布地奈德单药与联合孟鲁司特对发作期变异性支气管哮喘血清总IgE水平变化的影响比较

Comparison of influence between budesonide monotherapy and combination of montelukast on serum total IgE of patients with bronchial asthma

目的探讨布地奈德单药与联合孟鲁司特对发作期变异性支气管哮喘血清总IgE水平变化的影响。方法选择2014年6月至2015年6月我院接诊的80例发作期变异性支气管哮喘患者,通过抽签法随机分为观察组和对照组,对照组使用布地奈德单药治疗,观察组使用布地奈德联合孟鲁司特治疗。观察两组患者治疗前后血清IgE水平、咳嗽症状评分以及LCQ评分的变化,比较两组患者治疗后咳嗽改变情况、临床疗效及不良反应。结果治疗后,观察组血清IgE水平(76.18±10.05)IU/m L低于对照组(98.47±11.34)IU/mL,差异具有统计学意义(P<0.05);观察组患者咳嗽症状评分(1.12±0.32)低于对照组(1.49±0.41),LCQ评分(19.94±5.04)高于对照组(16.11±3.52),咳嗽减轻时间、夜咳停止时间、咳嗽消退时间(2.39±0.68,3.39±0.93,7.31±1.28)d,短于对照组(8.72±1.73,10.12±2.95,14.63±3.06)d,两组比较差异有统计学意义(P<0.05);观察组总有效率95.00%(38/40)高于对照组75.00%(30/40),不良反应发生率5.00%(2/40)低于对照组20.00%(8/40),差异具有统计学意义(P<0.05)。结论布地奈德联合孟鲁司特对发作期变异性支气管哮喘患者中疗效更为显著,可以对慢性炎症进行控制,降低Ig E水平的表达,从而控制哮喘的发生,值得在临床上应用推广。

Objective To compare the influence between budesonide monotherapy and combination of mon- telukast on serum total IgE of patients with bronchial asthma. Methods 80 patients with bronchial asthma attack were randomly divided into the observation group and the control group. The control group was given budesonide monotherapy, and the observation group was given budesonide combined with montelukast treatment. The changes of serum IgE level, cough symptom score and LCQ score were compared before and after treatment in the two groups. The clinical efficacy and adverse reactions were also analyzed after treatment between the two groups. Results After the treatment, the serum IgE level was （76. 18 ±10.05） IU/mL in the observation group and （98.47 ± 11.34） IU/ mL in the control group （P 〈0. 05）. The symptom score of the observation group （1.12±0. 32） was lower than that of the control group （ 1.49± 0. 41 ）, LCQ score was higher in the observation group （ 19. 94 ± 5.04） than that of the control group （16. 11 ± 3. 52）. The time of cough relieving, night cough stopped, and cough fading was （3.39 ± 0. 68）, （0. 93 ±7. 31）, and （2. 39 ±1.28） d in the observation group, which were shorter than those in the control group （8. 72 ± 1.73, 10. 12 ± 2. 95, 14. 63± 3.06） d （ P 〈 0. 05 ）. The total effective rate in the observation group was 95% （38/40）, higher than that of the control group （75.00%） （30/40）. The incidence of adverse reactions was 5% （2/40）in the observation group, which was lower than that of the control group （20%, 8/40） （P 〈 0. 05）. Conclusion Budesonide combined with montelukast has significant curative effect in the treatment of pa- tients with bronchial asthma, which is worthy of widely clinical application.