摘要
目的 探讨沙美特罗替卡松联合孟鲁司特对儿童咳嗽变异性哮喘（CVA）的疗效,及对肺功能、血清炎性因子的影响.方法 选取CVA患儿200例,采用随机数字表法将其分为观察组与对照组,各100例.对照组给予沙美特罗替卡松吸入,观察组在对照组基础上加用孟鲁司特钠咀嚼片,疗程为3个月.比较两组临床疗效、治疗前后肺功能指标和血清炎性因子的变化情况.结果 观察组总有效率（88.3％）明显高于对照组（70.3％）（χ2=9.146,P〈0.05）.观察组咳嗽缓解时间（5.45±1.32）d、消失时间（8.63±1.96）d,均显著短于对照组的（7.33±2.46）d、（12.61±1.84）d（t=6.505、14.229,均P〈0.05）.治疗前,两组第1秒用力呼气量（FEV1）、FEV1占用力肺活量的百分比（FEV1/FVC）、最大呼气峰流速占预计值百分比（PEF％）、免疫球蛋白E（IgE）、肿瘤坏死因子α（TNF-α）及白介素-17（IL-17）差异均无统计学意义（P〉0.05）;治疗后,观察组和对照组FEV1、FEV1/FVC、PEF均较同组治疗前明显升高[观察组：（2.11±0.34）L、（73.71±11.44）％、（86.34±7.85）％,t=18.149、7.664、19.196,均P〈0.05;对照组：（1.82±0.35）L、（69.36±10.79）％、（81.66±8.03）％,t=9.312、5.418、13.627,均P〈0.05],IgE、TNF-α、IL-17较同组治疗前明显降低[观察组：（141.3±38.2）ng/L、（624.7±213.2）ng/L、（6.1±2.1）ng/L,t=15.200、13.708、15.881,均P〈0.05;对照组：（191.5±41.9）ng/L、（835.5±326.3）ng/L、（9.4±2.7）ng/L,t=6.784、6.206、8.550,P〈0.05],且两组治疗后的差异均有统计学意义（t=5.717、2.659、4.008、8.521、4.842、9.296,均P〈0.05）.结论 沙美特罗替卡松联合孟鲁斯特钠治疗儿童咳嗽变异性哮喘具有良好的临床疗效,有助于改善患儿肺功能,降低炎性因子水平.
Objective To investigate the therapeutic effects of salmeterol xinafoate and fluticasone propio-nate powder（seretide） in combination with montelukast on children with cough variant asthma （CVA）,and its effect on pulmonary function and serum inflammatory cytokines .Methods 200 patients with CVA were enrolled ,and they were randomly divided into two groups according to the random number table ,100 cases in each group .The control group was treated with seretide ,while the observation group was treated with seretide and montelukast sodium ,both two groups were treated for 3 months.The clinical efficacy,pulmonary function and serum inflammatory cytokines were compared between the two groups .Results The total effective rate of the observation group （ 88.3%） was significantly higher than that of the control group （70.3%;χ2 =9.146,P〈0.05）.The duration of remission and disappearance of cough symptoms in the observation group were （5.45 ±1.32） d,（8.63 ±1.96） d,respectively, which were significantly shorter than those in the control group [（7.33 ±2.46） d,（12.61 ±1.84） d;t =6.505, 14.229,all P〈0.05].There were no statistically significant differences in FEV 1,FEV1/FVC,PEF,IgE,TNF-αand IL-17 between the two groups before treatment （all P〉0.05）.After treatment,the levels of FEV1,FEV1/FVC, PEF were all significantly higher than those before treatment [（2.11 ±0.34） L,（73.71 ±11.44）%,（86.34 ± 7.85）%,t=18.149,7.664,19.196,all P〈0.05;（1.82 ±0.35）L,（69.36 ±10.79）%,（81.66 ±8.03）%,t=9.312,5.418,13.627,all P 〈0.05],and IgE,TNF -α,IL -17 levels were significantly decreased [（141.3 ± 38.2）ng/L,（624.7 ±213.2） ng/L,（6.1 ±2.1） ng/L,t =15.200,13.708,15.881,all P 〈0.05;（191.5 ±41.9） ng/L,（835.5 ±326.3）ng/L,（9.4 ±2.7） ng/L,t=6.784,6.206,8.550,all P〈0.05].The differences between the two groups were statistically significant（t=5.717,2.659,4.008,8.521,4.842,9.296,all P〈0.05）. Conclusion Salmeterol xinafoate and fluticasone propionate powder in combination with montelukast sodium has excellent clinical effect in the treatment of children with CVA ,which can improve the pulmonary function and reduce inflammatory cytokines .
出处
《中国基层医药》
CAS
2018年第2期182-185,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
沙美特罗替卡松
孟鲁司特
哮喘
咳嗽
儿童
呼吸功能试验
炎症趋化因子类
Salmeterol xinafoate and fluticasone propionate powder
Montelukast
Asthma
Cough
Child
Respiratory function tests
Chemokines
