特布他林联合布地奈德雾化吸入治疗小儿闭塞性细支气管炎的疗效及安全性探讨

Clinical effects and safety of terbutaline combined with budesonide atomized inhalation in the treatment of children with bronchiolitis obliterans

目的探讨特布他林联合布地奈德雾化吸入治疗小儿闭塞性细支气管炎的治疗效果及安全性。方法选取舟山市妇幼保健院2015年6月至2017年6月收治闭塞性细支气管炎患儿140例为研究对象，以随机抽签法分为对照组（70例）和观察组（70例），对照组采用布地奈德雾化吸入，观察组采用特布他林联合布地奈德雾化吸入治疗。比较两组疗效，临床症状消失时间，治疗前后白细胞介素4（IL-4）、干扰素γ（IFN-γ）水平及药物不良反应发生率。结果对照组治疗显效率和总有效率分别为28.57%、78.57%，观察组治疗显效率和总有效率分别为44.29%、95.71%，观察组治疗显效率和总有效率均显著高于对照组（χ2＝9.73、8.60，均P〈0.05）；观察组临床症状消失时间均显著短于对照组（t＝2.67、3.15、2.20、2.36，均P〈0.05）；观察组治疗后IL-4和INF-γ水平均显著高于对照组、治疗前（t＝2.44、2.71、3.07、3.66、2.94、3.26，均P〈0.05）；对照组和观察组药物不良反应发生率分别为8.57%、11.43%，两组药物不良反应发生率差异无统计学意义（χ2＝1.49，P〉0.05）。结论特布他林联合布地奈德雾化吸入治疗小儿闭塞性细支气管炎可显著提高疗效，调节IL-4和IFN-γ水平，且未增加药物不良反应风险。

ObjectiveTo investigate the clinical effects and safety of terbutaline combined with budesonide atomized inhalation in the treatment of children with bronchiolitis obliterans.Methods140 cases of children with bronchiolitis obliterans from June 2015 to June 2017 were selected as research subjects, and they were randomly divided into control group and observation group according to the digital table, with 70 cases in each group.The control group was given budesonide atomized inhalation alone, and the observation group was given terbutaline combined with budesonide atomized inhalation.The clinical effects, disappeared time of symptoms, levels of IL-4 and INF-γ before and after treatment and incidence rate of adverse effects in the two groups were compared.ResultsThe excellent effective rate and total effective rate of the control group were 28.57%, 78.57%, respectively, which were significantly lower than those of the observation group（44.29%, 95.71%） （χ2=9.73, 8.60, all P〈0.05）. The disappeared time of symptoms of the observation group was significantly shorter than those of the control group（t=2.67, 3.15, 2.20, 2.36, all P〈0.05）. The levels of IL-4 and INF-γ after treatment of the observation group were significantly higher than those of the control group and before treatment（t=2.44, 2.71, 3.07, 3.66, 2.94, 3.26, all P〈0.05）. The incidence rates of adverse effects of the control group and the observation group were 8.57%, 11.43%, respectively, there was no statistically significant difference between the two groups（χ2=1.49, P〉0.05）.ConclusionTerbutaline combined with budesonide atomized inhalation in the treatment of children with bronchiolitis obliterans can efficiently control the disease progression, shorten the clinical disease course, regulate the levels of IL-4 and IFN-γ and not aggravate the adverse drug reactions.