盐酸氨溴索不同给药方式对小儿肺炎的药学价值研究

Study on the pharmaceutical value of ambroxol hydrochloride in pediatric pneumonia by different modes of administration

目的 探究小儿肺炎采用盐酸氨溴索不同给药方式治疗的效果。方法 100例小儿肺炎患儿,根据随机数字表法分为对照组与观察组,每组50例。两组均接受盐酸氨溴索治疗,对照组采用静脉滴注给药方式,观察组采用雾化吸入给药方式。对比两组治疗效果、症状消失时间、住院时间、炎症因子指标[C反应蛋白(CRP)、白细胞介素-2(IL-2)和白细胞介素-6(IL-6)]、血气指标[动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、氧合指数(PaO_(2)/FiO_(2))]及不良反应发生率。结果 观察组患儿的治疗总有效率96.00%高于对照组的84.00%,差异存在统计学意义(χ^(2)=4.0000,P=0.0455<0.05)。观察组发热、咳嗽、湿啰音消失时间和住院时间分别为(1.89±0.23)、(5.12±0.36)、(5.32±1.56)、(6.12±2.05)d,均短于对照组的(3.32±1.28)、(6.69±1.79)、(6.98±1.55)、(8.79±2.15)d,差异存在统计学意义(P<0.05)。治疗后,观察组CRP(3.56±1.00)mg/L、IL-6(73.56±11.56)ng/L低于对照组的(10.55±5.18)mg/L、(108.65±33.69)ng/L,IL-2(34.25±5.69)ng/L高于对照组的(26.58±6.79)ng/L,差异存在统计学意义(P<0.05)。治疗后,观察组PaCO_(2)(31.05±5.36)mm Hg(1 mm Hg=0.133 kPa)低于对照组的(34.89±7.15)mm Hg,PaO_(2)(93.65±8.15)mm Hg、PaO_(2)/FiO_(2)(197.58±48.52)mm Hg高于对照组的(82.15±7.48)、(172.56±44.79)mm Hg,差异存在统计学意义(P<0.05)。观察组不良反应发生率2.00%与对照组的4.00%对比,差异无统计学意义(χ^(2)=0.3436,P=0.5577>0.05)。结论 盐酸氨溴索不同给药方式治疗小儿肺炎的效果具有差异性,采用雾化吸入盐酸氨溴索治疗的效果更佳,且安全性高,值得在临床中使用与推广。

Objective To investigate the effect of ambroxol hydrochloride in pediatric pneumonia by different modes of administration.Methods 100 children with pneumonia were divided into a control group and an observation group according to random number table method,with 50 cases in each group.Both groups were treated with ambroxol hydrochloride,which was administered by intravenous drip in the control group and by aerosol inhalation in the observation group.Both groups were compared in terms of treatment effect,symptom resolution time,hospitalization time,inflammatory factors [C-reactive protein(CRP),interleukin-2(IL-2) and interleukin-6(IL-6)],blood gas indicators [arterial partial pressure of carbon dioxide(PaCO_(2)) and arterial partial pressure of oxygen(PaO_(2)),and oxygenation index(PaO_(2)/FiO_(2))],and occurrence of adverse reactions.Results The total effective rate of 96.00% in the observation group was higher than that of 84.00% in the control group,and the difference was statistically significant(χ^(2)=4.0000,P=0.0455 < 0.05).The duration of fever and cough,moist rale disappearance time and hospitalization time in the observation group were(1.89±0.23),(5.12±0.36),(5.32±1.56) and(6.12±2.05) d,which were shorter than those of(3.32±1.28),(6.69±1.79),(6.98±1.55) and(8.79±2.15) d in the control group,and the difference was statistically significant(P<0.05).After treatment,CRP of(3.56±1.00) mg/L and IL-6 of(73.56±11.56) ng/L in the observation group were lower than those of(10.55±5.18) mg/L and(108.65±33.69) ng/L in the control group;and IL-2 of(34.25±5.69) ng/L in the observation group was higher than that of(26.58±6.79) ng/L in the control group;and the difference was statistically significant(P<0.05).After treatment,PaCO_(2) of(31.05±5.36) mm Hg(1 mm Hg= 0.133 kPa) in the observation group was lower than that of(34.89±7.15) mm Hg in the control group;and PaO_(2) of(93.65±8.15) mm Hg and PaO_(2)/FiO_(2) of(197.58±48.52) mm Hg were higher than those of(82.15±7.48) and(172.56±44.79) mm Hg in the control group;and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions in the observation group(2.00%)compared with the control group(4.00%)(χ2=0.3436,P=0.5577 > 0.05).Conclusion The efficacy of ambroxol hydrochloride in the treatment of pediatric pneumonia is different in different modes of administration.The treatment of ambroxol hydrochloride by aerosol inhalation is more effective and safe,which is worthy of clinical use and promotion.