孟鲁司特治疗儿童咳嗽变异性哮喘疗效研究

Clinical Curative Effect of Montelukast on Cough Variation Asthma(CVA) in Children

目的：探讨孟鲁司特口服治疗儿童咳嗽变异性哮喘（CVA）的临床疗效。方法：将48例4-14岁确诊为CVA的患儿依数字随机法分为治疗组与对照组。治疗组25例,口服孟鲁司特每日1次（6-14岁5 mg,4-5岁4 mg）,并吸入布地奈德气雾剂1次（每次1喷,含量200μg）,对照组23例吸入布地奈德每日两次（每次1喷,每喷含量200μg）,两组均使用储雾罐吸入,疗程12周。观察3 d、1周、2周、4周和12周咳嗽改善情况,测量治疗前及治疗后1周、2周、4周、12周呼气峰流速（PEF）,计算PEF占预计值的百分比（PEF%pred）,记录患儿对治疗的感受及治疗中的不良反应。结果：治疗后两组咳嗽均有改善,治疗组治疗后3 d、1周咳嗽改善情况明显优于对照组（P〈0.01）,第2周时两组无显著性差异（P〉0.05）,两组治疗后PEF%pred与治疗前相比,均有明显上升（P〈0.01）,治疗组治疗后1周、2周、4周PEF%pred改善程度优于对照组（P〈0.01）。结论：孟鲁司特治疗儿童CVA起效快、疗效佳,可减少糖皮质激素用量。

Objective： To investigate the clinical curative effect of Montelukast taken orally on cough variation asthma（CVA） in children. Methods： All the 48 examples aged from 4 - 14 years old diagnosed CVA were divided into treatment group （n = 25 ） and control group （n = 23 ） randomly. The children in treatment group took Montelukast orally 1 time a day（5mg/time for 6- 14 years old, 4 mg/time for 4- 6 years old） and inhaled Budesenide Aerosol qd （each time 1 spurt, content 200μg）, and those in control group inhaled Budesenide Aerosol bid（each time 1 spurt, content 200μg ） only. Both groups inhaled Budesonide Aerosol with spacers and were observed for 12 weeks. Symptoms, peak expiratory flow rates （PEF）, percentage of PEF to predicted value（ PEF% pred） and side effects were recorded before and after treatment 3rd day, 1 week, 2 week, 4 week and 12 week. Result： Both of the groups could reduce symptoms such as cough, and treatment group had better effect than control group（P 〈 0.01 ） at 3rd day, 1 week after treatment, but there was not different between the two groups from 2 weeks after treatment. PEF% pred increased in both the groups after treatment, but it increased more remarkable 1 week, 2 week and 4 week after treatment in treatment group than in control group. Conclusion： Montelukast has more quickly and better effect on CVA in children than glucocorticoid and can reduce the dose used of the latter.