儿童哮喘急性发作应用不同剂量布地奈德雾化吸入的临床疗效对比

Comparison of the clinical efficacy between different doses of budesonide atomizing inhalation in the children with acute asthma attack

目的对比分析两种剂量布地奈德雾化吸入治疗儿童哮喘急性发作的临床效果及安全性。方法选取2015年9月~2017年3月我院收治的哮喘急性发作患儿86例为研究对象,经随机数字表法分为A、B两组,每组43例,均给予基础治疗,A组加用大剂量(1.0 mg/次)布地奈德雾化吸入,B组则加用常规剂量(0.5 mg/次)布地奈德雾化吸入,观察两组患儿症状与体征改善情况、肺功能变化及不良反应发生情况。结果 A组患儿用药后咳嗽、呼吸困难、哮鸣音及喘息消失时间均明显较B组短,差异有统计学意义(P<0.05);治疗前两组患儿肺功能指标无显著性差异(P>0.05),治疗后1 h均有改善,A组患儿用力肺活量(FVC)、呼气峰值流速(PEF)及第1秒最大呼气量(FEV_1)均显著大于B组,差异有统计学意义(P<0.05);A、B两组患儿用药后不良反应发生率分别为9.30%、4.65%,组间比较差异无统计学意义(P>0.05),均未出现严重不良反应。结论在儿童哮喘急性发作治疗中,应用大剂量布地奈德雾化吸入,可增强疗效,促进症状改善,且安全性高,值得推广。

Objective To compare and analyze the clinical efficacy and safety of two doses of budesonide atomizing inhalation in the treatment of acute asthma attack in children. Methods 86 patients with acute asthma attack who were admitted to our hospital from September 2015 to March 2017 were selected as the study subjects. The patients were assigned to group A and group B by random number table, with 43 patients in each group, who were given basic treatment. Group A was further given large dose（1.0 mg/time） of budesonide atomizing inhalation, and group B was further given regular dose（0.5 mg/time） of budesonide atomizing inhalation. The improvement of symptoms and signs, changes of pulmonary function and the occurrence of adverse reactions were observed in the two groups. Results Cough, dyspnea,wheezing and asthma disappearing time in group A after medication were significantly shorter than those in group B,and the differences were statistically significant（P〈0.05）; there were no significant differences in lung function index between the two groups before treatment（P〉0.05）. The indices were improved 1 h after treatment. Forced vital capacity（FVC）, peak expiratory flow rate（PEF） and the first expiratory volume（FEV1） in group A were significantly higher than those in group B, and the differences were statistically significant（P〈0.05）; the incidence rates of adverse reactions were9.30% and 4.65% after medication in the patients in group A and group B respectively, and the differences were not statistically significant（P〉0.05）. There were no serious adverse reactions. Conclusion In the treatment of children acute asthma attack, the application of high dose of budesonide atomizing inhalation can enhance the curative effect, promote the improvement of symptoms, with high safety, which is worthy of promotion.