布地奈德吸入时机对轻度持续性哮喘儿童肺功能及生长发育的影响

Effects of Different Inhalation Timing of Budesonide on Lung Function,Growth and Development of Children with Mild Persistent Asthma

目的:探讨布地奈德吸入时机对轻度持续性哮喘儿童肺功能及生长发育的影响。方法:选取2019年1月~2020年6月收治的轻度持续性哮喘儿童86例作为研究对象,采用随机数字表法分为A组和B组,每组43例。A组行布地奈德持续吸入治疗,B组在患儿出现哮喘征兆时间断吸入布地奈德治疗,两组患儿均持续治疗6周,并持续随访观察至少1年。评价比较两组患儿治疗前,治疗后,随访3、6个月和12个月的哮喘日间症状评分和夜间症状评分,并检测比较两组同期第1秒用力呼气容积占预计值百分比(FEV_(1)%pred)和呼气峰流速占预计值百分比(PEF%pred)。比较两组随访12个月的身高增长值以及治疗前、随访6个月和12个月的体重指数(BMI)。比较两组患儿治疗1年期间哮喘发作次数、不良反应发生率。结果:两组治疗后、随访3、6个月和12个月的哮喘日间症状评分和夜间症状评分均低于治疗前,而FEV_(1)%pred和PEF%pred高于治疗前(P<0.05);且A组随访3、6个月和12个月的哮喘日间症状评分和夜间症状评分低于B组,而FEV_(1)%pred和PEF%pred高于B组(P<0.05)。两组随访12个月的身高增长值以及治疗前、随访6个月和随访12个月的BMI比较无统计学差异(P>0.05)。A组治疗1年期间哮喘发作次数低于B组(P<0.05)。两组声音嘶哑、口腔真菌感染、皮肤瘙痒等不良反应发生率比较无统计学差异(P>0.05)。结论:布地奈德持续吸入和间断吸入均有助于改善轻度持续性哮喘儿童的哮喘症状和肺功能,且2种给药方案对儿童生长发育的影响无统计学差异。布地奈德持续吸入更有利于改善轻度持续性哮喘儿童的哮喘症状和肺功能。

Objective:To investigate the eff ects of diff erent budesonide inhalation timing on the lung function and growth and development of children with mild persistent asthma.Methods:A total of 86 children with mild persistent asthma admitted from January 2019 to June 2020 were selected as the research subjects and divided into group A and group B by random number method,43 cases in each group.Group A received continuous inhalation of budesonide,and group B received budesonide inhalation when the children showed signs of asthma.The children in both groups were treated continuously and observed for 6 weeks and were followed up for at least 1 year.The asthma day symptom scores and night symptom scores of the two groups before treatment,after treatment,and follow-up for 3 months,6 months and 12 months were evaluated and compared.Percentage of forced expiratory volume in one second to expected value(FEV_(1)%pred)and peak expiratory flow rate as a percentage of predicted value(PEF%pred)of the two groups were compared.The height growth during the 12-month follow-up and the body mass index(BMI)before treatment,6-month follow-up and 12-month follow-up of the two groups were tested and compared.The number of asthma attacks and the rate of adverse reactions between the two groups during 1-year treatment were statistically compared.Results:After treatment and follow-up for 3 months,6 months and 12 months,the daytime symptom scores and nighttime symptom scores of asthma in the two groups were lower than those before treatment,while FEV_(1)%pred and PEF%pred during the same period in the two groups were higher than those before treatment(P<0.05).And the daytime symptom scores and nighttime symptom scores of group A during the 3-month,6-month and 12-month follow-up were lower than those of group B,while in the same period FEV_(1)%pred and PEF%pred of group A were higher than those of group B(P<0.05).There was no significant diff erence in the growth of height during the 12-month follow-up and the BMI before treatment,6-month follow-up and 12-month follow-up between the two groups(P>0.05).The number of asthma attacks in group A was lower than that in group B during one year of treatment(P<0.05).There was no significant diff erence in the rate of hoarse voice,oral fungal infection,skin pruritus and other adverse reactions between the two groups(P>0.05).Conclusion:Both continuous and intermittent inhalation of budesonide can help improve asthma symptoms and lung function in children with mild persistent asthma,and there is no significant diff erence in the growth and development of children.Among them,continuous inhalation of budesonide is more beneficial to children with mild persistent asthma in the improvement of asthma symptoms and lung function.