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目的:探讨小儿喘息性支气管炎(PAB)应用孟鲁司特钠与氢化可的松琥珀酸钠联合治疗的临床效果。方法:选取某院2014年1月-2016年1月收治的114例喘息性支气管炎患儿,随机均分为2组。对照组:常规治疗+氢化可的松琥珀酸钠静脉滴注;观察组:在对照组基础上联合孟鲁司特钠口服。记录比较2组患者湿啰音、哮鸣音、喘息及咳嗽等临床症状与体征消失时间,治疗前后肿瘤坏死因子-α(TNF-α)、免疫球蛋白E(IgE)白细胞介素-6(IL-6)及白细胞介素-8(IL-8)水平,临床疗效与治疗结束后3个月内复发情况,以及治疗期间不良反应。结果:观察组湿啰音、哮鸣音、喘息及咳嗽等症状与体征消失时间均显著短于对照组(P<0.01);与治疗前比较,治疗后2组炎症因子TNF-α、IgE、IL-6及IL-8水平均显著改善(P<0.01),且观察组改善幅度更为显著(P<0.01);观察组总有效率、复发率依次为96.49%,5.26%,均显著优于对照组的84.21%,17.54%(P<0.05);2组不良反应比较,差异无统计学意义(P>0.05)。结论:PAB应用孟鲁司特钠与氢化可的松琥珀酸钠联合治疗能短期内控制患儿症状,改善炎症因子水平,复发率低,疗效切实,安全性高,具有较高临床参考价值。
Objective: To investigate the clinical effect of combination therapy of montelukast and hydrocortisone sodium succinate on infantile asthmatic bronchitis (PAB). Methods: A total of 114 asthmatic bronchitis patients admitted to our hospital from January 2014 to January 2016 were randomly divided into two groups. Control group: conventional treatment + hydrocortisone sodium succinate intravenous drip; observation group: on the basis of the control group combined with montelukast sodium orally. The clinical symptoms and signs of wet rales, wheezing, wheezing and coughing were recorded and compared between before and after treatment. The levels of tumor necrosis factor-α (TNF-α), IgE and interleukin-6 IL-6) and interleukin-8 (IL-8) levels, clinical efficacy and relapse within 3 months after the end of treatment, and adverse reactions during treatment. Results: The symptoms of wet rales, wheeze, wheezing, coughing and disappearance of signs in the observation group were significantly shorter than those in the control group (P <0.01). Compared with those before treatment, the inflammatory cytokines such as TNF-α, IgE, The levels of IL-6 and IL-8 in the observation group were significantly improved (P <0.01), and the improvement in the observation group was more significant (P <0.01). The total effective rate and recurrence rate in the observation group were 96.49% and 5.26% (84.21% vs 17.54%, P <0.05) in the control group. There was no significant difference in the adverse reaction between the two groups (P> 0.05). Conclusion: The combination of montelukast sodium and hydrocortisone sodium succinate in PAB can short-term control of children’s symptoms, improve the level of inflammatory cytokines, low recurrence rate, effective curative effect, high safety and high clinical reference value.