强化药物方案对螨虫过敏儿童咳嗽变异型哮喘疗效及安全性的影响

Influence of intensive drug regimen on clinical efficacy and safety of children with cough variant asthma combined with mite allergy

目的探讨强化药物方案对螨虫过敏儿童咳嗽变异型哮喘疗效及安全性的影响。方法研究对象选取湖南省第二人民医院2016年3月至2018年3月收治儿童咳嗽变异型哮喘伴螨虫过敏患儿共124例,以随机数字表法分为对照组(62例)和试验组(62例),分别在糖皮质激素基础上加用孟鲁司特钠或孟鲁司特钠+西替利嗪治疗,比较2组咳嗽消失时间、使用沙丁胺醇量、治疗前后咳嗽症状积分、气道反应性指标、血清学指标水平、随访复发率及不良反应发生率。结果试验组咳嗽消失时间显著短于对照组(t=3.46,P<0.05);试验组使用沙丁胺醇量显著少于对照组(t=2.92,P<0.05);试验组治疗后咳嗽症状积分显著低于对照组(t=3.11,P<0.05);试验组治疗后Dmin和PD35水平均显著优于对照组(t=3.89、4.03,P值均<0.05);试验组治疗后IL-4、IL-5、IL-13、总IgE及嗜酸粒细胞水平显著低于对照组(t=3.74、4.26、4.10、4.85、3.59,P值均<0.05);试验组随访复发率显著低于对照组(χ2=8.89,P<0.05);同时2组不良反应发生率比较差异无统计学意义(χ2=1.13,P>0.05)。结论强化药物方案用于儿童咳嗽变异型哮喘伴螨虫过敏患儿可有效缓解咳嗽症状,减少沙丁胺醇用量,改善气道反应性,降低慢性炎症损伤水平,避免远期复发,且安全性值得认可。

Objective To investigate the influence of intensive drug regimen on clinical efficacy and safety of children with cough variant asthma combined with mite allergy.Methods One hundred and twenty-four children with cough variant asthma combined with mite allergy were chosen in the period from March 2016 to March 2018 in Second People′s Hospital of Hunan Province and randomly divided into control group(62 cases)with montelukast sodium and glucocorticoid and experiment group(62 cases)with montelukast sodium and cetirizine on the basis of glucocorticoid,and the cough disappearance time,salbutamol dosage,cough symptom score,airway reactivity index and serological index before and after treatment,recurrence rate with follow-up and adverse reactions incidence of both groups were compared.Results The cough disappearance time of experiment group were significant shorter than control group(t=3.46,P<0.05).The salbutamol dosage of experiment group were significant less than control group(t=2.92,P<0.05).The cough symptom score of experiment group after treatment were significant less than control group(t=3.11,P<0.05).The levels of Dmin and PD35 of experiment group after treatment were significant less than control group(t=3.89,4.03,both P<0.05).The levels of IL-4,IL-5,IL-13,total IgE and EOS of experiment group after treatment were significant less than control group(t=3.74,4.26,4.10,4.85,3.59,all P<0.05).The recurrence rate with follow-up of experiment group were significant lower than control group(χ2=8.89,P<0.05).There was no significant difference in the adverse reaction incidence between 2 groups(χ2=1.13,P>0.05).Conclusions Intensive drug regimen in the treatment of children with cough variant asthma combined with mite allergy can efficiently relieve cough symptoms,decrease the salbutamol dosage,improve airway responsiveness,reduce the levels of chronic inflammatory injury,avoid long-term recurrence and safety should be satisfactory.