孟鲁司特钠咀嚼片治疗儿童支气管哮喘疗效观察

Effect of montelukast sodium chewable tablet in the treatment of children with bronchial asthma

目的探讨孟鲁司特钠咀嚼片治疗儿童支气管哮喘的临床疗效及作用机制。方法选择2015年3月至2016年6月随州市妇幼保健院收治的急性发作期支气管哮喘患儿180例,依据治疗方法分为孟鲁司特组(n=120)和对照组(n=60),对照组患儿给予布地奈德雾化、祛痰、维持电解质和酸碱平衡、抗感染、β-受体激动剂等常规治疗,孟鲁司特组患儿在常规治疗基础上给予孟鲁司特钠咀嚼片治疗,2组患儿均连续治疗14 d;对2组患儿的临床疗效、肺功能及血清核转录因子-κB(NF-κB)和白细胞介素-8(IL-8)水平进行比较。结果治疗前2组患儿血清NF-κB、IL-8水平比较差异均无统计学意义(P>0.05),2组患儿治疗后血清NF-κB、IL-8水平均显著低于治疗前(P<0.05),治疗后孟鲁司特组患儿血清NF-κB、IL-8水平显著低于对照组(P<0.05)。治疗前2组患儿第1秒用力呼气量(FEV1)、呼气峰流速(PEF)及FEV1占用力肺活量百分比(FEV1%)比较差异均无统计学意义(P>0.05),2组患儿治疗后FEV1、PEF及FEV1%均显著高于治疗前(P<0.05),治疗后孟鲁司特组患儿FEV1、PEF及FEV1%显著高于对照组(P<0.05)。孟鲁司特组和对照组患儿治疗总有效率分别为95.83%(115/120)、71.67%(43/60),孟鲁司特组患儿治疗总有效率显著高于对照组(χ~2=6.989,P<0.05)。孟鲁司特组和对照组患儿不良反应发生率分别为10.83%(13/120)、11.67%(7/60),2组患儿的不良反应发生率比较差异无统计学意义(χ~2=0.345,P>0.05)。2组患儿治疗期间均未发生严重不良反应。结论孟鲁司特钠咀嚼片可以显著减轻支气管哮喘患儿的呼吸道炎症反应,提高患儿肺功能,改善患儿临床症状,且安全性较好。

Objective To investigate the clinical efficacy and mechanism of montelukast sodium chewable tablet in the treatment of children with bronchial asthma. Methods A total of 180 children with bronchial asthma were selected from March2015 to June 2016 in Suizhou Maternal and Child Health Hospital. The children were divided into montelukast group（ n =120） and control group（ n = 60） according to the therapeutic method. The children in the control group were treated with conventional treatment,including budesonide atomization,expectorant,maintaining electrolyte and acid-base balance,anti-infective therapy,β-agonists and so on. The children in the montelukast group were treated with montelukast sodium chewable tablet on the basis of conventional treatment. The children in the two groups were treated for 14 days. The clinical effect,lung function and the levels of serum nuclear factor-κB（ NF-κB） and interleukin-8（ IL-8） were compared between the two groups. Results There was no significant difference in serum NF-κB and IL-8 levels between the two groups before treatment（ P 0. 05）.The levels of serum NF-κB and IL-8 after treatment were significantly lower than those before treatment in the two groups（ P 0. 05）. The levels of serum NF-κB and IL-8 in the montelukast group were significantly lower than those in the control group（ P 0. 05）. There was no significant difference in the forced expiratory volume in first second（ FEV1）,peak expiratory flow（ PEF） and percentage of FEV1 to forced vital capacity（ FEV1%） between the two groups before treatment（ P 0. 05）. The FEV1,PEF and FEV1% after treatment were significantly higher than those before treatment in the two groups（ P 0. 05）.The FEV1,PEF and FEV1% in the montelukast group were significantly higher than those in the control group after treatment（ P 0. 05）. The total effective rate in montelukast group and control group was 95. 83%（ 115/120） and 71. 67%（ 43/60）respectively,the total effective rate in montelukast group was significantly higher than that in control group（ χ~2= 6. 989,P 0. 05）. The incidence of adverse reactions in montelukast group and control group was 10. 83%（ 13/120） and 11. 67%（ 7/60） respectively,there was no significant difference in the incidence of adverse reactions between the two groups（ χ~2= 0. 345,P 0. 05）. There was no serious adverse reaction in the two groups during the treatment. Conclusion Montelukast sodium chewable tablet can significantly reduce the respiratory tract inflammatory reaction,improve the lung function,improve the clinical symptoms and have better safety in children with bronchial asthma.