孟鲁司特联合布地奈德治疗哮喘急性发作研究

Montelukast combined with budesonide in the treatment of acute asthma

目的探讨孟鲁司特联合布地奈德治疗哮喘急性发作临床疗效及安全性。方法将81例哮喘急性发作期患者按照治疗方法分为对照组(n=39)与观察组(n=42),两组患者均开展常规治疗,对照组在常规治疗基础上加用布地奈德雾化治疗,100～200μg/d,每日2次;观察组在对照组基础上联合孟鲁斯特进行治疗,每次10 mg,1次/晚。比较两组临床疗效、治疗前后肺功能相关指标水平、治疗后相关临床症状积分、治疗前后血清IL-4及IFN-γ水平、不良反应发生率。结果经治疗,观察组临床总有效率为95.24%(40/42),对照组为74.36%(29/39),差异具有统计学意义(P <0.05);两组治疗后肺功能相关指标(FEV_1/FVC、PEF)水平均显著高于治疗前(P <0.05),观察组治疗后上述指标与对照组相比差异明显(P <0.05);观察组鼻塞、打喷嚏、盗汗、易感冒、哮喘发作等情况明显低于对照组(P <0.05);两组患者治疗后血清IL-4水平均显著低于治疗前(P <0.05),两组患者治疗后血清IFN-γ水平均显著高于治疗前(P <0.05),且两组患者治疗后血清IL-4及IFN-γ水平差异均具有统计学意义(P <0.05);对照组出现2例轻度恶心、呕吐症状,观察组出现3例轻度恶心、呕吐症状,给药结束后,症状缓解并消失。结论孟鲁司特联合布地奈德治疗哮喘急性发作临床疗效显著,不良反应较轻。

Objective To investigate the clinical efficacy and safety of montelukast combined with budesonide in the treatment of acute asthma attack.Methods Eighty-one patients of acute asthma were included and divided into control group(n=39)and observation group(n=42).The control group was treated with budesonide,100~200μg/d,bid;The observation group was treated with Montelukast on the basis of control group,10 mg,qd.The pulmonary function,scores of clinical symptoms and serum IL-4 and IFN-γwere recorded and compared between the two groups.Results The total effective rate was 95.24%(40/42)in the observation group and 74.36%(29/39)in the control group(P<0.05).The pulmonary function(FEV1/FVC,PEF)in the two groups was significantly improved(P<0.05).There was a significant difference of FEV1/FVC,PEF between the observation group and the control group after treatment(P<0.05).The symptom of nasal congestion and sneezing,night sweating,cold,asthma attack in the observation group was significant improved compared to control group(P<0.05).The level of serum IL-4 after treatment in both groups was significantly lower than that before(P<0.05).The level of serum IFN-γin both groups was significantly higher than that before(P<0.05).The levels of serum IL-4 and IFN-γwere significant different between the two groups after treatment(P<0.05).There were 2 cases of mild nausea and vomiting in the control group and 3 cases of mild nausea and vomiting in the observation group.Conclusion Montelukast combined with budesonide is effective in the treatment of acute asthma attack.The effect of bed was remarkable and the adverse reaction was mild.