吸入布地奈德联合盐酸西替利嗪和/或孟鲁司特钠治疗儿童过敏性鼻炎-哮喘综合征的效果对比

Effect contrast of inhaled Budesonide combined Cetirizine and/or Montelukast sodium tablets treatment of allergic rhinitis and asthma syndrome in children

目的对比吸入布地奈德气雾剂联合盐酸西替利嗪和/或孟鲁司特钠治疗儿童过敏性鼻炎-哮喘综合征（CARAS）的效果。方法收集2015年1～12月北京大学首钢医院儿科门诊CARAS患儿75例,根据就诊顺序分为四组,分别给予吸入布地奈德气雾剂（布地奈德组,n=19）、吸入布地奈德气雾剂联合口服盐酸西替利嗪（布地奈德＋西替利嗪组,n=18）、吸入布地奈德气雾剂联合口服孟鲁司特钠（布地奈德＋孟鲁司特钠组,n=17）和吸入布地奈德气雾剂联合盐酸西替利嗪和孟鲁司特钠（布地奈德＋西替利嗪＋孟鲁司特钠组,n=21）。比较四组鼻部、胸部症状评分、肺功能和治疗费用。结果四组治疗前鼻部、胸部症状评分比较差异均无统计学意义（均P〉0.05）;四组治疗后鼻部、胸部症状评分均低于同组治疗前,差异均有统计学意义（均P〈0.05）;布地奈德组治疗后鼻部、胸部症状评分均高于布地奈德＋孟鲁司特钠组和布地奈德＋西替利嗪＋孟鲁司特钠组,差异均有统计学意义（P〈0.05或P〈0.01）,但与布地奈德＋西替利嗪组比较,差异无统计学意义（均P〉0.05）;布地奈德＋西替利嗪组治疗后鼻部、胸部症状评分均高于布地奈德＋孟鲁司特钠组和布地奈德＋西替利嗪＋孟鲁司特钠组,差异有统计学意义（P〈0.05或P〈0.01）;布地奈德＋孟鲁司特钠组治疗后鼻部、胸部症状评分与布地奈德＋西替利嗪＋孟鲁司特钠组比较,差异无统计学意义（均P〉0.05）。四组治疗后第1秒用力呼气容积和最大呼气流速均较治疗前提高,差异均有统计学意义（均P〈0.05）;四组治疗后比较,差异无统计学意义（均P〉0.05）。布地奈德组、布地奈德＋西替利嗪组、布地奈德＋孟鲁司特钠组、布地奈德＋西替利嗪＋孟鲁司特钠组费用依次增加,差异有统计学意义（F=3118.78,P〈0.01）。结论吸入布地奈德气雾剂治疗CARAS效果肯定,推荐使用,对于经济能力较好的家庭可联合孟鲁司特钠治疗。

Objective To compare the effect of inhaled Budesonide combined Cetirizine and/or Montelukast sodium tablets treatment of allergic rhinitis and asthma syndrome in children. Methods All 75 cases in Pediatric Outpatient of Peking University Shougang Hospital from January to December 2015 were collected. According to the medical order, the children were divided into four groups. 19 cases were treated by inhaled Budesonide（inhaled Budesonide group）; 18 cases were treated by inhaled Budesonide combined Cetirizine（inhaled Budesonide combined Cetirizine group）; 17 cases were treated by inhaled Budesonide combined Montelukast sodium tablets（inhaled Budesonide combined Montelukast sodium tablets group）; 21 cases treated by inhaled Budesonide combined Cetirizine and Montelukast sodium tablets（inhaled Budesonide combined Cetirizine and Montelukast sodium tablets group）. The symptom scores of chest and nasal, lung function, and treatment costs in four groups were compared. Results The symptom scores of chest and nasal before the treatment in four groups were no statistically significant differences（all P〉 0.05）; the symptom scores of chest and nasal after the treatment in four groups were lower than those before the treatment, the differences were statistically significant（all P〈 0.05）; the symptom scores of chest and nasal after the treatment in inhaled Budesonide group were higher than those in inhaled Budesonide combined Montelukast sodium tablets group and inhaled Budesonide combined Cetirizine and Montelukast sodium tablets group, the differences were statistically significant（P〈 0.05 or P〈 0.01）; the symptom scores of chest and nasal after the treatment in inhaled Budesonide combined Cetirizine group were higher than those in inhaled Budesonide combined Montelukast sodium tablets group and inhaled Budesonide combined Cetirizine and Montelukast sodium tablets group, the differences were statistically significant（P〈 0.05 or P〈 0.01）; the symptom scores of chest and nasal after the treatment in inhaled Budesonide group and in inhaled Budesonide combined Cetirizine group was no statistically significant difference（all P〈 0.05）; the symptom scores of chest and nasal after the treatment in inhaled Budesonide combined Montelukast sodium tablets group and inhaled Budesonide combined Cetirizine and Montelukast sodium tablets group was no statistically significant difference（all P〉 0.05）. FEV1 and PEFR after the treatment in four groups were higher than those before the treatment, the differences were statistically significant（all P〈 0.05）; FEV1 and PEFR after the treatment in four groups were compared, there was no statistically significant difference（all P〉 0.05）. The treatment costs in inhaled Budesonide group, inhaled Budesonide combined Cetirizine group, inhaled Budesonide combined Montelukast sodium tablets group, inhaled Budesonide combined Cetirizine and Montelukast sodium tablets group were increase in turn（F = 3118.78, P〈 0.01）. Conclusion The effect of inhaled Budesonide aerosol therapy CARAS is well,and is worthy of recommendation. Combination therapy of Budesonide aerosol and Montelukast sodium tablets is suitable for good economic ability family.