孟鲁司特钠联合布地奈德在小儿支原体感染所致慢性咳嗽的临床应用

Montelukast Combined with Budesonide in the Treatment of Children with Chronic Cough Caused by Mycoplasma Pneumoniae Infection

目的：探讨孟鲁司特钠联合布地奈德治疗小儿肺炎支原体（MP）感染所致的慢性咳嗽的疗效及其对C-反应蛋白（CRP）的影响。方法：将94例慢性咳嗽患儿按随机数字表法分为两组,均给予阿奇霉素抗感染,对照组47例给予布地奈德治疗,每次0.25~0.50 mg,每天2次,观察组47例在对照组治疗基础上每晚加用孟鲁司特钠4 mg口服,每天1次。疗程均为8周。观察两组治疗效果,并于治疗前、治疗后4周、治疗后8周测量患儿血清CRP水平。结果：治疗后第3天、第5天、第7天观察组咳嗽评分分别为（1.95±0.38）分、（0.82±0.21）分、（0.57±0.10）分,均低于对照组的（2.14±0.42）分、（1.44±0.37）分、（1.04±0.11）分（P〈0.01）;观察组总好转率为91.49%,高于对照组的76.60%（P〈0.05）;治疗4周后、8周后观察组血清CRP水平均显著低于对照组（P〈0.01）,治疗8周后观察组血清CRP水平全部正常,对照组仅部分患儿CRP水平正常。结论：孟鲁司特钠联合布地奈德治疗可缓解小儿慢性咳嗽症状,降低血清CRP水平,促进炎症消除。

Objective： To evaluate the efficacy of montelukast combined with budesonide in the treatment of children with chronic cough caused by Myeoplasma Pneumoniae （MP） infection, and the impact on C-reactive protein （CRP）. Methods： Ninety-four cases of chronic cough in children were randomly divided into two groups. Both groups were given azithromycin and budesonide 0.25 - 0.50 rag, 2 times per day ; while forty-seven cases in the observation group received montelukast 4 mg, 1 time per day on the basis of the control group treatment. The treatment effects were observed, serum CRP concentrations before and after treatment for four weeks and eight weeks were measured. Results： After treatment for three days, five days and seven days, the cough scores of the observation group were （1.95±0.38） points, （0.82±0.21） points and （0.57±0.10） points, which were lower than （2.14±0.42） points, （ 1.44±0.37 ） points and （ 1.04±0.11 ） points in the control group （P〈0.01） ; the total improvement rate of the observation group was 91.49%, which was higher than 76.60% in the control group （P〈0.05） ; After treatment for four weeks and eight weeks, the serum CRP levels in the observation group were significantly lower than those in the control group （P〈0.01）. After treatment for eight weeks the serum CRP levels were all normal in the observation group, while in the control group they were normal partially. Conclusions： Montelukast combined with budesonide can alleviate the symptoms of children with chronic cough, decrease serum CRP levels, and promote inflammation eliminating.