变应性鼻炎对支气管哮喘患者临床控制及肺通气功能的影响分析

Allergic rhinitis affects clinical control of bronchial asthma and pulmonary ventilation function analysis

目的通过观察变应性鼻炎对支气管哮喘（简称哮喘）患者临床控制及肺通气功能的影响，从而可为其患者临床治疗提供参考。方法截取2013年8月至2014年10月期间收治的哮喘及哮喘伴变应性鼻炎患者68例，分为观察组与对照组，其中观察组为哮喘伴变应性鼻炎者38例；对照组为哮喘患者30例。比较2组患者哮喘控制测试（asthma control test，ACT）评分和哮喘控制问卷（asthma control questionnaire，ACQ）评分，同时统计患者近1个月使用沙丁胺醇气雾剂的次数和FEV1％pred及呼气峰流量占预计值百分比（PEF％pred）。分析观察组患者的变应性鼻炎视觉模拟量表（visual analogue scale，VAS）评分与ACT评分、ACQ评分和肺通气功能之间的相关性。结果①ACT评分：观察组平均为（15．7±5．5）分，明显低于对照组（19．2±5．1）分，P〈0．05；②ACQ评分：观察组平均为（2．2±1．4）分，明显高于对照组（1．3±1．0）分，P〈0．05。③沙丁胺醇气雾剂使用：观察组平均为（4．2±0．3）次明显高于对照组（0．5±0．1）次，P〈0．05；④肺通气功能：观察组FEV1％pred平均为（65．1±21．9）％，明显低于对照组（78．5±22．3）％，P〈0．05；观察组PEF％pred平均为（66．1±21．9）％，明显低于对照组（79．9±25．8）％，P〈0．05。观察组呼吸困难和喘息及哮鸣音消失时间分别为（3．61±1．47）d、（2．68±0．97）d、（4．39±1．91）d，明显短于对照组（6．12±2．19）d、（4．30±1．28）d、（6．95±2．47）d，差异有统计学意义（P〈0．05）；⑤VAS与ACT呈负相关，与ACQ呈正相关，与肺通气功能呈负相关（P〈0．05）。结论伴变应性鼻炎不利于哮喘患者临床控制，同时还会增加患者哮喘症状和急救药物使用次数，使患者肺通气功能下降。患者鼻炎症状越严重，哮喘控制越差，且肺通气功能越低。

Objective By observing the impact of allergic rhinitis control pulmonary ventilation function of clinical bronchial asthma （asthma）, which can provide a reference for the clinical treatment of patients. Methods Interception of our hospital in January 2012-October 2014 period were treated with 68 cases of asthma and allergic rhinitis in asthma patients were divided into observation group and control group, in which the observation group for asthma with allergic rhinitis, 38 cases;control group of patients with asthma, 30 cases. Two groups were compared asthma control test （ATC） and the elimination of asthma control questionnaire （ACQ） score, while nearly a month statistics patient and the asthma frequency of use of salbutamol aerosol expiratory volume in ls percent predicted （FEVa % pred） and call gas percent predicted peak flow （PEF% pred）. Results （1）ACT score：mean observation group （15.7 ±5.5） was significantly lower than the control group points （19.2± 5.1） min, P 〈0.05. （2）ACQ score： mean observation group （2.2± 1.4） was significantly higher points in the control group （ 1.3 ± 1.0） rain, P 〈0.05. （3） The use of salbutamol aerosol：the observation group average （4.2±0.3） times the control group was significantly higher （0.5±0.1） times, P 〈0.05. （4） Pulmonary function：mean FEVI % pred in the observation group （65.1±21.9） % was significantly lower than the control group （78.5± 22.3）%, P〈0. 05. Mean PEF1 pred in the observation group （66.1 ±21.9）% was significantly lower than the control group （79.9 ± 25.8） %, P 〈0.05. Observation group dyspnea and wheezing and wheezing disappeared time was （3.61±1.47） days, （2.68±0.97） days, （4.39±1.91） was shorter than the control group （6.12±2.19） days, （4.30±1.28） days, （6.95±2.47） days, with statistical significance, P〈0.05.（5） VAS was negatively correlated with the ACT, was positively correlated with ACQ, and pulmonary function was negatively correlated, P 〈 0.05. Conclusions With allergic rhinitis is not conducive to clinical control of asthma patients, while also increasing the asthma symptoms and rescue medication use frequeney, so that patients pulmonary function decline. Patients with more severe symptoms of rhinitis, asthma control, the worse, and the lower the pulmonary function.