信必可和孟鲁司特对亚急性咳嗽的治疗效果比较

Comparison between symbicort and montelukast in treatment of patients with subacute cough

目的分析亚急性咳嗽的发病特点并比较信必可与孟鲁司特在治疗亚急性咳嗽中的效果。方法将131例门诊亚急性咳嗽患者纳入研究。将患者分为A组(n=66)与B组(n=65),在抗过敏、抗生素等常规治疗上,A组应用信必可、B组应用孟鲁司特钠片治疗,比较2组治疗前后肺功能指标(FEV1、FEV1/FVC、PEF)、炎症因子(IL-6、IL-8、TNF-α),生活质量评分应用莱斯特咳嗽问卷(LCQ)评价。结果感冒感染是亚急性咳嗽发病最常见原因,其次为支气管炎与变异性哮喘,且患者多有鼻部病史。2组治疗前各项肺功能指标、炎症因子指标及LCQ评分无显著差异(均P>0.05);治疗后A组FEV1、FEV1/FVC、PEF均升高,高于治疗前及B组治疗后,IL-6、IL-8、TNF-α均降低,低于治疗前及B组治疗后;A组治疗1周、6周、12周后,LCQ评分均高于B组(均P<0.05)。结论亚急性咳嗽病因以感染、支气管炎、变异性哮喘较为常见,信必可在亚急性患者中的应用可有效改善患者肺功能,抑制炎症反应并提高生活质量,效果优于孟鲁司特。

Objective To analyze the clinical characteristics of subacute cough and to compare the therapeutic effects of symbicort and montelukast in the treatment of subacute cough. Methods A total of 131 patients with subacute cough were enrolled and divided into group A （n = 66） and group B （n = 65 ）. For anti-allergic, antibiotic and other routine treatments, the group A was given symbicort while the group B was given montelukast sodium tablets. The pulmonary function indexes （FEV1, FEV1/FVC, PEF）, inflammatory factors （IL-6, IL-8, TNF-α） and quality of life scores （evaluated by LCQ） were compared before and after treatment in two groups. Results Cold infection was the most common cause of subacute cough, which followed by bronchitis and variant asthma, and most patients had history of nasal diseases. There were no significant differences in pulmonary function indexes, inflammatory factor indexes and LCQ score between the two groups before treatment （P 〉 0.05）. After treatment, the FEV1, FEV1/FVC and PEF of the group A increased significantly, and were significantly higher than those of the group B after treatment. IL-6, IL-8 and TNF-α decreased significantly, and were significantly lower than those of the group B after treatment. 1,6 and 12 weeks after treatment, LCQ scores of group A were significantly higher than the group B （P 〈 0.05 ）. Conclusion The common causes of subacute cough are infection, bronchitis and variant asthma. The application of symbicort in treatment of patients with subacute cough can effectively improve pulmonary function, inhibit the inflammatory reactions and improve the quality of life. The effect of symbicort is better than montelukast.