孟鲁司特钠联合沙美特罗替卡松治疗哮喘-慢阻肺重叠综合征患者的效果

Effects of Montelukast sodium combined with Salmeterol/Fluticasone in treatment of patients with asthma-chronic obstructive pulmonary disease overlap syndrome

目的:观察孟鲁司特钠联合沙美特罗替卡松治疗哮喘-慢阻肺重叠综合征(ACOS)患者的效果。方法:选取2020年5月至2023年5月该院收治的94例ACOS患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各47例。两组均给予常规治疗,在此基础上,对照组给予沙美特罗替卡松治疗,观察组在对照组基础上联合孟鲁司特钠治疗。比较两组临床疗效、治疗前后临床症状[哮喘控制测试(ACT)、慢性阻塞性肺病评估测试(CAT)、呼吸困难分级(MRC)]评分、肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)/FVC、最大呼气流量(PEF)]水平、炎性因子[白细胞介素-18(IL-18)、γ干扰素(INF-γ)、基质金属蛋白酶抑制因子-1(TIMP-1)、基质金属蛋白酶-9(MMP-9)]水平及不良反应发生率。结果:观察组治疗总有效率为89.36%(42/47),高于对照组的70.21%(33/47),差异有统计学意义(P<0.05);治疗后,两组MRC、CAT评分均低于治疗前,且观察组低于对照组,两组ACT评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);两组FVC、FEV1/FVC、PEF水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);两组IL-18、INF-γ、TIMP-1、MMP-9水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:孟鲁司特钠联合沙美特罗替卡松治疗ACOS患者,可提高临床疗效,减轻临床症状,抑制气道炎症反应,改善肺功能,效果优于单纯沙美特罗替卡松治疗。

Objective:To observe effects of Montelukast sodium combined with Salmeterol/Fluticasone in treatment of patients with asthma-chronic obstructive pulmonary disease overlap syndrome(ACOS).Methods:A prospective study was conducted on 94 patients with ACOS admitted to the hospital from May 2020 to May 2023.According to the random number table method,they were divided into control group and observation group,47 cases in each group.Both groups were given routine treatment.On this basis,the control group was treated with Salmeterol/Fluticasone,while the observation group was treated with Montelukast sodium on the basis of that of the control group.The clinical efficacy,the clinical symptoms[asthma control test(ACT),chronic obstructive pulmonary disease assessment test(CAT),dyspnea classification(MRC)]scores,the lung function indexes[forced vital capacity(FVC),forced expiratory volume in one second(FEV1)/FVC,maximum expiratory flow(PEF)]levels,the inflammatory factors[interleukin-18(IL-18),interferon-γ(INF-γ),matrix metalloproteinase inhibitor-1(TIMP-1),matrix metalloproteinase-9(MMP-9)]levels,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 89.36%(42/47),which was higher than 70.21%(33/47)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the MRC and CAT scores of the two groups were lower than those before the treatment,and those in the observation group were lower than those in the control group;the ACT scores of the two groups were higher than those before the treatment,and that in the observation group was higher than that in the control group;and the differences were statistically significant(P<0.05).The levels of FVC,FEV1/FVC and PEF in the two groups were higher than those before the treatment,those in the observation group were higher than those in the co ntrol group,and the differences were statistically significant(P<0.05).The levels of IL-18,INF-γ,TIMP-1 and MMP-9 in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Montelukast sodium combined with Salmeterol/Fluticasone in the treatment of the ACOS patients can improve the clinical efficacy,reduce the clinical symptoms,inhibit the airway inflammation reactions,and improve the lung function.Moreover,it is superior to single Salmeterol/Fluticasone treatment.