白三烯受体拮抗剂联合丙酸倍氯米松气雾剂治疗 咳嗽变异性哮喘患儿的临床研究

Clinical study of leukotriene receptor antagonist combined with beclomethasone propionate aerosol in children with cough variant asthma

摘要:

目的 探究白三烯受体拮抗剂联合丙酸倍氯米松气雾剂对咳嗽变异性哮喘（CVA）患儿的临床 疗效。方法 选取2016 年1 月—2018 年3 月在枣庄市中医医院治疗的114 例CVA 患儿，用随机数字表法分 为对照组和观察组，每组57 例。对照组单用丙酸倍氯米松气雾剂治疗，观察组在对照组基础上联合白三烯受 体拮抗剂（孟鲁司特钠）治疗，共8 周。统计两组临床疗效及复发情况，并对比治疗前后日间夜间咳嗽积分变化、 肺功能[ 第1 秒用力呼气容积（FEV1）、用力肺活量（FVC）、第1 秒用力呼气容积占用力肺活量百分比（FEV1/ FVC）]、血清白细胞介素-5（IL-5）、肿瘤坏死因子-α（TNF-α）及白细胞介素-8（IL-8）、嗜酸性粒 细胞（EOS）和嗜酸性粒细胞趋化因子（Eotaxin）水平变化。结果 观察组治疗总有效率高于对照组（P <0.05）。 观察组日间、夜间咳嗽积分差值高于对照组（P <0.05）；观察组FEV1、FVC 及FEV1/FVC 差值高于对照组 （P <0.05）；观察组血清IL-5、TNF-α 及IL-8 差值高于对照组（P <0.05）。观察组复发率低于对照组（3.92% VS 20.93%）（P <0.05）。结论 白三烯受体拮抗剂与丙酸倍氯米松气雾剂联合治疗CVA，可降低血清EOS、 Eotaxin 水平，加强抗炎作用；快速改善患儿临床症状及肺功能，提高临床疗效，降低复发率。

Abstract:

Objective To investigate the clinical effects of leukotriene receptor antagonists combined with beclomethasone propionate aerosol on children with cough variant asthma (CVA). Methods A total of 114 children with CVA were enrolled in our hospital. The random number table method was used to divide patients into two groups, 57 cases each. The control group was treated with beclomethasone dipropionate aerosol alone, and the observation group was treated with leukotriene receptor antagonist (montillastide sodium) on the basis of control group, for 8 weeks. The clinical treatment effect and recurrence of the two groups w ere compared, and the changes of daytime cough score and lung function before and after treatment were compared. First second forced vital capacity (FEV1), forced vital capacity (FVC), 1 second forced vital capacity occupancy capacity (FEV1) /FVC), serum interleukin-5 (IL-5), tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8), eosinophils (EOS) and Eosinophil chemoattractant (Eotaxin) levels change were counted. Results The total effective rate of the observation group was higher than that of the control group (P < 0.05). The difference between cough score at day and night in the observation group was higher than that in the control group (P < 0.05); the difference of FEV1, FVC and FEV1 / FVC in the observation group was higher than that in the control group (P < 0.05); the difference of IL-5, TNF-ɑ and IL-8 in the observation group was higher than that in the control group (P < 0.05). The recurrence rate of the observation group was lower than that of the control group (3.92% VS 20.93%) (P < 0.05). Conclusion The combination of leukotriene receptor antagonist and beclomethasone propionate aerosol in the treatment of CVA can reduce the serum EOS and Eotaxin levels, strengthen the anti-inflammatory effect, rapidly improve the clinical symptoms and lung function of children, and improve the clinical treatment effect and reduce the recurrence rate.