雾化吸入布地奈德与口服泼尼松对儿童咳喘急性发作期有效性的临床研究

Clinical study on efficacy of nebulized budesonide inhalation and oral prednisone in acute onset of cough and asthma in children

目的探索雾化吸入布地奈德与口服泼尼松对儿童咳喘急性发作期的有效性及安全性。方法选择上海市杨浦区中心医院2017年4月至2019年4月期间收治的急性发作期咳喘患儿中60例作为研究对象,按照随机分组的原则将患儿分为布地奈德组(19例)、泼尼松组(21例)和对照组(20例),对照组按照常规措施进行治疗,布地奈德组则在此基础上增加布地奈德雾化吸入治疗,泼尼松组则增加口服泼尼松龙片治疗,治疗7天后比较各组患儿治疗有效率;不良反应发生率,呼吸功能相关指标、呼吸困难评分及复发率。结果经过7天的治疗,对照组治疗有效率为80%,布地奈德组和泼尼松组有效率为100%,差异有统计学意义(P<0.05);对照组不良反应发生率为15%,布地奈德组不良反应发生率为42.1%,泼尼松组不良反应发生率为52.38%,差异有统计学意义(P<0.05);入院时各组患儿呼吸功能各指标及呼吸困难评分差异无统计学意义(P>0.05),经过治疗后,和治疗前比较差异有统计学意义(P<0.05),泼尼松组和布地奈德组在治疗后呼吸功能各指标改善程度更优于对照组,治疗后和对照组比较差异有统计学意义(P<0.05),呼吸困难评分治疗后和对照组比较差异无统计学意义(P>0.05);对照组复发率为30%,布地奈德组复发率为10.53%,泼尼松组复发率为14.29,差异有统计学意义(P<0.05)。结论雾化吸入布地奈德与口服泼尼松对儿童咳喘急性发作期均有较好的疗效,但是会增加发生不良事件的可能,因此建议临床应用中因综合考虑其各方利弊,最终确定最佳治疗方案。

Objective To explore the efficacy and safety of nebulized budesonide inhalation and oral prednisone in acute onset of cough and asthma in children.Methods From April 2017 to April 2019,60 children with cough and asthma in acute attack period were selected as the research objects.According to the principle of random grouping,the children were divided into budesonide group(19 cases),prednisone group(21 cases)and control group(20 cases).The control group was treated according to routine measures,and budesonide group was added Budesonide aerosol inhalation therapy on this basis.In the nisone group,oral prednisolone tablets were added,and the effective rate,adverse reactions,respiratory function related indexes,dyspnea score and recurrence rate were compared after 7 days of treatment.Results After 7 days of treatment,the effective rate of control group was 80%,the effective rate of budesonide group and prednisone group was 100%,the difference was statistically significant(P<0.05);the incidence of adverse reactions in control group was 15%,budesonide group was 42.1%,and prednisone group was 52.38%,the difference was statistically significant(P<0.05).There was no significant difference in index and dyspnea score(P>0.05).After treatment,there was significant difference compared with before treatment(P<0.05).After treatment,the improvement of respiratory function in prednisone group and budesonide group was better than that in control group.There was significant difference between the two groups after treatment(P<0.05).After treatment,dyspnea score was compared with the control group.There was no significant difference(P>0.05);the recurrence rate of control group was 30%,budesonide group was 10.53%,prednisone group was 14.29,the difference was statistically significant(P<0.05).Conclusion Nebulized budesonide inhalation and oral prednisone have better curative effect on acute attack of cough and asthma in children,but they increase the possibility of adverse events.Therefore,it is suggested that the best treatment plan should be determined in clinical application by considering the advantages and disadvantages of all parties.