老年支气管哮喘患者应用孟鲁司特联合布地奈德治疗的临床价值

The value of montelukast combined with budesonide in the treatment of elderly bronchial asthma

目的分析老年支气管哮喘采用孟鲁司特联合布地奈德治疗的临床效果。方法120例老年支气管哮喘患者,随机分成对照组及研究组,各60例。对照组给予布地奈德治疗,研究组给予孟鲁司特联合布地奈德治疗。比较两组患者治疗前后的肺功能指标[呼气峰值流速占预计值的百分比(PEF%)、第1秒用力呼气容积占用力肺活量的比值(FEV1/FVC)],临床症状(喘息、咳嗽、胸闷)缓解时间,白天、夜间的哮喘发作次数,不良反应发生情况。结果治疗前,两组患者的PEF%、FEV1/FVC比较,差异均无统计学意义(P>0.05);治疗后,研究组患者的PEF%、FEV1/FVC均高于对照组,差异均具有统计学意义(P<0.05)。研究组患者的喘息缓解时间为(3.45±0.45)d,咳嗽缓解时间为(6.10±0.36)d,胸闷缓解时间为(4.23±0.57)d,均短于对照组的(4.76±0.53)、(7.98±0.44)、(5.67±0.61)d,差异均具有统计学意义(P<0.05)。研究组患者的白天哮喘发作次数为(1.23±0.87)次,夜间哮喘发作次数为(0.44±0.13)次,均少于对照组的(3.56±1.10)、(1.48±0.77)次,差异均具有统计学意义(P<0.05)。两组患者的不良反应发生率比较,差异无统计学意义(χ^2=0.086,P=0.769>0.05)。结论老年支气管哮喘使用孟鲁司特联合布地奈德治疗,可以有效改善患者的肺功能和临床症状,减少哮喘发作次数,提高治疗效果。

Objective To analyze the clinical effect of montelukast combined with budesonide in the treatment of elderly bronchial asthma.Methods A total of 120 patients with elderly bronchial asthma were randomly divided into control group and research group,with 60 cases in each group.The control group was treated with budesonide,and the research group was treated with montelukast combined with budesonide.The pulmonary function indexes[percentage of peak expiratory flow to predicted value(PEF%)and forced expiratory volume in the first second to the forced vital capacity(FEV1/FVC)]before and after treatment,remission time of clinical symptoms(wheezing,coughing,chest tightness),frequency of asthma attacks during the day and night,and the occurrence of adverse reactions were compared between the two groups.Results Before treatment,there was no statistically significant difference in PEF%and FEV1/FVC between the two groups(P>0.05).After treatment,PEF%and FEV1/FVC of the research group were higher than those of the control group,and the difference was statistically significant(P<0.05).The remission time of wheezing,coughing,chest tightness of the research group were(3.45±0.45),(6.10±0.36)and(4.23±0.57)d,which were all shorter than(4.76±0.53),(7.98±0.44)and(5.67±0.61)d of the control group,and the difference was statistically significant(P<0.05).The frequency of asthma attacks during the day and night of the research group were(1.23±0.87)and(0.44±0.13)times,which were less than(3.56±1.10)and(1.48±0.77)times of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in incidence of adverse reactions between the two groups(χ~2=0.086,P=0.769>0.05).Conclusion Montelukast combined with budesonide can effectively improve the lung function and clinical symptoms of elderly patients with bronchial asthma,reduce the frequency of asthma attacks,and improve the therapeutic effect.