5周岁以下儿童轻度持续性哮喘临床疗效观察

The observation of clinic treatment of children with mild persistent asthma

目的比较轻度持续性哮喘儿童的治疗中各方案间的疗效差异。方法将105名5周岁以下轻度持续性哮喘患儿随机分为两组,分别给予抗白三烯(LTRA)、吸入激素(ICS)治疗并监测呼气峰流速(PEF)。经过1个月的治疗后比较各治疗方案控制等级、PEF及肺功能(达峰时间比、达峰容积比)改善情况;1个月后,将LTRA组未达到控制的患儿升级至ICS继续治疗1个月,将ICS组未达到控制的患儿升级至ICS+LTRA继续治疗1个月。经过第2个月的治疗后各治疗组自身前后比较控制等级情况并将未控制患儿再次升级治疗(按照上述方法)1个月并再次比较各组控制水平。结果经过第1个月的治疗,ICS组控制等级和PEF改善情况优于LTRA组,差异有统计学意义(P<0.05);达峰时间比、达峰容积比较治疗前改善明显,差异有统计学意义(P<0.05),组间比较差异无统计学意义(P>0.05);经过第2、3个月的治疗,升级治疗后的患儿得到控制。结论对于5周岁以下轻度持续性哮喘患儿:ICS疗效优于单一LTRA;单一LTRA治疗具有一定局限性;ICS疗效欠佳时可加用LTRA。

Objective To compare the efficacy in treatment of mild persistent asthma. Methods 105 children under 5 years with mild persistent asthma were randomly divided into two groups, one was given anti-leukotrienes （LTRA） ,the other was inhaled corticosteroid （ICS） treatments and monitoring of Peak expiratory flow（PEF） sepa- rately. To compare the improve situation before and after one month of treatments which including control levels, PEF and lung function （peak time ratio,peak volume ratio）. One month later, children in the group of LTRA who don＇ t meet the control were upgraded to ICS treatment one month, and children in the group of ICS who don＇ t meet the control were upgraded to ICS ＋ LTRA treatment one month. Before and after the first 2 months of treatments, to compare the control levels of each own group. That the children would not be control were upgraded again for one month （in accordance with the above method） and to compare the control levels in each own group again. Results After one month of treatment, ICS group were better than LTRA group in control levels and the improvement of PEF, and there was statistical significance （ P 〈 0.05 ）. Peak time ratio and peak volume ratio were better than before significantly（P 〈 0. 05 ）, and there was no significant difference between in groups（ P 〉 0. 05 ）. After the second and the third months of treatments, children with upgrade treatments had been controlled. Conclusion For children under 5 years old with mild persistent asthma ： ICS is better than single LTRA in treatment effects ; single anti-leukotriene treatment has limitation; we can add LTRA when ICS is not effective.