孟鲁司特钠联合特布他林对小儿咳嗽变异性哮喘的疗效观察

Observation on Therapeutic Effect of Montelukast Sodium Combined with Terbutaline on Cough Variant Asthma in Children

目的 :探讨孟鲁司特钠联合特布他林对小儿咳嗽变异性哮喘(CVA)的疗效。方法 :选取我院2015年11月—2017年3月收治的CVA患儿96例,采用随机数字表法分为对照组和研究组,各48例。对照组单纯予以特布他林(体质量20 kg以下患儿的剂量为2.5 mg,20 kg以上为5 mg,tid)雾化吸入治疗,研究组在对照组基础上加用孟鲁司特钠(10 mg,qd)治疗。比较两组治疗总有效率、复发情况、不良反应发生率,同时比较两组治疗前后肺功能指标及外周血嗜酸粒细胞(EOS)、肿瘤坏死因子(TNF)-α、免疫球蛋白(Ig)E水平的差异。结果 :研究组治疗总有效率明显高于对照组,复发率明显低于对照组,差异有统计学意义(P <0.05);治疗后,研究组嗜酸粒细胞(EOS)、肿瘤坏死因子(TNF)-α均明显低于对照组,用力肺活量(FVC)、一秒用力呼气容积(FEV_1)和FEV_1/FVC明显高于对照组,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 :孟鲁司特钠联合特布他林治疗CVA患儿的疗效显著,能够有效降低炎性细胞因子水平,促进肺功能恢复,减少复发,且安全性较高,值得临床推广。

Objective: To investigate the efficacy of montelukast sodium combined with terbutaline in children with cough variant asthma (CVA). Methods: 96 children with CVA admitted to our hospital from November 2015 to March 2017 were randomly divided into control group and study group, 48 children in each group. The children in the control group were given terbutaline (2.5 mg/time for children under 20 kg, 5 mg/time for children above 20 kg, tid) inhalation treatment only, and the children in the study group were further given montelukast sodium (10 mg, qd) treatment. The total effective rate, recurrence and adverse reaction rate were compared between the two groups. The differences in lung function indexes and peripheral blood eosinophils (EOS), tumor necrosis factor (TNF)-α and immunoglobulin E levels before and after treatment were compared between the two groups. Results: The total effective rate in the study group was significantly higher than that in the control group, and the recurrence was significantly lower than that in the control group (P<0.05). After treatment, The levels of eosinophils (EOS) and tumor necrosis factor (TNF)-α in the study group were significantly lower than those in the control group, and the forced vital capacity (FVC), one-second forced expiratory volume (FEV1) and FEV1/FVC were significantly 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 (P>0.05). Conclusion: Montelukast sodium combined with terbutaline has significant efficacy and high safety in the treatment of children with CVA, and can effectively reduce the levels of inflammatory cytokines, promote the recovery of lung function and reduce recurrence, which is worthy of clinical promotion.