白三烯拮抗剂与糖皮质激素治疗轻、中度毛细支气管炎的疗效比较

Compare with Leukotriene Antagonists and Glucocorticoid Treatment on Mild to Moderate Bronchiolitis

目的:比较白三烯拮抗剂与糖皮质激素治疗小儿轻、中度毛细支气管炎(简称毛支)的疗效。方法:83例符合入组标准并完成观察的轻中度毛支患儿随机分为Ⅰ组、Ⅱ组、Ⅲ组,3组患儿均按毛支常规治疗,Ⅰ组为对照组不用激素及白三烯拮抗剂孟鲁司特,Ⅱ组加用孟鲁司特4mg·d-1,Ⅲ组加用强的松1～2mg·kg-1·d-1分3次口服。观察患儿的喘息及肺部哮鸣音消失天数。结果:Ⅰ组、Ⅱ组、Ⅲ组患儿喘息消失天数分别为5.14±1.73、4.81±1.56、7.39±1.94,Ⅱ组的治愈天数最少,与Ⅲ组比较有显著差异,但与对照组相比无显著差异。结论:白三烯拮抗剂治疗小儿轻、中度毛细支气管炎的疗效优于激素,提示轻中度毛支患儿不宜加用激素治疗。

Objective：To compare leukotriene antagonists and glucocorticoids effect on children with mild to moderate bronchiolitis. Methods：Eight three cases accord with the study standards and complete observation of children with mild to moderate broncbiolitis were random assigned into Ⅰ, Ⅱ or Ⅲ group. On the basis of conventional therapy, group Ⅰ was the control group （without any glucocorticoid and leukotriene antagonist）; Group Ⅱ was was treated with leukotriene antagonist （montelukast） 4mg/d, Group Ⅲ was treated with prednisone 1-2 mg·kg^-1·d^-1 divided into 3 times oraled. Observation the wheezing disappeared days in all patients. Results： The wheezing disappeared days about the three groups are 5.14 ± 1.73, 4.81 ± 1.56 and 7.39±1.94,respectively. Montelukast Group clinically more effective than Glucocorticoid Group, but no statistical difference with control Group. Conclusion： Leukotriene antagonist more effective than Glucocorticoids on children with mild to moderate bronchiolitis, it is suggested that in the treatment of mild to moderate bronchiolitis, we can use the leukotriene antagonist with out glucocorticoids.