普米克令舒、万托林联合甲强龙治疗小儿毛细支气管炎疗效观察

Observation on the effect of pulmicort respulas and ventolin combined with methylprednisolone in the treatment of children with bronchiolitis

目的观察普米克令舒、万托林联合甲强龙治疗小儿毛细支气管炎的临床疗效。方法选取2013年10月至2016年10月巩义市人民医院儿科收治的毛细支气管炎患儿118例为研究对象,随机分为观察组与对照组各59例。两组患儿入院后均给予吸氧、镇咳、抗病毒等常规治疗,合并细菌感染者给予抗生素治疗。对照组患儿在此基础上给予吸入用布地奈德混悬液(普米克令舒)1mg与硫酸沙丁胺醇吸入气雾剂(万托林)0.5mL溶于2mL生理盐水中,通过氧气驱动给予雾化吸入进行治疗,吸入时间为10min左右,间隔时间为8h一次,连续治疗1周。观察组患儿在对照组基础上给予甲强龙注射液静脉滴注,每次1~2mg/kg,每日2次,3d为1个疗程。观察两组疗效及患儿咳嗽、喘憋、哮鸣音及肺部啰音消失时间,检测单核细胞趋化蛋白4(MCP-4)浓度,随访观察用药不良反应。结果治疗后观察组总有效率为98.3%(58/59),显著高于对照组86.4%(51/59),差异有统计学意义(P<0.05);观察组患儿在咳嗽、喘憋、哮鸣音以及肺部啰音症状消失时间均少于对照组,差异有统计学意义(P<0.05)。治疗后两组患儿较治疗前均有所降低,观察组患儿治疗后血清MCP-4浓度显著低于对照组,差异有统计学意义(P<0.05)。对照组患儿治疗期间出现1例声音嘶哑症状,观察组患儿治疗期间无一例出现用药不良反应,差异无统计学意义(P>0.05)。结论普米克令舒、万托林治疗小儿毛细支气管炎的基础上辅以甲强龙治疗,效果显著,缩短症状缓解时间,是目前较为安全且可靠的治疗方案,值得推广。

Objective To observe the clinical effect of pulmicort respulas and ventolin combined with methylprednisolone in the treatment of children with bronchiolitis. Methods A total of 118 children with bronchiolitis were included in the study, who were treated in the Pediatric Department of Gongyi People’s Hospital from Oct. 2013 to Oct. 2016. They were randomly divided into two groups; 59 in observation group and 59 in control group. After admission to the hospital, they were given oxygen inhalation, antitus-sive and antiviral treatment, and those with viral infection were given antibiotic. In addition, the children in control group received budesonide suspension（plumicort respulas） （1 mg） and salbutamol sulfate inhalation aerosol（ventolin） （0. 5 mL） , which was mixed with normal saline（2 mL）. Then it was inhaled by oxygen- driven method for about 10 minutes, once every eight hours, for continuously one week. The children in the observation group received the same treatment; besides, methylprednisolone injection was given through ve-nous dripping, 1^2 mg/kg〉 twice a day,for 3 day as a course. Observe the effect of the two groups〉 as well as the time for cough, asthma？ wheezing and pulmonary rales to be relieved〉 determine the concentra-tion of MCP-4 and follow up the incidence of adverse effects. Results The total effective rate in observation group was 98. 3 % （58/59） , significantly higher than that in control group 86. 4%（51/59）, and the difference was statistically significant（P〈0 . 05）. The time for cough, asthma, wheezing and pulmonary rales to be re-lieved in the observation group was short than that in control group, and there was statistical difference（P〈0. 05）. Concentration of MCP-4 decreased in both groups after treatment, which was even lower in the ob-servation group（P〈0. 05）. There was one case of hoarseness in the control group, while there was no ad-verse effect in the observation group, there being no statistical difference（P〉0. 05）. Conclusion Pulmicort respulas and ventolin combined with methylprednisolone has significant effect in the treatment of children with bronchiolitis, and can shorten the time of relieving symptoms, which is currently safe and reliable, and worth promotion.