孟鲁司特钠片联合维生素D治疗婴幼儿毛细支气管炎的临床效果研究

Effect of montelukast sodium combined with vitamin D on clinical symptoms of capillary bronchitis in infants

目的探讨孟鲁司特钠片联合维生素D治疗婴幼儿毛细支气管炎的临床效果。方法将我院212例婴幼儿毛细支气管炎患者随机分为对照组(A组)50例、孟鲁司特钠片组(B组)53例、维生素D组(C组)55例和孟鲁司特钠片联合维生素D组(D组)54例。A组给予常规治疗,B组在A组的基础上加用孟鲁司特钠咀嚼片,C组在A组的基础上加用维生素D滴剂,D组在A组基础上同时给予孟鲁司特钠片和维生素D治疗。检测患儿第3天,第7天及3个月血清中C-25羟化维生素D_3[25(OH)D_3]、血清半胱氨酸白三烯(Cys LTS)、血氧饱和度(Tc Sa O_2)水平、尿白三烯-4(LTE4)水平;治疗效果、咳嗽消失时间、喘憋消失时间、肺部湿罗音及哮鸣音消失时间、住院时间;治疗一周后的临床疗效及出院后3个月的复发情况。结果与A组患儿相比,B、C、D组患儿的喘憋消失时间、肺部哮鸣音消失时间、呼吸困难消失时间、住院天数均明显缩短,且D组患儿上述指标与B组和C组相比,差异有统计学意义(P<0.05)。B、C、D组患儿治疗3 d、7 d、3个月的血清25(OH)D_3和血清Tc Sa O_2水平,均显著高于A组患儿,B、C、D组患儿血清Cys LTS、尿LTE4水平均显著低于A组患儿,且D组患儿上述指标与B、C组患儿比较,差异有统计学意义(P<0.05)。D组患儿临床总有效率为98.14%,显著高于A组患儿临床总有效率82.00%,B组患儿的总有效率为90.57%,C组患儿的总有效率为90.91%,差异均有统计学意义(P<0.05)。D组患儿复发率1.85%(1/54),显著低于A组患儿复发率(7/50),差异有统计学意义(P<0.05);B组患儿复发率7.55%(4/53)、C组患儿复发率5.45%(3/55)与A组患儿复发率比较,差异无统计学意义(P>0.05)。结论孟鲁司特钠联合维生素D能够有效提高婴幼儿免疫力、增强体质。

Objective To observe the effect of montelukast sodium combined with Vitamin D on clinical symptoms of capillary bronchitis in infants.Methods 212 infants with capillary bronchitis were randomly divided into control group（group A,50 cases）,Montelukast sodium group（group B,53 cases）,Vitamin D group（group C,55 cases）and Montelukast sodium combined with Vitamin D group（group D,54 cases）.Group A received routine treatment.Group B received oral Montelukast sodium on the base of group A.Group C received Vitamin D drops on the base of group A.Group D received oral Montelukast sodium with Vitamin D drops on the base of group A.The indicator of C-25 hydroxyl,vitamin D3[25（OH）D3],homocysteine leukotriene（CysLTS）and oxygen saturation（TcSaO2）level in serum,leukotriene-4（LTE4）level in Urinary at 3rd day,7th day and3 month were collected and tested;Treatment effect,disappeared time of cough,asthma,moist rale in lung,wheezing sound and the length in hospital were collected in all infants;The clinical curative effect of one week and relapse of 3 months after treatment were compared among different groups.ResultsDisappeared time of cough,asthma,moist rale in lung,wheezing sound in B,C and D groups were significant lower than in group A（all P〈0.05）.The time of remission in group D was significant lower than in B and C groups（all P〈0.05）;while each indicator in group B and group C had no significant difference（all P〉0.05）.Compared with group A,the difference of 25（OH）D3,CysLTS,TcSaO2 and LTE4 in B,C and D group had significant difference（all P〈0.05）.All those indicators of B group and C groups had no significant difference（P〉0.05）.The level of 25（OH）D3in serum was significant difference before and after treatments.The effective rate of group A was82.00%,effective rate of group B was 90.57%,effective rate of group C was 90.91%;The recurrence rate of children in group D was 1.85%（1/54）,which was significantly lower than that in group A（7/50）,and the difference was statistically significant（P〈0.05）.The recurrence rate of the B group was 7.55%（4/53）,and the recurrence rate in the group C was 5.45%（3/55）.The difference was not statistically significant（P〉0.05）compared with the recurrence rate of the A group.Conclusions Montelukast sodium combined with vitamin D can effectively improve the immunity of infants and enhance their physique.