空气压缩泵与超声雾化吸入布地奈德联合特布他林治疗儿童咳嗽变异性哮喘临床研究

Effect of budesonide combined with terbutaline in the treatment of cough variant asthma in children by air compressor pump aerosol inhalation versus ultrasonic aerosol inhalation

目的探讨空气压缩泵与超声雾化吸入布地奈德联合特布他林对治疗咳嗽变异性哮喘患儿的疗效,为患者的临床治疗提供参考。方法选取深圳市福田区第二人民医院门诊部2016年6月至2018年6月收治的咳嗽变异性哮喘患儿54例进行研究,按照随机数表法将患儿分为观察组和对照组,每组27例。观察组采用空气压缩泵雾化吸入布地奈德联合特布他林进行治疗,对照组采用超声雾化吸入布地奈德联合特布他林进行治疗。治疗一周后,比较两组患儿的治疗总有效率,治疗前后检测并比较两组患儿的肺功能[FEV1 (第一秒用气量)、FVC (用力肺活量)、FEV1%(一秒率)]和血清学指标[EOS (嗜酸性粒细胞)、IL-4 (白细胞介素-4)、C型反应性蛋白(CRP)、IgE (免疫球蛋白E)的变化。结果治疗后,观察组患儿的治疗总有效率为96.30%,明显高于对照组的77.78%,差异具有统计学意义(P<0.5);治疗前,两组患者的FEV1、FVC及FEV1/FVC水平比较差异均无统计学意义(P>0.05);治疗后,两组患者的肺功能各项指标均明显升高,且观察组的FEV1、FVC及FEV1/FVC水平[(0.71±0.11) L、(3.21±0.41) L、(91.45±10.12)%]明显高于对照组[(0.63±0.10) L、(2.58±0.29) L、(80.32±8.32)%)],差异均有统计学意义(P<0.05);治疗前,两组患儿的EOS、IL-4、CRP及IgE水平比较差异均无统计学意义(P>0.05);治疗后,两组患儿的EOS、IL-4、CRP及IgE水平均明显降低,且观察组[(0.53±0.06)%、(50.78±6.43) ng/mL、(6.56±2.45) mg/L、(105.76±13.68) IU/mL]明显低于对照组[(0.73±0.12)%、(80.91±9.65) ng/mL、(8.79±3.21) mg/L、(187.67±21.10) IU/mL],差异均有统计学意义(P<0.05);治疗过程中,对照组有1例出现皮疹,2例出现胃肠不适;观察组有1例出现轻度胃肠不适,均经对症处理后缓解。对照组和观察组患者的不良反应发生率分别为3.70%和11.11%,差异无统计学意义(P>0.05)。结论空气压缩泵雾化吸入较超声雾化吸入治疗儿童咳嗽变异性哮喘的效果更显著,安全性高,值得临床上推广应用。

Objective To investigate the effect of air compressor pump aerosol inhalation and ultrasonic aerosol inhalation of budesonide and terbutaline on children with cough variant asthma, and to provide reference for clinical treatment. Methods Fifty-four children with cough variant asthma admitted to the Outpatient Department, the Second People’s Hospital of Futian District of Shenzhen from June 2016 to June 2018 were selected for the study. According to the random number table method, the children were divided into observation group and control group, with 27 cases in each group. The observation group was treated with aerosol inhalation of budesonide combined with terbutaline by air compressor pump, while the control group was treated with ultrasonic aerosol inhalation of budesonide combined with terbutaline. After one week of treatment, the total effective rate of treatment was compared between the two groups. The changes of lung function(forced expiratory volume in the first second [FEV1], forced vital capacity [FVC], percentage of FEV1 to the predicated value [FEV1%]) and serological indexes(eosinophil [EOS], interleukin-4 [IL-4], C-reactive protein [CRP], immunoglobulin E [IgE]) were detected and compared between the two groups before and after treatment. Results After treatment, the total effective rate of the observation group was 96.30%, which was significantly higher than 77.78% of the control group(P<0.5). Before treatment, there were no significant difference in the levels of FEV1, FVC, and FEV1/FVC between the two groups(P>0.05);after treatment, the indexes in the two groups were all significantly increased, and the levels of in the observation group were significantly higher than those in the control group(P<0.05): FEV1(0.71±0.11) L vs(0.63±0.10) L, FVC(3.21±0.41) L vs(2.58±0.29) L, FEV1/FVC(91.45±10.12)% vs(80.32±8.32)%. Before treatment, the levels of EOS, IL-4, CRP, and IgE between the two groups showed no significant difference(P>0.05);after treatment, the levels of EOS, IL-4, CRP, and IgE in the two groups were significantly decreased, and the levels in the observation group were significantly lower(P<0.05):(0.53 ± 0.06)% vs(0.73 ± 0.12)%,(50.78±6.43) ng/mL vs(80.91±9.65) ng/mL,(6.56±2.45) mg/L vs(8.79±3.21) mg/L,(105.76±13.68) IU/mL vs(187.67 ±21.10) IU/mL. In the course of treatment, there were 1 case of rash and 2 cases of gastrointestinal discomfort in the control group and 1 case of mild gastrointestinal discomfort in the observation group, which were alleviated after symptomatic treatment. There were no significant difference in the incidence of adverse reactions between the two groups(3.70%vs 11.11%, P>0.05). Conclusion Aerosol inhalation of budesonide combined with terbutaline by air compressor pump is more effective and safer than ultrasonic aerosol inhalation in the treatment of cough variant asthma in children, which is worthy of clinical application.