小剂量糖皮质激素联合口服茶碱片治疗小儿哮喘的疗效观察

Clinical effect of low-dose glucocorticoid combined with oral theophylline tablets in the treatment of children with asthma

目的比较小剂量糖皮质激素联合口服茶碱片或联合长效β_2受体激动剂在治疗小儿哮喘上的临床疗效,为小剂量糖皮质激素联合茶碱治疗小儿哮喘提供临床证据。方法深圳市宝安区中医院儿科收治患有持续性中度哮喘患儿82例,随机分为联合长效β_2受体激动剂组和联合茶碱组各41例。均予以糖皮质激素治疗,联合长效β_2受体激动剂组在糖皮质激素的基础上又予以长效β_2受体激动剂治疗,而联合茶碱组又予以氨茶碱治疗,治疗周期均为12周。于治疗开始前及结束后对两组患儿进行哮喘日间症状评分、夜间症状评分、最大呼气流速进行统计,并对比两组总有效率,注意监测两组药物的副反应。结果联合长效β_2受体激动剂组和联合茶碱组总有效率分别为90.2%(37/41)和73.2%(30/41),差异有统计学意义(P<0.05);在呼气最大流速方面,两组患儿在治疗前与治疗后相比较,差异有统计学意义(P<0.01),而治疗后两组患儿呼气最大流速相比差异无统计学意义(P>0.05);在症状的日间评分和夜间评分方面,治疗后相比治疗前两组患儿的评分都具有较大改善,治疗后与治疗前的差异有统计学意义(P<0.01),而治疗后联合长效β_2受体激动剂组与联合茶碱组相比,日间、夜间症状评分比较差异均无统计学意义(P>0.05)。两组副反应发生率比较差异无统计学意义(P>0.05)。结论小剂量糖皮质激素联合茶碱治疗小儿哮喘的临床疗效肯定,与小剂量糖皮质激素联合长效β_2受体激动剂的治疗方案有类似的疗效,两者副反应发生率也相近,值得向临床推广。

Objective To compare the clinical effect of low-dose glucocorticoid combined with oral theophylline tablets with that of low-dose glucocorticoid combined with long-acting beta2 receptor agonists in the treatment of children with asthma and provide evidence for clinical application of the former. Methods A total of 82 children with persistent moderate asthma admitted to the Pediatric Department of Baoan TCM Hospital were included in the study, and they were randomly divided into two groups：group A with combina- tion treatment of long-acting beta2 receptor agonists（41 cases） and group B with theophylline（41 cases）. Both groups received glucocorticoid treatment; meanwhile, group A was given long-acting beta2 receptor ago- nists and group B was given theophylline. The treatment course lasted for 12 weeks in both groups. The day- time symptom score, night symptom score and maximum expiratory flow rate were recorded before and after treatment,and the total effective rate was compared between the two groups. The adverse reactions in these two groups were also monitored. Results The total effective rate was 90. 2% in group A and 73.2% in group B,the difference being of statistical significance（P〈0. 05） ;with regard to maximum expiratory flow rate, there was statistical difference before and after treatment in both groups（P〈0. 01）, but no difference was found between the two groups after treatment（P〉0.05）. The daytime symptom score and night symptom score were improved a lot after treatment in both groups with statistical significance （P〈 0.01）, but there was no difference between the two groups（P〉0.05）. Conclusion The treatment with low-dose glucocorticoid combined with theophylline has definite effect on children with asthma,and its effect is similar to that of glucocorticoid combined with long-acting beta2 receptor agonists. The incidence of adverse reactions is also similar,so it is worthy of clinical application.