CAJ | 학술논문

目的：评价妥洛特罗贴剂在儿童咳嗽变异性哮喘( CVA)诊断性治疗中的作用，以及妥洛特罗贴剂联合孟鲁司特钠治疗儿童CVA的有效性和安全性。方法选取101例疑似CVA的慢性咳嗽患儿，给予妥洛特罗贴剂诊断性治疗1~2周后，根据咳嗽严重程度评分将其分为诊断性治疗阳性组(A组)和诊断性治疗阴性组(B组)。 A组继续给予妥洛特罗贴剂联合孟鲁司特钠治疗2周；B组根据初步诊断，给予相应的药物治疗2周。记录妥洛特罗贴剂在儿童CVA诊断性治疗中的灵敏度、特异度及起效时间，并对A组最终诊断为CVA的患儿进行疗效观察及安全性评价。结果①妥洛特罗贴剂诊断性治疗儿童CVA的灵敏度为98．78%，特异度为87．50%，平均起效时间为(12．15±2．58) d。②妥洛特罗贴剂联合孟鲁司特钠治疗后，临床控制率较诊断性治疗期显著增高(P<0．05)，而总有效率有增高趋势。③与基线期相比，妥洛特罗联合孟鲁司特钠治疗对日间及夜间症状均有显著改善(P<0．05)。④总体用药依从性及用药满意度均较好，不良反应发生率仅为3．06%。结论妥洛特罗贴剂可作为儿童CVA的诊断性治疗药物，诊断性治疗时间以2周为宜。妥洛特罗贴剂联合孟鲁司特钠在治疗儿童CVA上具有协同作用，可达到更好的疗效。
목적：평개타락특라첩제재인동해수변이성효천( CVA)진단성치료중적작용，이급타락특라첩제연합맹로사특납치료인동CVA적유효성화안전성。방법선취101례의사CVA적만성해수환인，급여타락특라첩제진단성치료1~2주후，근거해수엄중정도평분장기분위진단성치료양성조(A조)화진단성치료음성조(B조)。 A조계속급여타락특라첩제연합맹로사특납치료2주；B조근거초보진단，급여상응적약물치료2주。기록타락특라첩제재인동CVA진단성치료중적령민도、특이도급기효시간，병대A조최종진단위CVA적환인진행료효관찰급안전성평개。결과①타락특라첩제진단성치료인동CVA적령민도위98．78%，특이도위87．50%，평균기효시간위(12．15±2．58) d。②타락특라첩제연합맹로사특납치료후，림상공제솔교진단성치료기현저증고(P<0．05)，이총유효솔유증고추세。③여기선기상비，타락특라연합맹로사특납치료대일간급야간증상균유현저개선(P<0．05)。④총체용약의종성급용약만의도균교호，불량반응발생솔부위3．06%。결론타락특라첩제가작위인동CVA적진단성치료약물，진단성치료시간이2주위의。타락특라첩제연합맹로사특납재치료인동CVA상구유협동작용，가체도경호적료효。
Objective To evaluate the role of tulobuterol patch in the diagnostic therapy for children with cough variant asthma ( CVA) ,and evaluate the efficacy and safety of tulobuterol patch plus montelukast in the therapy of CVA. Methods 101 children with suspected CVA received diagnostic therapy with tulobuterol patch for 1 ~2 weeks. Then according to the cough severity score,they were divided into 2 groups:group A ( diagnostic therapy posi-tive group) and group B ( diagnostic therapy negative group) . Patients in group A received tulobuterol patch plus mon-telukast for 2 weeks. Patients in group B received medications for 2 weeks according to the empirical diagnosis. The sensitivity,specificity and duration of action onset of tulobuterol patch in diagnostic therapy for children with CVA were evaluated. The efficacy and safety of tulobuterol patch plus montelukast were observed in patients of group A with a fi-nal diagnosis of CVA. Results ①The sensitivity and specificity were 98. 78%and 87. 50%,the average duration of action onset was (12. 15 ± 2. 58) d.②After the treatment of tulobuterol patch plus montelukast,the clinical control rate increased more significantly compared with that in diagnostic therapy period (P<0. 05),and the overall effective rate had a tendency to increase. ③Compared with baseline, the daytime and nighttime symptoms were significantly im-proved by tulobuterol patch plus montelukast therapy ( P <0. 05 ) . ④The compliance and patients′ satisfaction were good and the rate of adverse effect was 3. 06%. Conclusion Tulobuterol patch can be used in the diagnostic therapy for children with CVA,and the duration should be 2 weeks. Tulobuterol patch plus montelukast has a synergistic effect on children with CVA,which can achieve better effects.