小剂量阿奇霉素联合沙美特罗替卡松气雾剂对慢性中度持续期哮喘患儿的疗效及依从性分析

Efficacy and compliance of ICS/LABA combined with low-dose azithromycin in children with chronic moderate persistent asthma

目的探究吸入小剂量阿奇霉素联合沙美特罗替卡松气雾剂对慢性中度持续期哮喘患儿的疗效及对其治疗依从性的影响。方法选择2015年1月—2016年1月于郑州大学附属儿童医院进行治疗的98例慢性中度持续期哮喘患儿,按照随机数字表法将其分为观察组与对照组,每组各49例患者。对照组患儿给予沙美特罗替卡松气雾剂,1掀/次,2次/d;观察组患儿在对照组基础上增加阿奇霉素干混悬剂进行治疗,使用剂量为0.1 g/次,1次/d,连续服用3 d后停用4 d,而后继续。两组患儿治疗时间均为12周。对比两组患者治疗有效率,对比治疗前后两组患儿儿童哮喘控制测试(C-ACT)评分、哮喘用药依从性量表(MARS-A)评分、1秒用力呼气容积(FEV1)及最大呼气峰流速(PEF),并对两组患儿治疗过程中不良反应发生率进行对比。结果观察组患儿哮喘有效率为87.76%,对照组患儿有效率为65.31%,两组对比差异具有统计学意义(P<0.05)。治疗后两组患儿C-ACT及MARS-A得分均有所上升,对比治疗前差异具有统计学意义(P<0.05);同时观察组患儿C-ACT及MARS-A得分均高于对照组,组间差异有统计学意义(P<0.05)。治疗后两组患儿FEV1及PEF均有提升,对比治疗前差异具有统计学意义(P<0.05);同时观察组患者上述指标均高于对照组,组间差异有统计学意义(P<0.05)。两组不良反应发生率对比差异不具有统计学意义。结论小剂量阿奇霉素联合沙美特罗替卡松气雾剂能够显著缓解慢性中度持续期哮喘患儿临床症状,改善患儿肺功能,同时具有较低的不良反应发生率,值得进行临床推广。

Objective To investigate the efficacy of inhaled corticosteroid/long-acting receptor agonist(ICS/LABA)combined with low-dose azithromycin in children with chronic moderate persistent asthma and its effect on treatment compliance.Methods 98 children with chronic moderate persistent asthma who were treated in our hospital from January 2015 to January 2016 were divided into experimental group(ICS/LABA+Low-dose azithromycin)and control group(ICS/LABA)according to random number table method.Each group had 49 patients.They were administered for 12 weeks in both groups.The effective rate of treatment was compared between the two groups.The C-ACT score,asthma medication compliance scale(MARS-A),forced expiratory volume(FEV1)and peak expiratory flow(PEF)were compared before and after treatment.The incidence of adverse reactions during treatment was compared.Results The effective rate of asthma was 87.76%(43/49)in the experimental group and 65.31%(32/49)in the control group,and the difference between the two groups was statistically significant(P<0.05).The difference of C-ACT and MARS-A counts between the two groups before and after intervention was not statistically significant.The scores of FEV1 and PEF in the experimental group were higher than those in the control group(P<0.05).There was no significant difference between the two groups before intervention.The above indexes in the experimental group after treatment were higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment.Conclusion ICS/LABA combined with low dose azithromycin can significantly relieve the clinical symptoms of children with chronic moderate persistent asthma,improve the lung function of children,and has a low incidence of adverse reactions,which is worthy of clinical promotion.