孟鲁司特联合小剂量舒利迭治疗咳嗽变异性哮喘的疗效及安全性研究

Study on efficacy and safety of Montelukast combined with low-dose Seretide in the treatment of cough variant asthma

目的研究孟鲁司特联合小剂量沙美特罗替卡松粉吸入剂(商品名:舒利迭)治疗咳嗽变异性哮喘的疗效及安全性。方法 60例咳嗽变异性哮喘患儿,随机分成观察组和对照组,每组30例。观察组采取孟鲁司特联合小剂量舒利迭治疗,对照组采取常规剂量舒利迭治疗。比较两组患儿临床疗效、临床指标、激发试验转阴率、肺功能指标及安全性。结果观察组总有效率为96.67%,高于对照组的80.00%,差异具有统计学意义(P<0.05)。观察组咳嗽缓解时间、咳嗽消失时间短于对照组,复发率低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组激发试验转阴率明显高于对照组,差异具有统计学意义(χ~2=5.455,P<0.05)。治疗后,观察组患儿第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占预计值的百分比(FEV1%pred)、第1秒用力呼气容积占用力肺活量的百分比(FEV1/FVC)均高于对照组,差异具有统计学意义(t=8.831、3.690、3.166,P<0.05)。两组患儿不良反应发生率比较差异无统计学意义(P>0.05)。结论孟鲁司特联合小剂量舒利迭治疗咳嗽变异性哮喘的疗效显著,安全性高,值得应用。

Objective To study the efficacy and safety of Montelukast combined with low-dose salmeterol xinafoate and fluticasone propionate powder for inhalation（trade name： Seretide） in the treatment of cough variant asthma. Methods A total of 60 children with cough variant asthma were randomly divided into observation group and control group, with 30 cases in each group. The observation group was treated with Montelukast combined with low-dose Seretide, and the control group was treated with routine-dose Seretide. Comparison were made on clinical efficacy, clinical indicators, incitement test negative-conversion rate, lung function indicators and safety between the two groups. Results The observation group had higher total effective rate as 96.67% than 80.00% in the control group, and the difference was statistically significant（P〈0.05）. The observation group had shorter cough remission time, cough disappearance time than the control group, and lower recurrence rate than the control group. The differences were statistically significant（P〈0.05）. After treatment, the observation group had obviously higher incitement test negative-conversion rate, and the difference was statistically significant（χ^2=5.455, P〈0.05）. After treatment, the observation group had higher forced expiratory volume in first second（FEV1）, percentage of forced expiratory volume in first second（FEV1%pred） and forced expiratory volume in first second/forced vital capacity（FEV1/FVC） than the control group, and their difference was statistically significant（t=8.831, 3.690, 3.166, P〈0.05）. Both groups had no statistically significant difference in incidence of adverse reactions（P〉0.05）. Conclusion Combination of Montelukast and low-dose Seretide shows remarkable efficacy in treating cough variant asthma with high safety, and it is worthy of application.