孟鲁司特钠联合布地奈德治疗咳嗽变异性哮喘的临床研究

Clinical study on montelukast combined with budesonide in treatment of cough variant asthma

目的探讨孟鲁司特钠联合布地奈德治疗咳嗽变异性哮喘的临床疗效。方法选取2014年7月—2016年11月郑州大学第五附属医院收治的咳嗽变异性哮喘患者78例,按照序列号法分为对照组(38例)和治疗组(40例)。对照组吸入布地奈德气雾剂,200μg/次,2次/d。治疗在对照组的基础上口服孟鲁司特钠片,10 mg/次,1次/d。两组患者均连续治疗8周。观察两组的临床疗效,比较两组的肺功能和炎症反应情况。结果治疗后,对照组和治疗组的总有效率分别为73.68%、92.50%,两组比较差异有统计学意义(P<0.05)。治疗后,两组最大通气量(MVV)、1秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)和最大呼气流量(PEF)均显著升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的升高程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、白细胞介素-4(IL-4)、白细胞介素-5(IL-5)和白细胞介素-13(IL-13)水平均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的下降程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论孟鲁司特钠联合布地奈德治疗咳嗽变异性哮喘具有较好的临床疗效,可改善肺功能,减轻炎症反应,具有一定的临床推广应用价值。

Objective To investigate the clinical effect of montelukast combined with budesonide in treatment of cough variant asthma. Methods Patients（78 cases） with cough variant asthma in the Fifth Affiliated Hospital of Zhengzhou University from July 2014 to November 2016 were randomly divided into control group（38 cases） and treatment group（42 cases）. Patients in the control group were inhalation administered with Budesonide Aerosol, 200 μg/time, twice daily. Patients in the treatment group were po administered with Montelukast Sodium Tablets on the basis of the control group, 10 mg/time, once daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacies were evaluated, and pulmonary function and inflammatory reaction in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 73.68% and 92.50%, respectively, and there was difference between two groups（P〈0.05）. After treatment, MVV, FEV1, FEV1/FVC, and PEF in two groups were significantly increased, and the difference was statistically significant in the same group（P〈0.05）. And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups（P〈0.05）. After treatment, the levels of IL-6, TNF-α, IL-4, IL-5, and IL-13 in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups（P〈0.05）. Conclusion Montelukast combined with budesonide in treatment of cough variant asthma, can improve pulmonary function, and relieve inflammatory reaction, which has a certain application value.