沙美特罗／氟替卡松干粉剂治疗咳嗽变异型哮喘疗效观察

Clinical effects and safety of salmeterol combined with fluticasone propionate dry powder in the treatment of cough variant asthma

目的探讨沙美特罗／氟替卡松干粉剂吸人治疗咳嗽变异型哮喘（CVA）的临床效果及安全性。方法45例CVA患儿随机分为治疗组23例和对照组22例，治疗组给予沙美特罗／氟替卡松干粉剂吸入，早晚各1次；对照组单纯给予丙酸氟替卡松干粉剂吸入，早晚各1次；两组疗程均为3个月。观察两组治疗前、后临床症状缓解情况、哮喘控制时间、肺功能改善情况和不良反应。结果治疗后两组咳嗽哮喘症状均有明显改善，治疗后1周治疗组改善情况好于对照组（x2=10．24，P〈0．05）；治疗后2周、4周时两组差异均无统计学意义（均P〉0．05）；治疗组哮喘完全控制时间明显短于对照组（t=8．36，P〈0．05）。治疗后1周、2周、4周，治疗组PEF％均明显高于对照组（t=6．22、7．68、7．95，均P〈0．05）；治疗后12周，治疗组PEF％与对照组差异无统计学意义（P〉0．05）。两组无严重不良反应发生。结论沙美特罗／丙酸氟替卡松干粉吸入治疗CVA安全、有效、使用方便，值得推广。

Objective To investigate the effect and safety of salmeterol combined with flutieasone pmpionate dry powder in the treatment of cough variant asthma（CVA）. Methods 45 children diagnosed as CVA（ aged from 5 to 14 years old） were randomly divided into treatment group （ n = 23 ） and control group （ n = 22 ）. The patients in treatment group were treated with salmetero] combined with fluticasone propionate every morning and evening, while the control group were only given fluticasone pmpionate every morning and evening. The two groups were treated for 3 months. The change of clinical symptoms, asthma control time, lung function （PEF% pred） and adverse reactions were observed before and after treatment. Results Cough was relieved in most cases after treatment in both groups, but the improvement was more significant in treatment group than that in control group 1 week after treatment （X2 = 10.24, P 〈 0. 05 ）. However, there were no significant differences of clinical efficacy between two groups 2 weeks later （ P 〉 0.05 ）. Full control time of asthma was in treatment group, which was significantly earlier than the control group （ t = 8.36 ,P 〈 0.05 ）. PEF% pred was shorter significantly higher in two groups after 1 week ,2 and 4 weeks, but the improvement was more significant in treatment group than that in control group （ t = 6.22,7.68,7.95, all P 〈 0.05 ）. 1 case of headache in treatment group was relieved by symptomatic treatment and no other serious adverse events occured. Conclusion Salmeterol combined with flutieasone propionate was safe, effective, easy to use for treating CVA.