孟鲁司特钠单用、布地奈德/福莫特罗单用及两者联用治疗对儿童咳嗽变异型哮喘的疗效比较

Comparison of the efficacy of montelukast alone,budesonide/formoterol alone,and a combination of the two drugs in children with cough variant asthma

目的 本研究旨在比较孟鲁司特钠(Mon)单用、布地奈德/福莫特罗(BF)单用及两者联用治疗儿童咳嗽变异型哮喘(CVA)的疗效。方法 选取2021年6月至2023年6月北京市海淀医院诊治的CVA患儿为研究对象。根据治疗方案,将CVA患儿分为Mon组、BF组和联合组。观察治疗8周后的治疗总有效率(TER)、不良反应发生率(TAER)、咳嗽症状评分[日间咳嗽症状评分(DCSS)和夜间咳嗽症状评分(NCSS)]、免疫功能[肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)和免疫球蛋白E(IgE)]、肺功能[第1秒用力呼出气体容量(FEV1)、肺活量(FVC)和呼气峰值流速(PEF)]和血清嗜酸性粒细胞计数(EOS)。结果 共选取180例CVA患儿,Mon组62例,BF组60例,联合组58例。治疗后,3组TER、TAER、DCSS、NCSS、血清TNF-α、血清IL-4和血清IgE水平差异无统计学意义(P> 0.05)。联合组患儿FEV1、FVC和PEF显著高于Mon组和BF组(P <0.05),EOS显著低于Mon组和BF组(P <0.05);而Mon组和BF组FEV1、FVC、PEF和EOS学差异无统计学意义(P>0.05)。结论 Mon或BF可有效改善CVA患儿咳嗽症状和免疫功能,其镇咳作用和抗炎作用同Mon和BF联用相似。此外,Mon和BF联用可进一步改善CVA患儿肺功能,减少血清EOS水平。

Objective To compare the efficacy of montelukast(Mon)alone,budesonide/formoterol(BF)alone and the combination of the two drugs in the treatment of pediatric cough variant asthma(CVA).Methods Children with CVA treated in Beijing Haidian Hospital from June 2021 to June 2023 were selected as the study subjects.According to the treatment plans,the children were divided into Mon group,BF group and combined group.After 8 weeks of treatment,the total effective rate(TER),incidence of adverse effects(TAER),cough symptom scores[daytime cough symptom score(DCSS)and nocturnal cough symptom score(NCSS)],immune functions[tumor necrosis factor-alpha(TNF-α),interleukin-4(IL-4),immunoglobulin E(IgE)],pulmonary functions[forcedexpir-atoryvolumeinonesecond(FEV1),forcedvitalcapacity(FVC)and peak expiratory flow(PEF)]and serum eosinophil count(EOS)were observed.Results A total of 180 children with CVA were selected,with 62 in the Mon group,60 in the BF group,and 58 in the combined group.After treatment,there was no statistically significant difference in the levels of TER,TAER,DCSS,NCSS,serum TNF-α,serum IL-4 and serum IgE among the three groups(P>0.05).The FEV1,FVC and PEF of children in the combined group were significantly higher than those in the Mon and BF groups(P<0.05),and the EOS was significantly lower than those in the Mon and BF groups(P<0.05);whereas the differences in FEV1,FVC,PEF and EOS between the Mon and BF groups were not statistically significant(P>0.05).Conclusion Mon or BF can effectively improve cough symptoms and immune function in children with CVA,and its antitussive and anti-inflammatory effects are similar to those of the combination of Mon and BF.In addition,the combination of Mon and BF can further improve the lung function and reduce the serum EOS level in children with CVA.