布地奈德联合特布他林及异丙托溴铵雾化吸入治疗急性发作期中度儿童哮喘临床研究

Clinical Study of Aerosol Inhalation of Budesonide Combined with Terbutaline and Ipratropium Bromide in the Treatment of Children with Moderate Asthma During the Acute Attack Stage

目的探讨布地奈德联合特布他林及异丙托溴铵雾化吸入治疗急性发作期中度儿童哮喘的临床疗效及对患儿骨桥蛋白(OPN)、对氧磷酶1(PON1)水平的影响。方法选取医院2017年1月至2019年1月收治的急性发作期中度哮喘患儿148例,按随机数字表法分为观察组和对照组,各74例。两组患儿均予常规治疗,并予吸入用布地奈德混悬液、硫酸特布他林雾化吸入用溶液雾化吸入;观察组患儿加用吸入用异丙托溴铵溶液雾化吸入;两组均根据体质量(以20 kg为界)用药,用药频次均为每6 h 1次,连续7 d。结果观察组总有效率为94.59%,显著高于对照组的75.68%(P<0.05);观察组患儿治疗后的白细胞介素6(IL-6)、白细胞介素8(IL-8)、肿瘤坏死因子-α(TNF-α)、OPN水平均显著低于对照组,PON1水平显著高于对照组(P<0.05),气喘、咳嗽、哮鸣音消失时间及住院时间均显著短于对照组(P<0.05);观察组与对照组不良反应发生率相当(10.81%比6.76%,χ^2=0.759,P>0.05)。结论布地奈德联合特布他林及异丙托溴铵雾化吸入治疗急性发作期中度儿童哮喘,能降低患儿血清炎性因子和OPN水平,升高PON1水平,缩短临床症状缓解时间及住院时间。

Objective To investigate the clinical efficacy of aerosol inhalation of budesonide combined with terbutaline and ipratropium bromide in the treatment of children with moderate asthma during the acute attack stage and its effect on the levels of osteopontin(OPN)and paraoxonase 1(PON1).Methods Totally 148 children with moderate asthma during the acute attack stage admitted to our hospital from January 2017 to January 2019 were selected and divided into the observation group and the control group according to the random number table method,74 cases in each group.The children in the two groups were given conventional treatment,and aerosol inhalation of Budesonide Suspension for Inhalation and Terbutaline Sulphate Solution for Nebulization,on this basis,the children in the observation group were given aerosol inhalation of Ipratropium Bromide Solution for Inhalation.The children in the two groups were given medication according to their body weight(20 kg was taken as the dividing line),and they were continuously treated for 7 d,once every 6 h.Results The total effective rate of the observation group was 94.59%,which was significantly higher than 75.68%of the control group(P<0.05).After treatment,the levels of interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)and OPN in the observation group were significantly lower than those in the control group,while the level of PON1 in the observation group was significantly higher than that in the control group(P<0.05).The disappearance time of asthma,cough,wheezing and hospitalization stay in the observation group were significantly shorter than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was similar to that in the control group(10.81%vs.6.76%,χ^2=0.759,P>0.05).Conclusion Aerosol inhalation of budesonide combined with terbutaline and ipratropium bromide in the treatment of children with asthma can reduce the levels of serum inflammatory factors and OPN,increase the level of PON1,and shorten the relief time of clinical symptom and hospital stay.