三种不同方式治疗儿童哮喘的疗效及不良反应研究

Efficacy and Adverse Reactions of Three Kinds of Different Ways in Treating Children with Asthma

目的:观察规范吸入沙美特罗替卡松(SM/FP)、口服孟鲁司特及不规范用药对儿童哮喘的疗效与不良反应,指导临床治疗。方法:将哮喘患儿分A组(规范吸入SM/FP)、B组(口服孟鲁司特)和C组(不规范用药),观察患儿6个月、12个月、18个月的肺功能、临床症状、治疗费用、身高、体质量及不良反应。结果:A组、B组患儿的肺功能在治疗后6个月、12个月及18个月均较基础值明显改善(P<0.05);用药12个月、18个月后,A组的气道高反应性明显低于B组。C组患儿除观察后6个月PEF%较基础值有改善外,其余指标较基础值无好转。C组轻度咳喘发作、急诊输液及住院人次所占比例均明显高于A组、B组,差异有统计学意义(P<0.05);用药18个月时A组的急诊输液及住院人次所占比例明显低于B组,差异有统计学意义(P<0.05)。三组患儿的身高及体质量增长均在正常范围。结论:规范用药能更好控制哮喘儿童的症状,改善肺功能,减轻气道高反应性,减少不良反应;不规范用药则不能控制哮喘。

Objective： To observe the standard inhalation Salmeterol flutieasone, oral montelukast and non-standard medication for efficacy and adverse reactions of children with asthma, in order to guide clinical treatment. Methods： Children with asthma were divided into group A （standard inhaled SM/FP）, group B （oral montelukast）, group C （non-standard medication）. The pulmonary function, clinical symptoms, treatment costs, height, weight and adverse reactions were observed in 6, 12, 18 months. Results： The pulmonary function of children in group A and group B at 6, 12 and 18 months after treatment compared with baseline were significantly improved （P〈0.05）. At 12 and 18 months after treatment, group A of airway hyperresponsiveness was significantly lower than that in group B. Except 6 month, children in group C of PEF% improved compared with the baseline values were observed, the other indicators did not improve compared with the baseline values. Children in group C of mild cough episodes, emergency infusion and hospital visits were significantly higher than group A and group B （P〈0.05）. After 18 months＇ medication, group A of emergency infusion and hospital visits were significantly lower than group B （P〈0. 05 ）. Three groups of children＇ s height and weight gain were in the normal range. Conclusion： For children with asthma, regular inhaled corticosteroids can control the symptoms better and improve lung function, reduce airway hyperresponsiveness and have less adverse reactions. If the medication is not standardized, children asthma can not control very well.