不同途径吸入布地奈德气雾剂治疗儿童过敏性鼻炎哮喘综合征的临床效果对比

Clinical effect comparison of different ways of inhaled Budesonide Aerosol in the treatment of children with combined allergic rhinitis and asthma syndrome

目的 探讨不同途径吸入布地奈德气雾剂治疗儿童过敏性鼻炎哮喘综合征(CARAS)的临床效果。方法选择2011年6月~2015年1月在深圳市人民医院儿科治疗的轻、中度CARAS患儿113例为研究对象,根据随机数字表法将其分为三组:A组(39例)采用经口吸入布地奈德气雾剂,200μg/次,2次/d;B组(36例)采用闭嘴经鼻吸入布地奈德气雾剂,200μg/次,2次/d;C组(38例)采用经口吸入布地奈德气雾剂(100μg/次,2次/d)与经鼻吸入布地奈德鼻喷雾剂200μg/次(每边鼻腔各喷100μg/次,1次/d);均进行8周治疗。记录三组患儿治疗前后的相关参数并进行比较。结果与A组比较,B组临床症状评分、肺功能、EOS绝对值、血清总Ig E等水平有显著改善(均P<0.05);B组总有效率明显高于A组(χ2=5.943,P<0.05);而B组与C组比较,差异无统计学意义(均P>0.05)。C组不良反应发生率明显高于A组和B组,B组与C组比较,差异有统计学意义(χ2=11.402,P<0.05)。结论采用闭嘴经鼻吸入200μg/次、2次/d(400μg/d)布地奈德气雾剂治疗轻、中度CARAS患儿效果显著,不良反应少,操作更简便,值得临床推广和应用。

Objective To discuss the clinical curative effect of different ways of inhaled Budesonide Aerosol in the treatment of combined allergic rhinitis and asthma syndrome(CARAS) in children. Methods A total of 113 children with mild and moderate CARAS in Department of Pediatrics of Shenzhen People’s Hospital form June 2011 to January2015 were selected as the research objects, and according to random number table method they were divided into group A(39 cases) treated through the mouth inhaled budesonide aerosol, 200 μg/time, 2 times/d; group B(36 cases) treated through the nasally inhaled Budesonide Aerosol, 200 μg/time, 2 times/d; and group C(38 cases) treated through the mouth inhaled Budesonide Aerosol(100 μg/time, 2 times/d) and the nasally inhaled budesonide nasal spray 200 μg/time(each side nasal spray 100 μg each time, 1 time/d); each group were treated for 8 weeks. Correlation parameters of patients in the three groups before and after the treatment were recorded and compared. Results Compared with the group A, the clinical symptom score, pulmonary function, EOS absolute value, and serum total Ig E levels of the group B were improved significantly(all P < 0.05), the total effective rate was significantly higher(χ2= 5.943, P < 0.05); compared the group B with the group C, the difference was not obviously significant(P > 0.05), but the incidence of adverse reactions of group C was significantly higher than the group A and B, and the difference between group B and group C was statistically significant(χ2= 11.402, P < 0.05). Conclusion The curative effect through the nasally inhaled Budesonide Aerosol, 200 μg/time, 2 times/d(400 μg/d) treated with mild and moderate CARAS is distinct, with less adverse reactions, simple operation, it is worthy of clinical popularization and application.