孟鲁司特治疗儿童咳嗽变异性哮喘的效果观察

Efficacy of montelukast in the treatment of children with cough variant asthma

目的观察孟鲁司特在儿童咳嗽变异性哮喘的效果,为替代激素治疗哮喘提供理论依据。方法将符合入组标准的86例儿童咳嗽变异性哮喘患者按随机数字表分为观察组43例和对照组43例,对照组给予布地奈德联合特布他林治疗,观察组给予孟鲁司特联合特布他林治疗,两组均治疗3个月,随访6个月,治疗前后观察患儿症状与肺功能指标改善情况,记录症状缓解时间,随访期间观察复发情况,比较复发率,记录不良反应发生情况,评判两组临床疗效。结果 (1)观察组和对照组的总有效率分别为93.02%、95.35%,差异无统计学意义(χ2=0.367,P>0.05);(2)观察组和对照组的临床缓解时间、复发比例分别为(5.6±2.5)d比(5.3±3.0)d,6.98%比6.98%,差异均无统计学意义(P>0.05);观察组与对照组治疗前后1秒钟用力呼气容积占预计值百分比(FEV1%)、最大呼气流量占预计值百分比(PEF%)水平差异无统计学意义(P>0.05);(3)观察组与对照组的不良反应发生率分别为0比9.30%,差异有统计学意义(χ2=4.195,P<0.05)。结论孟鲁司特与布地奈德治疗儿童咳嗽变异性哮喘的临床疗效相当,但孟鲁司特的安全性及治疗依从性更好,具有糖皮质激素的替代作用。

Objective To observe the efficacy of Montelukast in the treatment of children with cough variant asthma （CVA） and to provide theoretical basis for alternative hormone treatment to asthma. Methods Eighty six children with CVA in accordance with our standards were chosen and divided into control group and observation group according to random digits table with 43 patients respectively. Patients in the control group were given Budesonide and Terbutaline treatment while patients in the observation group were given Montelukast plus Terbutaline treatment. Patients were treated for 3 months and 6 months follow-up. Symptoms and lung function indicators of the patients were measured before and after treatment. Symptomatic relief time and recurrence rate was recorded and compared. Adverse effects were recorded to evaluate clinical efficacy. Results （1）No statistically significant differences （χ2= 0.367, P 〉 0.05） ex- isted in total effective rate in which observation group and control group showed 93.02% and 95.35% respectively. （2） Symptomatic relief time and recurrence rate of the observation group and the control group were （5.6±2.5） d, （5.3±3.0） d, 6.98% and 6.98% respectively, no statistically significant differences （P 〉 0.05） existed; forced expiratory volume in one second percentage of predicted （FEV1%） and peak expiratory flow percentage of predicted （PEF%） level between the two groups during treatment didn/t have statistically significant differences （P 〉 0.05）. （3）Adverse effect occurrence rate of observation group and control group was 0 and 9.30% respectively, statistically significant differences existed （χ2 = 4.195, P 〈 0.05）. Conclusion Montelukast and Budesonide has same efficacy in the treatment of children＇s CVA. Children taken Montelukast have better compliance and safety. Montelukast has alternativefunction to Glucocorticoid.