丙酸氟替卡松聯(lián)合孟魯司特治療小兒哮喘的療效探討

李影明

[摘要] 目的 分析丙酸氟替卡松聯(lián)合孟魯司特治療小兒哮喘的療效。 方法 選擇2019年1月～2020年1月我院收治的110例小兒哮喘患兒作為研究對(duì)象，按照隨機(jī)數(shù)表法分為兩組。對(duì)照組55例，在常規(guī)治療的基礎(chǔ)上給予丙酸氟替卡松氣霧劑吸入治療;實(shí)驗(yàn)組55例，在對(duì)照組的基礎(chǔ)上聯(lián)合使用孟魯司特鈉咀嚼片治療。治療6個(gè)月后，比較兩組患兒的臨床療效、不良反應(yīng)及治療前后的臨床癥狀積分、肺功能指標(biāo)、炎癥指標(biāo)、氣道重塑指標(biāo)變化情況。 結(jié)果 實(shí)驗(yàn)組總有效率為92.73%（51/55），顯著高于對(duì)照組的78.18%（43/55）（P<0.05）;治療前兩組患兒FEV1、PEF、FEV1/FVC、LA、WA、TA、hs-CRP、TNF-α、IL-8、日間癥狀、夜間癥狀評(píng)分比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）;治療后兩組FEV1、PEF、FEV1/FVC、LA、TA均顯著提高（P<0.05），且實(shí)驗(yàn)組各指標(biāo)值均顯著高于對(duì)照組（P<0.05）;治療后兩組WA、hs-CRP、TNF-α、IL-8、日間癥狀、夜間癥狀評(píng)分均顯著降低（P<0.05），且實(shí)驗(yàn)組各指標(biāo)值均顯著低于對(duì)照組（P<0.05）;兩組患兒治療期間不良反應(yīng)發(fā)生情況比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論 采用丙酸氟替卡松聯(lián)合孟魯司特治療小兒哮喘，能夠提高臨床療效，有效抑制炎癥反應(yīng)，增強(qiáng)肺功能，逆轉(zhuǎn)氣道重塑進(jìn)程，改善癥狀，且安全性良好。

[關(guān)鍵詞] 丙酸氟替卡松;孟魯司特;小兒哮喘;臨床療效

[中圖分類號(hào)] R725.6? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] B? ? ? ? ? [文章編號(hào)] 1673-9701（2020）28-0084-04

Efficacy investigation of fluticasone propionate combined with montelukast in the treatment of infantile asthma

LI Yingming

Department of Pediatrics， Maternal and Child Health Care Hospital in Jiamusi City in Heilongjiang Province， Jiamusi? ?154002， China

[Abstract] Objective To analyze the efficacy of fluticasone propionate combined with montelukast in the treatment of infantile asthma. Methods From January 2019 to January 2020， a total of 110 children with asthma admitted to our hospital were selected as the research objects， and they were divided into two groups according to the random number table method. The control group（n=55） was treated with fluticasone propionate aerosol inhalation on the basis of routine treatment， and the observation group（n=55） was treated with montelukast sodium chewable tablets on the basis of the control group. After 6 months of treatment， the changes of clinical efficacy， adverse reactions（ADRs）， clinical symptom scores before and after treatment， pulmonary function index， inflammatory index， airway remodeling index were compared between the two groups. Results The total efficacy rate of the experimental group was 92.73%（51/55）， which was significantly higher than 78.18%（43/55） of the control group（P<0.05）. Before treatment， there were no significant differences in FEV1， PEF， FEV1/FVC， LA， WA， TA， hs-CRP， TNF-α， IL-8， daytime symptoms and nighttime symptoms scores between the two groups（P>0.05）. After treatment， FEV1， PEF， FEV1/FVC， LA， TA in both groups were significantly increased（P<0.05）， and all indexes in the experimental group were significantly higher than those in the control group（P<0.05）. The scores of WA， hs-CRP， TNF-α， IL-8， daytime symptoms and nighttime symptoms in both groups were all decreased significantly after treatment（P<0.05）， and the experimental group was significantly lower than the control group（P<0.05）. There were no significant differences in ADRs between the two groups during the treatment（P>0.05）. Conclusion The combination of fluticasone propionate and montelukast in the treatment of infantile asthma improve the clinical efficacy， effectively inhibit inflammatory reaction， enhance pulmonary function， reverse airway remodeling process， improve symptoms， and have good safety.