孟鲁司特联合阿奇霉素治疗小儿副鼻窦炎引起的慢性咳嗽

Clinical study on the therapeutic efficacy of combination therapy of montelukast and azithromycin on chronic cough caused by rhinosinusitis in children

目的:观察孟鲁司特联合阿奇霉素治疗小儿副鼻窦炎引起的慢性咳嗽的疗效。方法:采用随机、双盲对照的方法,对副鼻窦炎引起慢性咳嗽的患儿给予阿奇霉素口服,连服3 d,停药7 d为1疗程。治疗组阿奇霉素服用3个疗程,同时口服孟鲁司特,1次/d;对照组阿奇霉素服用至观察疗效终点同时口服安慰剂。比较两组治疗后1周咳嗽评分、8周内咳嗽完全缓解天数、治疗8周副鼻窦CT情况。结果:治疗1周咳嗽评分、8周内咳嗽完全缓解时间、副鼻窦CT完全恢复正常例数三项指标两组比较差异均有统计学意义(P<0.05)。结论:孟鲁司特联合阿奇霉素治疗小儿副鼻窦炎引起的慢性咳嗽与单用阿奇霉素比较,咳嗽缓解得更快,观察期间无咳嗽症状的时间更多,副鼻窦积液清除更快,且可以减少阿奇霉素的用量。

Objective： To observe the therapeutic efiqcacy of combinated montelukast and zithromycin therapy on chronic cough caused by rhinosinusltis in children. Methods： A randomized and double-blinded comparison study was carried out. Sixty children with chronic cough of rhinosinusitis were randomly divided into two groups with the same number each. One group received the therapy of combined montelukast and azithrommycin, and the other group received montelukast only as the control group. Total study period was eight weeks. One course of montelukast treatment defined administrating drugs for three days and discontinuing for seven days. The control group received montelukast for initial three periods of treatment and azithromycin once daily during the whole eight weeks. Two groups were compared in the following aspects including one-week cough scores, the time for entire clearance of coughing in the eight weeks and rhinosinus CT images at the end of the study period. Results： Regarding to one-week cough score, the entirely-clearance of coughing in the eight weeks, rhinosinus CT images at the end of study period, there were statistically significant differences between two groups （ P 〈 0.05）. Conclusions： Compared with the method of using montelukast only, the combination montelukast and azithromycin therapy is safe and more effective. That combined therapy can release cough caller with less dosage of montelukast than the therapy of receiving montelukast only. The fluid of rhinosinus can disappear more quickly.