CAJ | 학술논문

目的：观察孟鲁司特钠联合丙酸氟替卡松治疗螨虫过敏的咳嗽变异型哮喘患儿的临床疗效和安全性。方法以2012年2月至2013年10月来广州市妇女儿童医疗中心门诊就诊的≥5岁的螨虫过敏的咳嗽变异型哮喘患儿40例为研究对象，按随机数字表法分为治疗组和对照组，每组20例，对照组用丙酸氟替卡松气雾剂治疗；治疗组在对照组基础上加用孟鲁司特钠咀嚼片。疗程为0.5年，治疗结束停药观察3个月。治疗过程中观察和记录所有患儿的临床症状改善情况，包括咳嗽症状积分、累积吸入沙丁胺醇的 puff 数、肺功能检查结果及支气管激发试验第1秒用力呼气量下降20%时累积吸入乙酰胆碱的剂量（PD20），以及不良反应情况。结果治疗组急性期咳嗽明显好转/消失时间[（5.82±0.90）d 比（6.54±1.30）d]及沙丁胺醇吸入量明显少于对照组，差异有统计学意义（P ﹤0.05）。治疗前及治疗过程中，患儿4次的咳嗽症状积分分别为治疗组[（3.90±0.90）分、（0.90±0.30）分、（0.70±0.30）分、（1.90±0.70）分]、对照组[（4.10±0.70）分、（1.20±0.40）分、（1.30±0.50）分、（2.40±0.80）分]，2组相比差异均有统计学意义（P 均﹤0.05），但2组停药3个月后均出现咳嗽症状积分的反跳。2组肺功能 PD20在治疗前及治疗0.5年均有所改善，治疗组治疗前及治疗后0.5年 PD20[（0.46±0.08）mg 比（1.76±0.07）mg]，对照组[（0.49±0.07）mg 比（1.70±0.07）mg]；治疗组治疗后0.5年 PD20的改变优于对照组，差异有统计学意义（P ﹤0.05）。结论孟鲁司特钠联合丙酸氟替卡松治疗螨虫过敏的咳嗽变异型哮喘患儿，急性期疗效及控制效果较好，且改善呼吸道反应性效果更佳。
목적：관찰맹로사특납연합병산불체잡송치료만충과민적해수변이형효천환인적림상료효화안전성。방법이2012년2월지2013년10월래엄주시부녀인동의료중심문진취진적≥5세적만충과민적해수변이형효천환인40례위연구대상，안수궤수자표법분위치료조화대조조，매조20례，대조조용병산불체잡송기무제치료；치료조재대조조기출상가용맹로사특납저작편。료정위0.5년，치료결속정약관찰3개월。치료과정중관찰화기록소유환인적림상증상개선정황，포괄해수증상적분、루적흡입사정알순적 puff 수、폐공능검사결과급지기관격발시험제1초용력호기량하강20%시루적흡입을선담감적제량（PD20），이급불량반응정황。결과치료조급성기해수명현호전/소실시간[（5.82±0.90）d 비（6.54±1.30）d]급사정알순흡입량명현소우대조조，차이유통계학의의（P ﹤0.05）。치료전급치료과정중，환인4차적해수증상적분분별위치료조[（3.90±0.90）분、（0.90±0.30）분、（0.70±0.30）분、（1.90±0.70）분]、대조조[（4.10±0.70）분、（1.20±0.40）분、（1.30±0.50）분、（2.40±0.80）분]，2조상비차이균유통계학의의（P 균﹤0.05），단2조정약3개월후균출현해수증상적분적반도。2조폐공능 PD20재치료전급치료0.5년균유소개선，치료조치료전급치료후0.5년 PD20[（0.46±0.08）mg 비（1.76±0.07）mg]，대조조[（0.49±0.07）mg 비（1.70±0.07）mg]；치료조치료후0.5년 PD20적개변우우대조조，차이유통계학의의（P ﹤0.05）。결론맹로사특납연합병산불체잡송치료만충과민적해수변이형효천환인，급성기료효급공제효과교호，차개선호흡도반응성효과경가。
Objective To observe the clinical effects and safety degree of treating children's cough variant asthma for mite allergy with Montelukast sodium combined with Flixotide. Methods Forty cases of infant patients with cough variant asthma for mite allergy in Guangzhou Women and Children's Medical Center from February 2012 to Octo-ber 2013 were taken as research subjects and randomly divided into treatment group and control group,each group 20 cases. The control group was treated with Flixotide aerosol;the treatment group took extra medicine Montelukast sodium chewable tablets. The treatment period covered half a year. After treatment both groups were observed for 3 months. During the treatment period the recovery process of clinical symptoms and adverse reaction of all the infant patients were observed and recorded. The data was analyzed with statistical software SPSS 17. 0. Results The duration of cough im-proved and solved in treatment group in the acute phase was(5. 82 ± 0. 90)d,much shorter than that of the control group[(6. 54 ± 1. 30)d],and the difference was of statistical significance(P ﹤ 0. 05). In the procedure,4 times of cough scores of treatment group[(3. 90 ± 0. 90)scores,(0. 90 ± 0. 30)scores,(0. 70 ± 0. 30)scores,(1. 90 ± 0. 70) scores]declined apparently more than those of control group[(4. 10 ± 0. 70)scores,(1. 20 ± 0. 40)scores,(1. 30 ± 0. 50)scores,(2. 40 ± 0. 80)scores];the difference was of statistical significance(all P ﹤ 0. 05);and the both were rebounded after 3 months without medicine. In terms of pulmonary function PD20,the patients in treatment group [(0. 46 ± 0. 08)mg vs(1. 76 ± 0. 07)mg]showed better improvement than those in control group[(0. 46 ± 0. 07) mg vs(1. 70 ± 0. 07)mg],and the difference was of statistical significance(P ﹤ 0. 05). Conclusions Treating chil-dren's cough variant asthma for mite allergy with Montelukast sodium combined with Flixotide is of good therapy effect in the acute phase and the control phase,worthy of further clinical application.