高渗盐水联合布地奈德经鼻雾化治疗儿童呼吸道过敏性疾病临床疗效

A clinical study on nasal atomization of budesonide combined with hypertonic saline

目的分析3%高渗盐水联合布地奈德经鼻雾化辅助治疗儿童呼吸道过敏性疾病的临床疗效。方法纳入符合诊断标准的上气道咳嗽综合征及经规范抗哮喘治疗未能控制的轻中度持续哮喘患儿,同时合并有鼻塞和(或)流涕等症状、并经鼻部CT证实有鼻部病变;30例患儿采用传统治疗方法(常规药物治疗+避开过敏原)作为对照组;89例患儿采用经鼻雾化联合治疗方法(常规药物治疗+避开过敏原+鼻雾化治疗)作为治疗组;并根据IgE高低将治疗组分为IgE介导组和非IgE介导组二个亚组;疗程为7 d。观察患儿临床症状评分、鼻部症状视觉评分(VAS)、最大呼气流量(PEF)指标,记录并分析其疗效。结果治疗组与对照组患儿治疗1周临床症状评分、鼻部症状VAS评分呈下降趋势,PEF%值呈上升趋势。治疗组临床症状评分、鼻部症状VAS评分均显著低于对照组,PEF%值显著高于对照组。治疗方案的不同与治疗时间存在交互作用(P<0.05)。治疗1周后非IgE介导组PEF%值显著高于IgE介导组,差异有统计学意义(P<0.05)。结论高渗盐水联合布地奈德雾化辅助治疗儿童呼吸道过敏性疾病疗效显著,有较好的临床应用价值。

Objective To study the clinical efficacy of respiratory allergic diseases in children treated by nasal atomization of budesonide combined with 3% hypertonic saline. Methods Children diagnosed as upper air- way cough syndrome or mild to moderate asthma without being controlled by anti-asthma treatment were included in the study. They contracted with complications of nasal congestion and/or running noseand other symptoms, and na- sal CT confirmed the nasal lesions. Thirty children undergoing conventional treatment （conventional drug therapy ＋ keeping away from allergen ） were defined as the control group. 89 children treated with nasal spray therapy （con- ventional drug therapy ＋ keeping away from allergen ＋ nasal spray treatment ） were defined as the therapy group. The treatment group was subdivided into IgE-mediated group and non-IgE-mediated group according to IgE level. The treatment course was 7 days. The clinical symptoms score, nasal symptom visual scale （VAS） , peak expirato- ry flow （PEF） index were observed and analyzed. Results The clinical symptom score and nasal VAS showed a decreasing trend and the percentage of PEF showed an increasing trend in the two groups within 1 week after treat- ment. The clinical symptom score and nasal VAS score of the treatment group were significantly lower than those of the control group, while the PEF% value was significantly higher. The difference in treatment method was interact- ed with the treatment time （P 〈 0.05 ）. The percentage of PEF in the non-IgE-mediated group was significantly high- er than that of IgE-mediated group 1 week after treatment （P 〈 0.05）. Conclusion The nasal atomization of budesonide combined with hypertonic saline in the treatment of children with respiratory allergic diseases is effec- tive and of a good clinical value.