维生素D_(3)联合孟鲁司特钠治疗小儿支气管哮喘临床疗效研究

Clinical effect of vitamin D_(3) combined with montelukast sodium in the treatment of children with bronchial asthma

目的探讨维生素D_(3)联合孟鲁司特钠治疗小儿支气管哮喘临床疗效,观察其对患儿肺功能及免疫功能的影响。方法选取自2016年1月至2020年12月唐山市妇幼保健院收治的支气管哮喘患儿92例,采用随机数字表法将患儿分为常规组(n=45)与观察组(n=47)。常规组给予孟鲁司特钠治疗,观察组在常规组治疗基础上给予维生素D_(3)治疗。观察两组患儿咳嗽、喘息、呼吸困难、肺部哮鸣音的临床症状改善时间,记录并比较两组患儿治疗前、后肺功能[最大呼气流量(PEF)、用力肺活量(FVC)、第1秒用力呼气量(FEV1)]、免疫功能(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))及血清补体3(C3)、抗凝血酶Ⅲ(AT-Ⅲ)水平。结果观察组患儿咳嗽、喘息、呼吸困难、肺部哮鸣音症状改善时间均短于常规组,差异有统计学意义(P<0.05)。治疗前,两组患儿PEF、FVC、FEV1比较,差异无统计学意义(P>0.05)。治疗14 d后,两组患儿PEF、FVC、FEV1均高于治疗前,且观察组高于常规组,差异有统计学意义(P<0.05)。治疗前,两组患儿CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平比较,差异无统计学意义(P>0.05)。治疗14 d后,两组患儿CD4^(+)、CD4^(+)/CD8^(+)均高于治疗前,且观察组高于常规组;两组患儿CD8^(+)低于治疗前,且观察组低于常规组,差异有统计学意义(P<0.05)。治疗前,两组患儿血清C3、AT-Ⅲ水平比较,差异无统计学意义(P>0.05)。治疗14 d后,两组患儿C3、AT-Ⅲ水平低于治疗前,且观察组低于常规组,差异有统计学意义(P<0.05)。结论对小儿支气管哮喘采取维生素D_(3)联合孟鲁司特钠治疗可明显缓解患儿临床症状,降低血清C3、AT-Ⅲ水平,改善其肺功能及免疫功能。

Objective To investigate the clinical effect of vitamin D_(3) combined with montelukast sodium in the treatment of children with bronchial asthma,and observe the influence on lung function and immune function.Methods Totally 92 children with bronchial asthma admitted to Tangshan Maternal and Child Health Hospital from January 2016 to December 2020 were selected,and divided into routine group(n=45)and observation group(n=47)by random number table method.Patients in the routine group were treated with montelukast sodium,and patients in the observation group were treated with vitamin D_(3) in addition to routine group.The improvement time of clinical symptoms in the two groups were observed,including cough,wheezing,dyspnea and lung wheezing.Lung function[peak expiratory flow(PEF),forced vital capacity(FVC)and forced expiratory volume in 1 second(FEV1)],immune function(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),serum complement 3(C3)and antithrombinⅢ(AT-Ⅲ)levels were recorded before and after the treatment,and compared between the two groups.Results The improvement time of cough,wheezing,dyspnea and lung wheezing in observation group were significantly shorter than those in routine group(P<0.05).Before the treatment,there was no statistically significant difference in PEF,FVC and FEV1 between the two groups(P>0.05).After 14-day treatment,PEF,FVC and FEV1 were increased in the two groups,which were higher in observation group than in routine group(P<0.05).Before the treatment,there was no statistically significant difference in CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)between the two groups(P>0.05).After 14-day treatment,CD4^(+)and CD4^(+)/CD8^(+)were increased,which were higher in observation group than in routine group,while CD8^(+)was reduced in the two groups,and which was lower in observation group than in routine group(P<0.05).Before the treatment,there was no statistically significant difference in C3 and AT-Ⅲlevels between the two groups(P>0.05).After 14-day treatment,C3 and AT-Ⅲlevels were reduced in the two groups,and the levels in observation group were lower than those in routine group(P<0.05).Conclusion Vitamin D_(3) combined with montelukast sodium can significantly alleviate clinical symptoms,decrease serum C3 and AT-Ⅲlevels,and improve lung function and immune function in children with bronchial asthma.