氨溴特罗联合沙丁胺醇治疗儿童支气管哮喘的临床研究

Clinical study on ambroxol and clenbuterol combined with salbutamol in treatment of bronchial asthma in children

目的研究氨溴特罗口服溶液联合吸入用硫酸沙丁胺醇溶液治疗儿童支气管哮喘的临床疗效。方法选取2016年1月—2016年12月郑州大学第三附属医院收治的80例支气管哮喘患儿作为研究对象,采用随机数字表法将患儿随机分为对照组和治疗组,每组各40例。对照组雾化吸入吸入用硫酸沙丁胺醇溶液,0.03 mL/kg加入2 mL生理盐水,2次/d。治疗组在对照组治疗的基础上口服氨溴特罗口服溶液,2.5～15m L/次,2次/d。两组患者均连续使用7d。观察两组患者的临床疗效,同时比较两组治疗前后的肺功能指标、圣乔治呼吸疾病问卷(SGRQ)评分、血清细胞因子水平和不良反应发生情况。结果治疗后,对照组和治疗组总有效率分别为80.00%、90.00%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患儿第一秒用力呼吸容积占预计值百分比(FEV1%)和FEV1/用力肺活量(FVC)水平均显著升高,SGRQ评分显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组患儿的肺功能和SGRQ评分显著优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组的基质金属蛋白酶-2(MMP-2)、降钙素原(PCT)和基质金属蛋白酶抑制剂-1(TIMP-1)水平均显著下降,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组细胞因子水平显著低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,对照组的不良反应发生率为40.00%,显著高于治疗组的10.00%,两组比较差异具有统计学意义(P<0.05)。结论氨溴特罗口服溶液联合吸入用硫酸沙丁胺醇溶液治疗儿童支气管哮喘的临床疗效显著,可改善患者的肺功能指标,减轻机体的炎性反应,具有一定的临床推广应用价值。

Objective To study the clinical study of Ambroxol Hydrochloride and Clenbuterol Hydrochloride Oral Solution combined with Salbutamol Sulfate Inhalation Solution in treatment of bronchial asthma in children.Methods Children(80 cases)with bronchial asthma in the Third Affiliated Hospital of Zhengzhou University from January 2016 to December 2016 were randomly divided into control and treatment groups,and each group had 40 cases.Children in the control group were aerosol inhalation administered with Salbutamol Sulfate Inhalation Solution,0.03 mL/kg added into normal saline 2 mL,twice daily.Children in the treatment group were po administered with Ambroxol Hydrochloride and Clenbuterol Hydrochloride Oral Solution on the basis of the control group,2.5—15 mL/time,twice daily.Children in two groups were treated for 7 d.After treatment,the clinical efficacy was evaluated,and the lung function indexes,SGRQ scores,serum cytokine levels,and adverse reactions in two groups before and after treatment were compared.Results After treatment,the clinical efficacy in the control and treatment groups was 80.00%and 90.00%,respectively,and there were differences between two groups(P<0.05).After treatment,FEV1%and FEV1/FVC in two groups were significantly increased,but SGRQ scores were significantly decreased,and there were differences in the same group(P<0.05).After treatment,the lung function indexes and SGRQ scores were significantly better than those in the control group,and there were differences between two groups(P<0.05).After treatment,the levels of MMP-2,PCT,and TIMP-1 in two groups were significantly decreased,and there were differences in the same group(P<0.05).After treatment,the serum cytokine levels in the treatment group were significantly lower than those in the control group,and there were differences between two groups(P<0.05).After treatment,the incidence of adverse reactions in the control group was 40.00%,which was significantly higher than 10.00%in the control group,and there were differences between two groups(P<0.05).Conclusion Ambroxol Hydrochloride and Clenbuterol Hydrochloride Oral Solution combined with Salbutamol Sulfate Inhalation Solution has remarkable clinical effect in treatment of bronchial asthma in children,can improve the lung function indexes of patients,and reduce the inflammatory reaction of the body,which has a certain clinical application value.