孟鲁司特钠联合不同剂量布地奈德治疗毛细支气管炎临床疗效及安全性评价

Evaluation on the Safety and Clinical Efficacy of Montelukast Sodium Combined with Different Doses of Budesonide in Treatment of Bronchiolitis

目的:探讨孟鲁司特钠联合不同剂量布地奈德治疗毛细支气管炎的临床疗效及安全性。方法:选择符合标准的患儿80例,随机分为观察组和对照组各40例,患儿给予常规治疗、口服孟鲁司特钠及雾化吸入,观察组患儿病情缓解后雾化吸入布地奈德混悬液剂量由每次1.0mg调整为0.5mg,每日雾化次数由3次改为2次;对照组布地奈德混悬液剂量(1.0mg)和雾化次数(每日3次)不变,治疗7d。结果:两组患儿发热、喘憋、气促、咳嗽、哮鸣音及湿啰音消失时间相似,差异均无统计学意义(P>0.05)。治疗7d,观察组患儿显效25例(62.50%)、有效12例(30.00%)和无效3例(7.50%);对照组患儿显效28例(70.00%)、有效10例(25.00%)和无效2例(5.00%),差异无统计学意义(P>0.05)。观察组患儿不良反应发生率7.50%,低于对照组的25.00%,差异有统计学意义(P<0.05)。结论:毛细支气管炎患儿急性期口服孟鲁司特钠,大剂量布地奈德混悬液雾化吸入,症状控制后减少用量,临床疗效显著,降低不良反应发生率。

Objective： To investigate the safety and clinical efficacy of montelukast sodium combined with different doses of budesonide in treatment of bronchiolitis. Method： 80 cases with bronchiolitis were selected and randomly divided into two groups： observation group and control group,with 40 cases in each group. All the patients were given conventional therapies,oral Montelukast Sodium and spray inhalation. After remission,the dose of spray inhalation of Budesonide Suspension for the patients of the observation group was changed from 1. 0mg tid to 0. 5mg tid,while the times of spray inhalation was also change,from three times to two times each day. The patients of the control group remained unchanged,that was（ 1. 0mg tid） at a time and three times each day; All the patients were treated for 7 days. Results： The patients of two groups had similar disappearance time of fever,dyspnea,shortness of breath,cough,wheezing sound,and moist rales,（ all P〈0. 05）. After 7 days of treatment,25 cases in the observation group（ 62. 50%） showed marked response to the treatment,12 cases（ 30. 00%） showed response,and 3 cases（ 7. 50%） showed no response,while in the control group,28 cases（ 70. 00%）,10 cases（ 25. 00%）,and 2 cases（ 5. 00%） repectively with no significant differences between the two groups（ P〈0. 05）. The incidence of adverse reactions in the observation group was 7. 50%,lower than 25. 00% in the control group（ P〈0. 05）. Conclusion： In patients with bronchiolitis,oral Montelukast Sodium,spray inhalation of a large dose of Budesonide Suspension in the acute phase,and a reduced dose after symptom control,showed significant clinical efficacy,and reduced the incidence of adverse reactions.