布地奈德联合孟鲁司特钠治疗儿童急性哮喘的效果及其影响因素分析

Clinical efficacy of budesonide combined with montelukast sodium in the treatment of acute asthma and influencing factors thereof

目的:探究布地奈德联合孟鲁司特钠治疗儿童急性哮喘的疗效,并分析疗效的影响因素。方法:抽取2017年2月至2019年2月于孟州市人民医院治疗的儿童急性哮喘患儿200例为研究对象,将采用布地奈德治疗的100例患儿设为对照组,采用布地奈德联合孟鲁司特钠治疗的100例患儿设为观察组,连续治疗3个月后进行疗效观察。根据临床疗效将所有患儿分为有效组与无效组,通过单因素分析探究影响疗效的危险因素,并通过多因素分析确定影响疗效的独立危险因素。结果:观察组治疗总有效率为94.00%(94/100),高于对照组的78.00%(78/100),差异有统计学意义(P<0.05)。治疗后,两组第1 s用力呼气量(FEV1)、肺活量(FVC)、FEV1/FVC、夜间的最大呼气流速(PEF)均改善,且观察组高于对照组,差异有统计学意义(P<0.05)。影响儿童急性哮喘的临床疗效的危险因素有治疗依从性、药物吸入方式、致喘因素、哮喘知识培训、居住地等(P<0.05);治疗依从性差(OR=4.426,95%CI 1.342~8.316)、存在致喘因素(OR=3.424,95%CI 1.231~10.478)、居住地为农村(OR=5.216,95%CI 2.131~11.665)是影响临床疗效的独立危险因素。结论:布地奈德联合孟鲁司特钠能够提升儿童急性哮喘的临床疗效,改善肺部功能。治疗依从性差,存在致喘因素及居住地为农村是影响临床疗效为危险因素。

Objective:To investigate clinical efficacy of budesonide combined with montelukast sodium on children with acute asthma,and to analyze influencing factors of curative effect.Methods:A total of 200 acute asthma children who were treated in Mengzhou People’s Hospital from February 2017 to February 2019 were chosen as the research object;of them,100 cases treated with budesonide were selected as the control group,and 100 cases treated by budesonide combined with montelukast sodium were chosen as the observation group.Both groups were treated for 3 months,and then the curative effects were observed.All patients were divided into effective group and ineffective group according to clinical efficacy.The single factor analysis was taken to analyze the risk factors of clinical efficacy,and multivariate analysis was taken to identify independent risk factors.Results:The total effective rate of the observation group was 94.00%(94/100),significantly higher than the 78.00%(78/100)of the control group(P<0.05).After treatment,the forced expiratory volume in one second(FEV1),vital capacity(FVC),FEV1/FVC,peak expiratory flow(PEF)at night of the two groups were significantly improved,and these indexes in the observation group were higher than those in the control group(P<0.05).Risk factors affecting clinical effect of acute asthma in children included treatment compliance,drug inhalation method,asthma,asthma knowledge training and residence(P<0.05).And poor treatment compliance(OR=4.426,95%CI 1.342-8.316),asthma(OR=3.424,95%CI 1.231-10.478),rural residence(OR=5.216,95%CI 2.131-11.665)were independent risk factors that affecting the clinical therapeutic effect.Conclusions:Budesonide combined with montelukast sodium can significantly improve the clinical curative effects of children with acute asthma,and improve lung function.Poor treatment compliance,asthma and rural residence are independent risk factors that affeeting the clinical therapeutic effect.