雾化吸入不同剂量布地奈德混悬液对儿童感染后咳嗽的疗效和安全性研究

Efficacy and safety of different doses of budesonide mixed suspension atomization inhalation in children with post infectious cough

目的 探讨不同剂量布地奈德混悬液雾化吸入对儿童感染后咳嗽的疗效和安全性,为布地奈德的合理使用提供借鉴.方法 选取2～14岁感染后咳嗽患儿120例按随机数字表法分为三组,每组40例.对照组：孟鲁司特钠咀嚼片2～5岁,4 mg/次,6～ 14岁,5 mg/次,睡前服用.高剂量组：在对照组基础上,布地奈德混悬液1.0 mg加0.9％氯化钠溶液至4ml,2次/d,氧气雾化吸入;低剂量组：在对照组基础上,布地奈德混悬液0.5 mg加0.9％氯化钠溶液至4ml,2次/d,氧气雾化吸入.疗程均为7d.比较三组治疗后的疗效.结果 治疗3d后,高剂量组、低剂量组和对照组总有效率分别为70.0％（28/40）,52.5％（21/40）,35.0％（14/40）.高剂量组总有效率显著高于对照组,差异有统计学意义（P＜0.01）.治疗7d后,高剂量组、低剂量组、对照组总有效率分别为92.5％（37/40）,90.0％（36/40）,72.5％（29/40）,三组比较差异无统计学意义（P＞ 0.025）.鹅口疮、咽喉不适、声音嘶哑等与吸入激素相关的不良反应极少.结论 吸入布地奈德混悬液可明显改善感染后咳嗽症状,且高剂量吸入起效更快,并无明显不良反应,具有较好的安全性,值得推广应用.

Objective To explore the efficacy and safety of different doses of budesonide mixed suspension atomization inhalation in children with post infectious cough,and provide reference for the rational use of budesonide.Methods One hundred and twenty children with post infectious cough aged 2-14 years old were selected and divided into three groups by random digits table method （40 cases in each group）.Control group was treated with 4 mg once montelukast sodium chewable tablets for 2-5 years old children,or 5 mg once for 6-14 years old children.Low-dose group was treated 2 times/d with a dose of 0.5 mg budesonide mixed suspension diluted in normal saline to 4 ml based on control group and high-dose group was treated 2 times/d with a dose of 1.0 mg budesonide mixed suspension diluted in normal saline to 4 ml based on control group.The outcome of curative effects were recorded and analyzed after 7 days of treatment.Results The total efficacy rate was 70.0%（28/40）,52.5%（21/40）,35.0%（14/40） in high-dose group,low-dose group and control group after 3 days of treatment,and there was significant difference between high-dose group and control group （P〈 0.01）.The total efficacy rate was 92.5%（37/40）,90.0%（36/40）,72.5% （29/40） in high-dose group,low-dose group and control group after 7 days of treatment,and there was no significant difference（P 〉 0.025）.Few adverse events associated with inhaled corticosteroids,such as thrush,sore throat,hoarseness were observed in three groups.Conclusions Budesonide mixed suspension atomization inhalation alleviates symptom of post infectious cough significantly with no obvious side effects,even in high-dose group which has a more outstanding efficacy.Therefore,this therapy is valuable in clinical application.