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目的:比较布地奈德(BUD)和孟鲁司特(LTM)对儿童轻度持续哮喘应用途径与药物的疗效。方法:60名轻度持续哮喘患儿,平均年龄(7.66±2.28)岁。随机分为BUD组和LTM组。LTM组:男15例,女15例,口服孟鲁司特5 mg,每晚1次;BUD组:男16例,女14例,吸入布地奈德200μg,每天2次。疗程8周。治疗前后,分别检测患儿第1秒用力呼气容积(FEV_1)、第1秒用力呼气容积占肺活量比率(FEV_1/FVC)、组胺支气管激发试验(PD20)、痰嗜酸性粒细胞计数(Eos%),并作临床症状评分。结果:BUD组:治疗后日间症状评分(0.13±0.18)和夜间症状评分(0.093±0.28)较治疗前日间症状评分(1.26±0.51)和夜间症状评分(0.32±0.41)显著降低(P<0.01,P<0.05);治疗后FEV_1(1.61±0.35)L较治疗前(1.42±0.46)L显著提高(P<0.01);治疗后PD20(3.19±2.17)μmol较治疗前(1.68±1.74)μmol显著提高(P<0.01),治疗后Eos%(6.39±6.63)%较治疗前(22.2±23.6)%显著降低(P<0.01)。LTM组:疗后日间症状评分(0.19±0.26)和夜间症状评分(0.12±0.22)较治疗前日间症状评分(1.17±0.27)和夜间症状评分(0.48±0.38)显著降低(P<0.01,P<0.05);治疗后FEV_1(1.36±0.31)L与治疗前(1.33±0.36)L差异无显著性(P=0.291);治疗后PD20(2.87±1.75)μmol较治疗前(1.9±1.79)μmol显著提高(P<0.01);治疗后Eos%(7.29±8.24)%较治疗前(12.17±14.47)%差异无显著性(P=0.726)。结论:吸入布地奈德和口服孟鲁司特均可有效地改善儿童哮喘的临床症状,降低气道高反应。但在改善肺功能,减轻气道炎症方面,布地奈德优于孟鲁司特。
Objective: To compare the curative effect of budesonide (BUD) and montelukast (LTM) on children with mild persistent asthma. Methods: 60 mild persistent asthmatic children, mean age (7.66 ± 2.28) years old. Randomly divided into BUD group and LTM group. LTM group: 15 males and 15 females, oral montelukast 5 mg, 1 night; BUD group: 16 males and 14 females, inhaled budesonide 200μg, 2 times a day. Treatment for 8 weeks. Before and after treatment, FEV 1, FEV 1 / FVC, PD 20 and sputum eosinophil counts (FEV 1), sputum eosinophil count Eos%), and clinical symptom score. Results: The scores of daytime symptom score (0.13 ± 0.18) and nighttime symptom score (0.093 ± 0.28) in BUD group were significantly lower than those before treatment (1.26 ± 0.51) and nighttime symptom score (0.32 ± 0.41) (P < 0.01, P <0.05). After treatment, FEV_1 (1.61 ± 0.35) L was significantly higher than that before treatment (1.42 ± 0.46) L (P <0.01) μmolol (P <0.01). The Eos% (6.39 ± 6.63)% after treatment was significantly lower than that before treatment (22.2 ± 23.6)% (P <0.01). LTM group had significantly lower daytime symptom score (0.19 ± 0.26) and nocturnal symptom score (0.12 ± 0.22) than daytime symptom score (1.17 ± 0.27) and nocturnal symptom score (0.48 ± 0.38) (P <0.01, (P <0.05). There was no significant difference between FEV_1 (1.36 ± 0.31) L and pretreatment (1.33 ± 0.36) L after treatment (P = 0.291) μmolol (P <0.01). There was no significant difference in Eos% (7.29 ± 8.24)% vs 12.17 ± 14.47% before treatment (P = 0.726). Conclusion: Inhaled budesonide and oral montelukast can effectively improve the clinical symptoms of childhood asthma and reduce airway hyperresponsiveness. However, budesonide is superior to montelukast in improving pulmonary function and reducing airway inflammation.