氨茶碱、酮替芬、布地奈德三联结合治疗儿童变异性哮喘的临床分析

Analysis on the effect of triple combination therapy contained Aminophylline,Ketotifen and Budesonide in the treatment of children's variant asthma

目的观察氨茶碱、酮替芬、布地奈德三联法治疗儿童变异性哮喘的临床疗效。方法将98例儿童变异性哮喘按照随机对照的原则分为两组,分别为对照组49例和观察组49例,对照组患儿口服氨茶碱,3～5 mg/kg,3次/d,观察组在对照组基础上,雾化吸入布地奈德,200μg/次,2次/d,口服酮替芬片2 mg,2次/d,4周为1个疗程,两组均治疗3个疗程,比较两组临床疗效、肺功能改善、血清、痰液检测指标的差异。结果①观察组总有效率为95.92%,对照组总有效率仅为71.43%,观察组总有效率显著高于对照组,差异有高度统计学意义(χ2=11.400,P<0.01);②观察组随访复发率为6.12%,对照组随访复发率为20.41%,观察组的复发率显著低于对照组(χ2=4.899,P<0.05);③组内比较,两组患儿治疗后肺功能指标FEV1、PEF均较治疗前明显升高,血清IgE、痰液嗜酸性粒细胞计数、痰液IL-4较治疗前明显降低,差异有高度统计学意义(P<0.01);④组间比较,治疗前,两组患儿各项指标差异均无统计学意义,具有可比性;治疗后,观察组FEV1、PEF明显高于对照组,观察组血清IgE、痰液嗜酸性粒细胞计数、痰液IL-4明显低于对照组(P<0.05)。结论氨茶碱、酮替芬、布地奈德三联法治疗儿童变异性哮喘,快速缓解咳嗽症状,抑制变态反应与炎症介质释放,标本兼治,防治结合,可作为儿童变异性哮喘治疗的理想方案,值得临床推广使用。

Objective To observe the effect of triple combination therapy contained Aminophylline,Ketotifen and Budesonide in the treatment of children＇s variant asthma.Methods 98 variant asthma children were randomly divided into 2 groups,respectively,49 cases of the control group and 49 cases of observation group.The control group was given oral Aminophylline,3-5 mg/kg,3 times/d,the observation group was inhaled Budesonide 200 μg once,2 times/d,oral Ketotifen Tablets 2 mg,2 times/d,4 weeks for a course,on the basis of the control group.The clinical efficacy,lung function improve,serum,sputum indexes were compared.Results ①The total effective rate of observation group was 95.92%,the control group was only 71.43%,the observation group was significantly higher than the control group,the difference was statistically significant（χ2 = 11.400,P 〈0.01）;②the recurrence rate of the observation group was 6.12%,the control group was 20.41%,the observation group was significantly lower than the control group（χ2 = 4.899,P 〈0.05）;③compare in group,the FEV1 and PEF were significantly higher than before treatment;the serum IgE,sputum eosinophil count and IL-4 were significantly lower than before treatment,the differences were statistically significant（P 〈0.01）;④compare between groups,the indicators of two groups were not statistically significant before treatment,FEV1 and PEF of the observation group were significantly higher than control group before treatment,the serum IgE,sputum eosinophilscell counts,sputum IL-4 was significantly lower than the control group before treatment（P 〈0.05）.Conclusion Triple combination therapy contained Aminophylline,Ketotifen and Budesonide can duickly relief cough symptoms,and have an inhibition of allergic and inflammatory mediators release,not only treat the symptoms,but also the treatment causes,have a combination of prevention and treatment,can be the ideal solution for the treatment of asthma,which is worthy of clinical use.