3%高渗盐水和重组人干扰素α-2b雾化吸入辅助治疗儿童轻中度毛细支气管炎疗效比较

Therapeutic Effect of Atomization Inhalation of 3% Hypertonic Saline and Recombinant Human Interferonα-2b in the Treatment of Mild to Moderate Bronchiolitis

目的:比较3%高渗盐水和重组人干扰素α-2b雾化吸入辅助治疗轻中度毛细支气管炎患儿的疗效。方法:收集2015年11月至2017年4月在安徽医科大学附属安庆医院儿科住院治疗的轻中度毛细支气管炎患儿134例,随机分为三组:对照组给予沙丁胺醇2.5 mg+布地奈德0.5 mg用生理盐水配成2.5 mL雾化吸入,每日2次;高渗盐水组在对照组基础上给予3%高渗盐水4 mL雾化吸入,间隔4 h一次,每日3次;干扰素组在对照组雾化方案中加入重组人干扰素α-2b 200 000 IU/kg,每日2次。记录患儿治疗前及治疗后5 d内的临床病情严重程度评分、不良反应发生情况、退出研究例数和住院时间。结果:对照组3例、高渗盐水组2例、干扰素组2例因病情加重加用其他药物治疗后退出(P>0.05)。高渗盐水组4例因阵发性刺激性咳嗽退出,干扰素组和对照组未出现明显不良反应(P<0.05)。最终完成研究123例,其中对照组40例,高渗盐水组42例,干扰素组41例。高渗盐水组病情严重程度评分在治疗后第2~4天低于干扰素组,在第2~5天低于对照组(P均<0.01);干扰素组病情严重程度评分在第4~5天低于对照组(P均<0.01)。高渗盐水组和干扰素组的住院时间均短于对照组(P均<0.05)。结论:雾化吸入3%高渗盐水和重组人干扰素α-2b均能改善轻中度毛细支气管炎患儿的病情,缩短住院时间,但前者可引起刺激性咳嗽。

Objective： To compare the therapeutic efficacy of atomization inhalation of 3% hypertonic saline and recombinant human interferon（ rh IFN） α-2 b in the treatment of children with mild to moderate bronchiolitis. Methods： A total of 134 children with mild to moderate bronchiolitis hospitalized in department of pediatrics of Anqing Hospital Affiliated to Anhui Medical University from November2015 to April 2017 were randomly divided into three groups： children in the control group received atomization inhalation（ salbutamolsolution 0. 5 mg＋budsonide 0. 5 mg） twice a day. Children in hypertonic saline group received additional atomization inhalation of 3%hypertonic saline 4 mL,3 times a day every 4 hours based on the treatment of the control group. Children in interferon group received additional atomization inhalation of rh IFN α-2 b（ 200,000 IU/kg each time） twice a day based on the treatment of the control group. The clinical severity scores before and after treatment in 5 days,adverse reactions,number of withdrew from the study in each group and the length of stay were recorded. Results： Among the 134 cases,3 cases in the control group,2 cases in hypertonic saline group and 2 cases in interferon group withdrew from the study because of treatment with additional drugs due to aggravation of the disease（ P〈0. 05）.Four cases in hypertonic saline group withdrew because of paroxysmal irritable cough,while no obvious adverse reactions were observed in interferon group or control group（ P 0. 05）. Practically,123 cases were enrolled in the clinical study,among which 40 cases in control group,42 cases in hypertonic saline group and 41 cases in interferon group. The severity scores of hypertonic saline group were lower than that of interferon group from the 2 nd to 4 th day after treatment,and the differences were statistically significant（ P〈0. 01）.The severity scores of hypertonic saline group were lower than those of the control group from the 2 nd to 5 th day after treatment,and the differences were statistically significant（ P〈0. 01）. The severity scores of interferon group were lower than those of the control group on the 4 th and 5 th day after treatment and the differences were statistically significant（ P〈0. 01）. The hospital stays of both hypertonic saline group and interferon group were shorter than that of the control group and the differences were statistically significant（ P〈0. 05）.Conclusion： Atomization inhalation of 3% hypertonic saline and rh IFN α-2 b can improve the condition of children with mild to moderate bronchiolitis. Both of them can shorten hospital stay,but the atomization inhalation of 3% hypertonic saline may cause irritable cough.