舌下含服粉尘螨滴剂联合布地奈德福莫特罗雾化吸入治疗中重度支气管哮喘的临床疗效观察

Clinical Effect of Sublingual Administration of Dermatophagoides Farinae Drops Combined with Atomization Inhalation of Symbicort Turbuhaler on Moderate or Severe Bronchial Asthma

目的观察舌下含服粉尘螨滴剂联合布地奈德福莫特罗雾化吸入治疗中重度支气管哮喘的临床疗效。方法选取恩施土家族苗族自治州中心医院2013年1月—2014年10月收治的中重度支气管哮喘患者128例,采用抽签法分为对照组和观察组,每组64例。两组患者入院后均给予基础治疗,对照组患者在基础治疗基础上给予布地奈德福莫特罗粉吸入剂,观察组患者在对照组基础上给予粉尘螨滴剂;两组患者均连续治疗6个月。比较两组患者临床疗效及治疗前后哮喘症状评分、嗜酸粒细胞分数、气道通气功能指标,观察两组患者治疗期间不良反应情况。结果观察组患者临床疗效优于对照组(u=-2.657,P=0.008)。治疗前两组患者哮喘症状评分、嗜酸粒细胞分数及第一秒用力呼气容积/用力肺活量(FEV1/FVC)、最大呼气中段平均流速(MMEF)、呼气峰值流速(PEF)比较,差异均无统计学意义(P>0.05);治疗6个月后观察组患者哮喘症状评分、嗜酸粒细胞分数低于对照组,FEV1/FVC、MMEF、PEF高于对照组,差异有统计学意义(P<0.05)。两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论舌下含服粉尘螨滴剂联合布地奈德福莫特罗雾化吸入治疗中重度支气管哮喘的临床疗效确切,安全性高,可有效改善患者临床症状及气道通气功能。

Objective To observe the clinical effect of sublingual administration of dermatophagoides farinae drops combined with atomization inhalation of symbicort turbuhaler on moderate or severe bronchial asthma. Methods A total of 128 patients with moderate or severe bronchial asthma were selected in the Centeral Hospital of Enshi Tujia and Miao Autonomous Prefecture from January 2013 to October 2014,and they were divided into control group and observation group by draw lots,each of 64 cases. Based on basic treatment,patients of control group were given atomization inhalation of symbicort turbuhaler,while patients of observation group were given sublingual administration of dermatophagoides farinae drops combined with atomization inhalation of symbicort turbuhaler; both groups treated for 6 months. Clinical effect, asthma- symptom score, eosinophilic granulocyte percentage and airway ventilation function index before and after treatment were compared between the two groups,and incidence of adverse reactions during treatment was recorded. Results The clinical effect of observation group was statistically significant better than that of control group（ u =- 2. 657, P = 0. 008）. No statistically significant differences of asthma- symptom score,eosinophilic granulocyte percentage,FEV1/ FVC,MMEF or PEF was found between the two groups before treatment（ P 〉0. 05）; after treatment,asthma- symptom score and eosinophilic granulocyte percentage of observation group were statistically significantly lower than those of control group,while FEV1/ FVC,MMEF and PEF of observation group were statistically significantly higher than those of control group（ P 〈0. 05）. No statistically significant differences of incidence of adverse reactions during treatment was found between the two groups（ P 〉0. 05）. Conclusion Sublingual administration of dermatophagoides farinae drops combined with atomization inhalation of symbicort turbuhaler has certain clinical effect in treating moderate or severe bronchial asthma,can effectively relieve the clinical symptoms and improve the airway ventilation function,and is safe.