布地奈德雾化吸入疗法在妊娠期慢性咳嗽患者中的应用价值

Analysis on application value of budesonide aerosol inhalation in pregnant patients with chronic cough

目的观察布地奈德雾化吸入疗法对妊娠期慢性咳嗽患者的疗效及其对血浆细胞因子的影响。方法将92例妊娠期慢性咳嗽患者随机分为观察组和对照组,每组46例。对照组给予抗感染、抗炎、止咳祛痰、平喘等常规治疗,观察组在对照组基础上使用空气压缩泵雾化吸入布地奈德混悬液,比较2组患者的临床症状及肺功能改善情况,以及治疗前后血浆细胞因子白介素4(IL 4)、IL 6、IL 10、肿瘤坏死因子(TNF-α)及γ干扰素(IFN-γ)等水平的变化。结果观察组呼气峰流量(PEFR)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)及用力呼出50%肺活量时呼气流量显著高于对照组;观察组IL 4、TNF-α、IL6、嗜酸性粒细胞(EOS)及免疫球蛋白E(IgE)水平显著低于对照组,而IL 10和IFN-γ水平显著高于对照组;观察组咳嗽症状积分、咳嗽视觉模拟尺评分及胸闷气短、咳嗽等主要临床症状的持续时间显著低于对照组,且有效率显著优于对照组,差异均有统计学意义。结论布地奈德雾化吸入疗法治疗妊娠期慢性咳嗽疗效确切,可快速改善咳嗽、胸闷气短等症状,迅速恢复肺功能,纠正细胞因子失衡,且不良反应少,值得临床推广应用。

Objective To observe the therapeutic effect of budesonide aerosol inhalation on pregnant patients with chronic cough and its influences on plasma cytokine.Methods Ninety-two pregnant patients with chronic coughs were randomly divided into observation group and control group,46 cases in each group.Patients in the control group were given routine treatment,such as anti-infection,anti-inflammation,relieving cough and eliminating phlegm as well as relieving asthma,while those in the observation group were inhaled with budesonide suspension by air pressure pump based on the treatment of control group.The clinical symptoms,improvement of lung function and levels of plasma cytokine before and after treatment,including interleukin-4 （IL-4）,IL-6,IL-10,tumor necrosis factor α （TNF-α） and interferon γ （IFN-γ）,were compared in both groups.Results The peak expiratory flow rate （PEFR）,forced vital capacity （FVC）,forced expiratory volume in 1 second （FEV1） and expiratory volume at the time of forced expiratory 50％ vital capacity in the observation group were significantly higher than those in the control group.The levels of IL-4,TNF-α,IL-6,eosnophils （EOS） and immunoglobulin E （IgE） in the observation group were obviously lower than those in the control group,while the levels of IL-10 and IFN-γsignificantly higher than the control group.The symptomatic and visual analog scale scores of cough as well as duration of major clinical symptoms like chest oppression,shortness of breath and coughs in the observation group were all markedly lower than those in the control group,and the effectiveness rate was notably superior to the control group,in which the statistical significance was presented.Conclusion Budesonide aerosol inhalation has explicit therapeutic effects and few adverse reactions in the treatment of chronic cough during pregnancy,is capable of enhancing the symptoms like coughs,chest oppression and shortness of breath rapidly,recovering lung function and correcting the imbalance of cell factors,so it deserves to be popularized and applied in clinical practice.