布地奈德、阿奇霉素联合特布他林治疗小儿急性支气管炎的临床观察

Clinical Observation of Budesonide,Azithromycin Combined Terbutaline in the Treatment of Infantile Acute Bronchitis

目的:观察布地奈德、阿奇霉素联合特布他林治疗小儿急性支气管炎的疗效和安全性。方法:150例急性支气管炎患儿随机分为对照组(75例)和观察组(75例)。两组患儿均给予补充电解质、平喘、解痉等常规治疗。在此基础上,对照组患儿给予注射用阿奇霉素10 mg/kg,加入5%葡萄糖注射液250 ml中,静脉滴注,滴注时间>60 min,每日1次+硫酸特布他林雾化液2 mg,加入0.9%氯化钠注射液2 ml中,雾化吸入,每日2次,每次15 min;观察组患者在对照组治疗的基础上雾化吸入布地奈德气雾剂1.0mg,每日3次,每次10 min。两组疗程均为10 d。观察两组患儿的临床疗效,治疗前后1秒用力呼气容积(FEV1)、50%肺活量时的最大呼气流速(MEF50)、最大呼气流速峰值(PEF),临床症状消失时间、住院时间及不良反应发生情况。结果:观察组患儿总有效率显著高于对照组,临床症状消失时间、住院时间均显著短于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患儿FEV1、MEF50、PEF均显著高于同组治疗前,且观察组高于对照组,差异均有统计学意义(P<0.05)。两组患儿不良反应发生率比较差异无统计学意义(P>0.05)。结论:在常规治疗的基础上,布地奈德、阿奇霉素联合特布他林治疗小儿急性支气管炎的疗效显著,可显著改善肺功能,且安全性较好。

OBJECTIVE：To observe the efficiency and safety of budesonide,azithromycin combined with terbutaline in the treatment of infantile acute bronchitis. METHODS：150 children with acute bronchitis were randomly divided into control group（75 cases） and observation group（75 cases）. All children were given electrolyte supplement,antiasthmatic,antispasmodic and other conventional treatment;based on it,control group was treated with 10 mg/kg Azithromycin injection,adding into 250 ml 5% Glu-cose injection,by intravenous infusion with time of more than 60 min,once everyday＋2 mg Terbutaline sulfate spray solution,add-ing into 2 ml 0.9%sodium chloride injection,aerosal inhalation,twice a day,15 min for every times. Observation group was addi-tionally given 1.0 mg Budesonide aerosol;3 times a day,10 min for every times. The treatment course for both groups was 10 d. FEV1,MEF50,PEF before and after treatment,total effective rate and disappearance time of clinical symptoms,hospitalization time and incidence of adverse reactions were recorded. RESULTS：The total effective rate in observation group were significantly higher than control group,disappearance time of clinical symptoms and hospitalization time were significantly shorter than control group,the differences were statistically significant（P〈0.05）. After treatment,FEV1,MEF50 and PEF in 2 groups were significant-ly higher than before,and observation group was higher than control group,the differences were statistically significant（P〈0.05）;there was no significant difference in the incidence of adverse reactions between 2 groups（P〉0.05）. CONCLUSIONS：Based on conventional treament,budesonide,azithromycin combined with terbutaline is effective in the treatment of infantile acute bronchi-tis,and it can significantly improve lung function,with good safety.