盐酸丙卡特罗口服或硫酸特布他林雾化联合布地奈德雾化治疗儿童咳嗽变异性哮喘的有效性及经济性研究

Efficacy and economy of oral procaterol hydrochloride or terbutaline sulfate nebulization combined with budesonide nebulization in treatment of cough variant asthma in children

目的比较盐酸丙卡特罗口服溶液口服联合布地奈德雾化与硫酸特布他林雾化液雾化吸入联合布地奈德雾化治疗儿童咳嗽变异性哮喘患儿的有效性和经济性。方法纳入2020年1月—2020年12月上海中医药大学附属龙华医院收治的120例咳嗽变异性哮喘患儿,按随机数字表法将其分为丙卡特罗组与特布他林组,每组各60例。丙卡特罗组予以布地奈德雾化联合盐酸丙卡特罗口服溶液口服治疗,特布他林组予以布地奈德联合硫酸特布他林雾化治疗。评估两组疗效和安全性。比较两组治疗前后1秒用力呼气容积(FEV1)、用力肺活量(FVC)、呼气峰值流速(PEF)、嗜酸性粒细胞(EOS)、免疫球蛋白E(IgE)水平。比较两组成本-效果。结果特布他林组总有效率(96.67%)显著高于丙卡特罗组(86.67%,P<0.05)。两组患儿治疗后FEV1、FVC、PEF显著高于治疗前(P<0.05),特布他林组患儿FEV1、FVC、PEF显著高于丙卡特罗组(P<0.05)。两组患儿治疗后EOS和IgE水平显著低于治疗前(P<0.05),特布他林组患儿EOS和IgE水平显著低于丙卡特罗组(P<0.05)。特布他林组患儿不良反应发生率与丙卡特罗组比较差异无统计学意义(P>0.05)。丙卡特罗组治疗经济学显著优于特布他林组(P<0.05)。结论与丙卡特罗口服液相比,硫酸特布他林雾化吸入治疗儿童咳嗽变异性哮喘可能具有较好效果及安全性,但丙卡特罗口服液具有更高经济价值。

Objective To compare the efficacy and economy of procaterol hydrochloride oral solution combined with budesonide nebulization and terbutaline sulfate atomization inhalation combined with budesonide nebulization in treatment of children with cough variant asthma.Methods A total of 120 children with cough variant asthma treated in Longhua Hospital Shanghai University of Traditional Chinese Medicine from January 2020 to December 2020 were randomly divided into procaterol group and terbutaline group,with 60 cases in each group.Children in procaterol group were treated with budesonide nebulization combined with procaterol hydrochloride oral solution,and children in terbutaline group were treated with budesonide nebulization combined with terbutaline sulfate nebulization.The efficacy and safety of two groups were evaluated.The levels of forced expiratory volume in one second(FEV1),forced vital capacity(FVC),peak expiratory flow rate(PEF),eosinophils(EOS)and immunoglobulin E(IgE)were compared between two groups before and after treatment.The cost-effectiveness of two groups were compared.Results The total effective rate of terbutaline group(96.67%)was significantly higher than that of procaterol group(86.67%,P<0.05).After treatment,FEV1,FVC and PEF in two groups were significantly higher than those before treatment(P<0.05),and FEV1,FVC and PEF in terbutaline group were significantly higher than those in procaterol group(P<0.05).The levels of EOS and IgE in two groups after treatment were significantly higher than those before treatment(P<0.05),and the levels of EOS and IgE in terbutaline group were significantly lower than those in procaterol group(P<0.05).There was no significant difference in incidence of adverse reactions between terbutaline group and procaterol group(P>0.05).The therapeutic economics of procaterol group was significantly better than that of terbutaline group(P<0.05).Conclusion Compared with procaterol oral liquid,terbutaline sulfate nebulized inhalation may have better effect and safety in treatment of variant asthma in children,but procaterol oral liquid has higher economic value.