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目的探讨孟鲁司特治疗儿童支气管哮喘并变应性鼻炎(AR)的疗效。方法哮喘并AR患儿90例随机分为3组:A组吸入布地奈德福莫特罗粉吸入剂加口服孟鲁司特(5mg,1次/d);B组吸入布地奈德福莫特罗粉吸入剂加鼻内吸入布地奈德鼻喷剂(64μg,1次/d);对照组仅吸入布地奈德福莫特罗粉吸入剂。随访为6个月,每隔4周随访1次,记录患儿的哮喘日间、夜间症状评分及鼻炎症状评分、哮喘急性发作次数及无症状天数,于治疗前和治疗后第8、24周检查肺功能:记录1s用力呼气量占正常预计值的百分比(FEV1%)。结果与治疗前比较,A组和B组患儿治疗后哮喘日间、夜间症状评分及鼻炎症状评分均明显降低,差异均有统计学意义(A组F=3.45,3.35Pa<0.05;B组F=3.52,3.43Pa<0.05)。治疗后,A组哮喘日间、夜间症状评分及鼻炎症状评分与对照组比较,差异有统计学意义(t=4.53,3.36Pa<0.05),与B组比较差异无统计学意义(t=0.41,0.36Pa>0.05)。A组在改善FEV1%、增加无症状天数及减少哮喘急性发作的次数方面均优于B组(t=3.83,3.76,4.26Pa<0.05)及对照组(t=3.47,5.04,12.95Pa<0.05)。结论对哮喘并AR患儿兼顾上下呼吸道的同治优于单一治疗。孟鲁司特可同时改善哮喘及AR症状,改善肺功能,减少哮喘的急性发作,增加无症状天数,与吸入布地奈德福莫特罗粉吸入剂合用可作为哮喘并AR患儿联合治疗安全有效的方法。
Objective To investigate the efficacy of montelukast in children with bronchial asthma and allergic rhinitis (AR). Methods 90 asthmatic children with asthma were randomly divided into three groups: group A inhaled budesonide formoterol powder inhalation plus oral montelukast (5mg, 1 / d); group B inhaled budesonide Fofo Tron powder inhaler plus inhaled budesonide nasal spray (64 μg, 1 time / d); the control group inhaled budesonide formoterol powder inhaler only. The patients were followed up for 6 months and followed up every 4 weeks. The asthma daytime and nighttime symptom scores and rhinitis symptom score, the number of asthma exacerbations and the number of asymptomatic asthma were recorded. At the 8th and 24th week Check lung function: Record 1s forced expiratory volume as a percentage of the normal expected value (FEV1%). Results Compared with those before treatment, the scores of asthma daytime and nighttime symptom scores and rhinitis symptoms of children in group A and group B were significantly lower after treatment (the difference was statistically significant (F = 3.45,3.35Pa <0.05 in group A; F = 3.52, 3.43Pa <0.05). After treatment, the scores of asthma daytime and nighttime symptom scores and rhinitis symptoms in group A were significantly different from those in control group (t = 4.53,3.36Pa <0.05), but there was no significant difference between group A and group B (t = 0.41 , 0.36Pa> 0.05). A group was better than B group (t = 3.83,3.76,4.26Pa <0.05) and control group (t = 3.47,5.04,12.95Pa <0.05) in improving FEV1%, increasing asymptomatic days and reducing the number of acute asthma attacks ). Conclusions Asthma with AR in both upper and lower respiratory tract is better than monotherapy. Montelukast can improve both asthma and AR symptoms, improve lung function, reduce acute asthma attacks, increase the number of days without symptoms, combined with inhaled budesonide formoterol powder inhaler can be used as asthma and AR combined treatment of children with safety effective method.