布地奈德混悬液阶梯雾化吸入治疗婴幼儿哮喘的前瞻性研究

Prospective study of budesonide suspension in escalation aerosol inhalation therapy for infantile asthma

目的比较布地奈德混悬液阶梯雾化吸入和布地奈德气雾剂+贮雾罐吸入治疗婴幼儿哮喘的效果,为改善婴幼儿哮喘提供依据。方法 106例哮喘婴幼儿随机分为观察组和对照组,各53例。观察组采用布地奈德混悬液阶梯雾化吸入方案;对照组采用布地奈德气雾剂+贮雾罐吸入治疗。在入院时,治疗12、24、28周时进行症状评分,并在48周随访结束时,统计患儿吸入依从率、发作就医次数、发作总天数、缓解期药物用量。结果两组经治疗,症状评分均较入院时显著改善,差异具有统计学意义(P<0.05)。其中:观察组治疗12、24、48周时症状评分分别为(0.63±0.35)、(0.61±0.32)、(0.52±0.36)分,均显著低于对照组(t值分别为6.436、6.418、6.835,P<0.05)。观察组依从率为94.34%,显著高于对照组77.36%(P<0.05)。观察组发作就医次数、发作总天数、缓解期药物使用量分别为(2.2±1.4)次、(12.8±6.5)d、(0.18±0.13)mg/d,均显著低于对照组(P<0.05)。结论阶梯雾化吸入可以显著改善婴幼儿哮喘的症状评分,提高患儿的依从率,减少治疗期间发作次数和发作天数,并减低布地奈德的使用量,是目前临床上治疗婴幼儿哮喘的一种相对理想的方法。

Objective To compare the effects between budesonide suspension in escalation aerosol inhalation therapy and budesonide aerosol＋spacer inhalation therapy in the treatment of infantile asthma, in order to provide reference for improving infantile asthma. Methods A total of 106 children with infantile asthma were randomly divided into observation group and control group, with 53 cases in each group. The observation group received budesonide suspension in escalation aerosol inhalation therapy, and the control group received budesonide aerosol＋spacer inhalation therapy. Symptoms scores were taken in admission, 12, 24, 28 weeks of treatment. Compliance rate of inhalation, onset medical visit times, total onset time, drug dose in catabasis were summarized at the end of follow-up in 48 weeks. Results After treatment, both groups had improved symptom score than that in admission, and the difference had statistical significance（P〈0.05）. Symptom score in 12, 24, 48 weeks were（0.63±0.35）,（0.61±0.32）, and（0.52±0.36） points in the observation group. Those were much lower than the control group（t values were 6.436, 6.418, 6.835, P〈0.05）. The observation group had higher compliance rate as 94.34% than 77.36% of the control group（P〈0.05）. The observation group had much lower onset medical visit times, total onset time, drug dose in catabasis as（2.2±1.4） times,（12.8±6.5） d, and（0.18±0.13） mg/d than the control group（P〈0.05）. Conclusion Escalation aerosol inhalation therapy can effectively improve symptom score and compliance of infantile asthma, and reduce onset times and budesonide dose in treatment. This is an ideal method in present clinical treatment for infantile asthma.