氨溴特罗联合沙美特罗替卡松粉吸入剂治疗儿童咳嗽变异性哮喘临床研究

Influence of ambroxol hydrochloride and clenbuterol hydrochloride plus seretide on children's cough variant asthma

目的探讨氨溴特罗联合沙美特罗替卡松粉吸入剂治疗儿童咳嗽变异性哮喘的临床效果及对肺功能的影响。方法选择2010年1月至2012年6月收治的儿童咳嗽变异性哮喘患者共90例,全部患者随机分为3组:分别是氨溴特罗联合沙美特罗替卡松粉吸入剂治疗组30例,氨溴特罗治疗组30例和沙美特罗替卡松粉吸入剂治疗组30例。3组均常规给予雾化吸入糖皮质激素、化痰、止咳等治疗,合并感染者同时给予抗生素治疗。观察3组治疗后的哮喘控制测试评分(C-ACT)及肺功能[呼气峰流速(PEF)变异率]的改变。结果两周后联合用药治疗组临床效果明显,咳嗽症状减轻、C-ACT评分明显高于其他两组,PEF变异率明显低于其他两组,且差异有统计学意义(P<0.05),应用氨溴特罗治疗组虽比应用沙美特罗替卡松粉吸入剂治疗组C-ACT评分高,但差异无统计学意义(P>0.05);治疗4周后,3组C-ACT及PEF变异率比较,差异无统计学意义(P>0.05)。结论使用氨溴特罗联合沙美特罗替卡松粉吸入剂治疗儿童咳嗽变异性哮喘安全、有效,明显改善患儿肺功能和C-ACT评分,且疗效优于单一使用氨溴特罗或沙美特罗替卡松粉吸入剂。

Objective To evaluate the influence of ambroxol hydrochloride and clenbuterol hydrochloride on children cough variant asthma symptoms score and lung function. Methods 90 children with cough variant asthma（ CVA） were randomly divided into group A,B and C,with each group 30 cases. Group A was given seretide only,group B was given seretide combined with ambroxol hydrochloride and clenbuterol hydrochloride. And group C was given ambroxol hydrochloride and clenbuterol hydrochlorid. The changes of asthma control test score（ C- ACT）and pulmonary function（ PEF mutation rate） were observed in the three groups after treatment. Results After two weeks＇ treatment,the asthma control test score in group B was significantly higher than that in group A and group C（ P 〈 0. 05）. The PEF mutation rate in group B was significantly lower than that in group A and group C（ P 〈0. 05）. However,there＇s no significant difference between group A and group C in both the asthma control test score and the PEF mutation rate（ P〉 0. 05）. After four weeks＇ treatment,the asthma control test score and the PEF mutation rate in group A,group B and group C showed no statistically significant differences（ P〈0. 05）. Conclusion Ambroxol hydrochloride and clenbuterol hydrochloride can significantly improve C- ACT score and lung function in children with CVA,and the combined use with seretide has superimposition effect.