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目的探讨酮替芬联合沙美特罗/丙酸氟替卡松治疗咳嗽变异性哮喘的疗效和安全性。方法咳嗽变异性哮喘患者104例随机分为3组,均吸入沙美特罗/丙酸氟替卡松50/250μg,2次/d,治疗7d后A组继续吸入沙美特罗/丙酸氟替卡松50/250μg,2次/d;B组在A组基础上同时给予富马酸酮替芬1mg/次,2次/d,口服;C组在A组基础上同时给予复方甲氧那明胶囊2粒/次,3次/d,口服;3组疗程均为8周。观察3组治疗2、8周后咳嗽症状总评分及治疗8周后第1秒用力呼气容积(forced expiratory volume in one second,FEV1)占预计值百分比(FEV1%)、呼气峰值流速(peak expiratory flow,PEF)水平变化。结果治疗2、8周后3组咳嗽症状总评分均低于基线值(P<0.01),B、C组治疗后咳嗽症状总评分低于A组(P<0.05),B组与C组比较差异无统计学意义(P>0.05);3组治疗8周后FEV1%和PEF均高于基线值(P<0.05),但治疗后3组间比较差异无统计学意义(P>0.05);C组不良反应发生率(10.00%)高于A组(2.78%)、B组(2.63%)(P<0.05)。结论沙美特罗/丙酸氟替卡松联合富马酸酮替芬及复方甲氧那明治疗咳嗽变异性哮喘效果优于单用沙美特罗/丙酸氟替卡松,但联合富马酸酮替芬治疗较联合复方甲氧那明不良反应轻。
Objective To investigate the efficacy and safety of ketotifen combined with salmeterol / fluticasone propionate in the treatment of cough variant asthma. Methods One hundred and four patients with cough variant asthma were randomly divided into 3 groups. All of them were exposed to salmeterol / fluticasone propionate 50 / 250μg twice daily for 7 days. Group A continued inhalation of salmeterol / fluticasone propionate 50 / 250μg, 2 times / d; group B was given ketotifen fumarate 1mg / time, twice a day on the basis of group A, and oral; Group C was given on the basis of group A the same time the compound metoprolol capsules 2 tablets / time , 3 times / d, orally; 3 courses of treatment were 8 weeks. The total score of cough symptom after 2 and 8 weeks of treatment and the ratio of predicted value of FEV1 (% FEV1) and peak expiratory volume in one second (FEV1) expiratory flow, PEF) level changes. Results After 2 and 8 weeks of treatment, the total score of cough symptom in 3 groups was lower than the baseline value (P <0.01). The cough symptom scores in group B and C were lower than those in group A (P <0.05) (P> 0.05). FEV1% and PEF in three groups were higher than the baseline (P <0.05) after 8 weeks treatment, but there was no significant difference between the three groups after treatment (P> 0.05). The incidence of adverse reactions in group C (10.00%) was higher than that in group A (2.78%) and group B (2.63%) (P <0.05). Conclusions The combination of salmeterol / fluticasone propionate and ketotifen fumarate and metoprolol in treatment of cough variant asthma is superior to salmeterol / fluticasone propionate alone, but the combination of salmeterol / Compound metoprolol light adverse reactions.