divided into observation group(n=58)and control group(n=52)according to different treatment methods.The control group was treated with Budesonide on the basis of conventional treatment,and the observation group was treated with Montelukast on the basis of the control group.The course of treatment in both groups was two weeks.The clinical efficacy of the two groups,the immune function indexes before and after treatment,and the forced expiratory volume in 1 second(FEV 1),maximum expiratory peak flow rate(PEF),forced vital capacity(FVC),and 25%vital capacity expiratory flow rate(FEF 25)were compared,and the occurrence of adverse reactions during treatment was observed.Results The total effective rate of treatment in the observation group was higher than that in the control group(P<0.01).After treatment,the levels of IgA,IgG,IgM,CD3+,CD4+,CD4+/CD8+,FEV 1,FVC,PEF and FEF 25 in both groups were higher than those before treatment,and the levels of IgE and CD8+were lower than those before treatment.The increase in IgA,IgG,IgM,CD3+,CD4+,CD4+/CD8+,FEV 1,FVC,PEF,FEF 25 in the observation group and the decrease in IgE and CD8+were greater than those in the control group(P<0.05 or P<0.01).There was no significant difference in the incidence of total adverse reactions between the two groups(P>0.05).Conclusion In the treatment of children with acute attack of bronchial asthma,Montelukast combined with Budesonide can significantly improve the clinical effect,effectively alleviate the clinical symptoms,reduce the airway hyperresponsiveness,and improve the immune function and lung function of children,with good safety.