吸入性沙美特罗替卡松联合孟鲁司特钠治疗儿童支气管哮喘的临床分析

Clinical Analysis on Inhaled Salmeterol/Fluticasone Combining with Montelukast Sodium in Pediatric Bronchial Asthma

目的观察吸入性沙美特罗替卡松联合孟鲁司特钠治疗儿童支气管哮喘(BA)的疗效及安全性。方法选取2015年3月至2017年8月湖北省妇幼保健院收治的76例BA患儿为研究对象,采用随机数字法分为两组,各38例。对照组给予沙美特罗替卡松粉剂,每次1吸(50μg),每12小时1次。观察组在对照组基础上口服孟鲁司特钠5 mg,每日1次。比较两组患儿治疗28 d后的临床疗效、哮喘控制测试评分(ACT)、肺功能[呼气流量峰值(PEF)、第1秒用力呼气量(FEV_1)/用力肺活量(FVC)、FEV_1]改善情况,症状缓解、症状消失时间以及不良反应发生率。结果治疗后观察组总有效率显著高于对照组[94.7%(36/38)比78.9%(30/38)],ACT显著高于对照组[(25.77±0.78)分比(21.01±0.71)分](P<0.01);治疗后观察组PEF、FEV_1/FVC和FEV_1显著高于对照组[(82±39)L/min比(72±35)L/min,(90±11)%比(73±9)%,(2.4±0.3)L比(1.7±0.5)L,P<0.01];观察组临床症状缓解时间和消失时间均显著短于对照组[(4.9±1.9)d比(8.2±1.4)d,(7.1±1.1)d比(9.8±1.6)d,P<0.01]。治疗期间两组不良反应发生率比较差异无统计学意义(P>0.05)。结论吸入性沙美特罗替卡松联合孟鲁司特钠治疗BA患儿临床疗效显著,可有效控制临床症状,改善肺功能,不良反应少。

Objective To evaluate the efficacy and safety- of inhaled salmeterol/fluticasone combining with montelukast sodium in the treatment of pediatric bronchial asthma（ BA }. Methods A total of 76 children with BA adnfitted to Maternal and Child Health Hospital of Hubei Province from Mar. 2015 to Aug. 2017 were included in the study and divided into two groups according to the random number method, 38 cases each group. Children in the control group were treated with inhaled salmeterol/fluticasone powder, one inhale per time （50 g） , once per 12 hours; while the observation group patients were given inhalation treatment plus oral montelukast sodium 5 rag, once per day. Total effective rate, asthma control test（ ACT）, lung function[ peak expiratory-flow（PEF）, forced expiratory volume in one second （FEV-）/forced vital capacity（ FVC ）, and FEV1] , time of resolution and relief of symptoms, as well as adverse reactions of the two groups after 28 day-s of treat-ment were compared. Results Compared with the control group, total effective rate of the observation group was higher [94.7% （36/38） vs 78.9% （30/38） ], and ACT scores significantly higher than that of the control group[ （25.77 ± 0.78） score vs （21.01 ± 0.71 ） score ] （ P 〈 0.01 ）. After treatmnet, the PEF, FEV-/FVC and FEV of the observation group were higher than those in the control group[ （82 ± 39 ） L/rain vs （72 ± 35 ） L/rain, （90 ± 11 ）% vs （73 ± 9 ）%, （2.4 ± 0.3） L vs （ 1.7 ± 0.5 ） L,P 〈 0.01 ]. Time of relief and resolution of symptoms in the observation group was nota-bly shorter than that in the control group[ （4.9 ±1.9） d vs （8.2 ±1.4） d,（7.1 ±1.1） d vs （9.8 ±1.6） d,P 〈0.01]. There was no significant difference in the incidence of adverse reactions between the two groups during the treatment period（P 〉 0.05 ）. Conclusion Inhaled salmeterol/fluticasone combining with montelukast sodium are effective and safe for children with BA,which can rapidly control the clinical symptoms and improve lung function with less adverse reactions.