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目的探讨孟鲁司特治疗纯母乳喂养婴儿胃肠道过敏症的疗效及对保留母乳喂养的作用。方法符合Goldman诊断标准的42例纯母乳喂养婴儿胃肠道过敏症患儿按监护人意愿分为观察组(22例,接受常规消化道抗过敏及孟鲁司特治疗)和对照组(20例,只采用常规消化道抗过敏治疗),于治疗前、治疗第1周、治疗第2周及治疗第4周,对两组之间各临床症状及辅助检查相关指标的比例分别进行比较。结果治疗第1周观察组患儿腹泻、血便、阵发性苍白哭闹的比例明显低于对照组,差异均有统计学意义(均P<0.05),观察组与对照组之间便秘、皮疹比例差异无统计学意义(P>0.05);治疗第2周观察组患儿皮疹的比例明显低于对照组,差异有统计学意义(P<0.05),观察组与对照组患儿便秘的比例比较,差异无统计学意义(P>0.05);治疗1周时观察组大便中白细胞阳性的比例低于对照组,差异有统计学意义(P<0.05),其他辅助检查差异无统计学意义(P>0.05);治疗2周时观察组大便中白细胞、红细胞阳性的比例低于对照组,差异有统计学意义(P<0.05),其他辅助检查结果比较,差异无统计学意义(P>0.05)。治疗第4周时两组总共有4例患儿依然存在消化道症状,3例再次出现皮肤症状(其中2例同时再现消化道症状和皮肤症状),患儿被迫停用母乳喂养,其余患儿均在孟鲁司特维持治疗下能坚持继续母乳喂养。结论孟鲁司特治疗纯母乳喂养胃肠道过敏症患儿疗效较好,大部分患儿能够重新恢复母乳喂养或在坚持服用孟鲁司特前提下继续母乳喂养。
Objective To investigate the curative effect of montelukast on gastrointestinal allergy in exclusive breastfeeding infants and its effect on keeping breastfeeding. Methods Forty-two children with exclusively breastfeeding infants with gastrointestinal allergy according to Goldman’s diagnostic criteria were divided into observation group (n = 22, receiving conventional gastrointestinal anti-allergy and montelukast treatment) and control group (n = 20) Only using conventional gastrointestinal anti-allergy treatment), before treatment, the first week of treatment, the first two weeks of treatment and the fourth week of treatment, the clinical symptoms of the two groups and the proportion of auxiliary examination-related indicators were compared. Results The proportion of diarrhea, bloody stools and paroxysmal crying in the observation group was significantly lower than that of the control group in the first week of treatment (all P <0.05). The constipation and rash between the observation group and the control group (P> 0.05). The proportion of rash in the observation group was significantly lower than that in the control group in the second week (P <0.05). The proportion of constipation in the observation group and the control group (P> 0.05). The proportion of leucocyte positive in the stool of the observation group was lower than that of the control group at 1 week (P <0.05), and there was no significant difference in other auxiliary examinations (P> 0.05) P> 0.05). The ratio of leucocytes and erythrocytes in the observation group was lower than that in the control group at 2 weeks after treatment, the difference was statistically significant (P <0.05). There was no significant difference in other auxiliary examinations (P> 0.05 ). At 4 weeks after treatment, a total of 4 children in both groups remained with gastrointestinal symptoms, 3 had re-appearance of the skin (2 of them simultaneously reproduced gastrointestinal symptoms and skin symptoms), their children were discontinued from breastfeeding, and the rest Children were able to continue breastfeeding under montelukast maintenance treatment. Conclusion Montelukast treatment of gastrointestinal allergy in patients with exclusive breastfeeding is better, most children can resume breastfeeding or continue to breastfeed while insisting on taking montelukast.