酮替芬联合孟鲁司特钠治疗咳嗽变异性哮喘临床疗效及对患儿肺功能的影响

Clinical efficacy of ketotifen combined with montelukast sodium in the treatment of cough variant asthma and its effect on childrens lung function

目的 探讨酮替芬联合孟鲁司特钠治疗咳嗽变异性哮喘的临床疗效及对患儿肺功能、气道炎症的影响.方法 将120例咳嗽变异性哮喘患儿按随机数字表法分为3组,各40例.A组给予酮替芬联合孟鲁司特钠治疗,B组给予孟鲁司特钠治疗,C组给予酮替芬治疗,观察12周.统计3组的疗效及不良反应发生情况,比较治疗前及治疗4周、12周末3组咳嗽症状评分、肺功能(第一秒用力呼气容积、用力肺活量、最大呼气流量占正常预计值的百分比)、气道炎症因子(白细胞介素-5、白细胞介素-8、白细胞介素-10、肿瘤坏死细胞因子-α)改善情况.结果 A组治疗总有效率显著高于B组及C组(P<0.05),B组与C两组比较差异无统计学意义.3组患儿治疗期间均未出现明显不良反应.治疗4周、12周末,3组患儿咳嗽症状评分及痰液白细胞介素-5、白细胞介素-8、白细胞介素-10、肿瘤坏死细胞因子-α水平均较治疗前显著降低(P<0.01),A组显著低于B组及C组(P<0.01);两组第一秒用力呼气容积、用力肺活量、最大呼气流量占正常预计值的百分比均治疗前显著升高(P<0.01),A组显著高于B组及C组(P<0.05);B组与C两组上述指标比较差异无统计学意义(P>0.05).结论 酮替芬联合孟鲁司特钠治疗咳嗽变异性哮喘疗效显著,能有效改善患儿的咳嗽症状,明显减轻气道炎症反应,显著改善肺功能,安全可靠.

Objective To investigate the value of ketotifen combined with montelukast sodium in treat-ment of cough variant asthma(CVA),to analyze its effect on pulmonary function and airway inflammation of children.Methods 120 CVA children were divided into three groups by random number table,with 40 cases inl each group.Group A was given kelotifen combined witl montelukast sodiul,group B was giveln montelukast sodium,and group C was given ketotifen,patients were observed for 12 weeks.After treat-ment,the efficacy of three groups were compared,and the adverse reactions during treatment were recor-ded.The scores of cough in the three groups on admission.after treatment for 4 weeks.at the end of treatment were compared.The pulmonary function(FEV1,FVC,PEF%),airway inflammatory factors(IL-5,IL-8,IL10).tumor necrosis factor-a(TNF-a)at each time were compared.Results The curative effects of group A were better than those of group B and groupC(P<0.05),and there was no statistical difference between group B and group C.There were no obvious adverse reactions during treatment among the three groups.After treatment for 4 weeks,12 weeks,the scores of cough symptoms and sputum IL-5.IL-8,IL.10 and TNF-a levels in the three groups were significantly lower than before treatment(P<0.01),and group A was significantly lower than group B and group C(P<0.01).The levels of FEV1,FVC and PEF%of the two groups were higher than those on admission(P<0.01).Group A was significantly higher than group B and group C(P<0.05),there was no significant difference in the above indicators between group B and group C(P>0.05).Con-clusions Ketotifen combined with montelukast sodium in treatment of CVA is effective,it can relieve cough of children,reduce airway inflammatory response,improve pulmonary function,which is safe and reliable.