孟鲁司特钠辅助治疗哮喘-慢性阻塞性肺疾病重叠患者的临床疗效

Clinical Effect of Montelukast Sodium in the Adjuvant Therapy of Asthma-COPD Overlap

目的观察孟鲁司特钠辅助治疗哮喘-慢性阻塞性肺疾病重叠(ACO)患者的临床疗效。方法选取2017年10月-2018年10月上海市浦东医院收治的ACO患者92例,采用随机数字表法分为对照组和试验组,每组46例。对照组患者给予常规对症治疗,试验组患者在对照组基础上给予孟鲁司特钠辅助治疗;4周为1个疗程,两组患者均连续治疗2个疗程。比较两组患者临床疗效及治疗前后慢性阻塞性肺疾病评估测试(CAT)评分、哮喘控制测试(ACT)评分、肺功能指标〔包括第一秒用力呼气容积(FEV1)、第一秒用力呼气容积与用力肺活量比值(FEV1/FVC)、一氧化碳弥散量(DLCO)、呼出气一氧化氮浓度(FeNO)〕、炎性因子〔包括白介素6(IL-6)、肿瘤坏死因子α(TNF-α)〕,并观察两组患者治疗期间不良反应发生情况。结果(1)试验组患者临床疗效优于对照组(P<0.05)。(2)治疗前两组患者CAT评分和ACT评分比较,差异无统计学意义(P>0.05);治疗后试验组患者CAT评分低于对照组,ACT评分高于对照组(P<0.05)。(3)治疗前两组患者FEV1、FEV1/FVC、DLCO、FeNO比较,差异无统计学意义(P>0.05);治疗后试验组患者FEV1、DLCO大于对照组,FEV1/FVC高于对照组,FeNO低于对照组(P<0.05)。(4)治疗前两组患者血清IL-6、TNF-α水平比较,差异无统计学意义(P>0.05);治疗后试验组患者血清IL-6、TNF-α水平低于对照组(P<0.05)。(5)两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论孟鲁司特钠辅助治疗ACO患者的临床疗效确切,可有效控制患者病情,改善患者肺功能,减轻患者炎性反应,且安全性较高。

Objective To observe the clinical effect of montelukast sodium in the adjuvant therapy of asthma-COPD overlap(ACO). Methods A total of 92 patients with ACO were selected in Pudong Hospital of Shanghai from October 2017 to October 2018,and they were divided into control group and test group according to random number table,with 46 cases in each group. Patients in control group received conventional symptomatic treatment,while patients in test group received adjuvant therapy of montelukast sodium based on conventional symptomatic treatment;both groups continuously treated for 2 courses(4 weeks as a course). Clinical effect,pre and post-treatment CAT score,ACT score,index of pulmonary function(including FEV1,FEV1/FVC,DLCO and FeNO)and inflammatory cytokines(including IL-6 and TNF-α)were compared between the two groups,and incidence of adverse reactions was observed during treatment. Results(1)Clinical effect in test group was statistically significantly better than that in control group(P<0.05).(2)No statistically significant difference of CAT score or ACT score was found between the two groups before treatment(P>0.05);after treatment,CAT score in test group was statistically significantly lower than that in control group,while ACT score in test group was statistically significantly higher than that in control group(P<0.05).(3)No statistically significant difference of FEV1,FEV1/FVC,DLCO or FeNO was found between the two groups before treatment(P>0.05);after treatment,FEV1 and DLCO in test group were statistically significantly larger than those in control group,FEV1/FVC in test group was statistically significantly higher than that in control group,while FeNO in test group was statistically significantly lower than that in control group(P<0.05).(4)No statistically significant difference of IL-6 or TNF-α was found between the two groups before treatment(P>0.05),while IL-6 and TNF-α in test group were statistically significantly lower than those in control group after treatment(P<0.05).(5)No statistically significant difference of incidence of adverse reactions was found between the two groups during treatment(P>0.05).Conclusion Montelukast sodium has certain clinical effect in the adjuvant therapy of ACO,can effectively control the illness,improve the pulmonary function and reduce the inflammatory reaction,with relatively high safety.