丙酸氟替卡松联合布地奈德治疗小儿支气管哮喘的临床研究

目的探讨丙酸氟替卡松吸入气雾剂联合吸入用布地奈德混悬液治疗小儿支气管哮喘的临床疗效。方法选取2015年1月—2016年1月在第四军医大学第一附属医院治疗的支气管哮喘患儿96例作为研究对象,利用随机数字表法将患儿分为对照组和治疗组,每组各48例。对照组雾化吸入吸入用布地奈德混悬液,0.5 mg/次,2次/d。治疗组在对照组基础上吸入丙酸氟替卡松吸入气雾剂,2揿/次,2次/d。两组患儿均连续治疗12周。观察两组的临床疗效,比较两组肺功能、血气指标和炎性因子情况。结果治疗后,对照组和治疗组总有效率分别为83.3%、95.8%,两组比较差异有统计学意义(P0.05)。治疗后,两组呼气峰流速值(PEF)、1 s用力呼气容积(FEV1)、呼气高峰流量(PEFR)和FEV_1/用力肺活量(FVC)均明显上升,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血氧分压(Pa O_2)和酸碱度(p H)值均显著上升,二氧化碳分压(Pa CO2)均显著下降,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组肿瘤坏死因子α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素4(IL-4)、白细胞介素8(IL-8)和白细胞介素13(IL-13)水平均明显下降,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论丙酸氟替卡松吸入气雾剂联合吸入用布地奈德混悬液治疗小儿支气管哮喘具有较好的疗效,可改善肺功能,缓解炎症反应,具有一定临床推广应用价值。

Clinical study on fluticasone propionate combined with budesonide in treatment of bronchial asthma in children

Objective To explore the clinical effect of Fluticasone Propionate Inhaled Aerosol combined with Budesonide Suspension for inhalation in treatment of bronchial asthma in children. Methods Children (96 cases) with bronchial asthma in the First Affiliated Hospital of the Fourth Military Medical University from January 2015 to January 2016 were randomly divided into control and treatment groups, and each group had 48 cases. Children in the control group were nebulization inhalation administered with Budesonide Suspension for inhalation, 0.5 mg/time, twice daily. Children in the treatment group were inhalation administered with Fluticasone Propionate Inhaled Aerosol on the basis of the control group, 2 presses/time, twice daily. Children in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and lung function, blood gas indexes, and inflammatory factors in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 83.3% and 95.8%, respectively, and there was difference between two groups (P < 0.05). After treatment, PEF, FEV1, PEFR, and FEV1/FVC in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, PaO2and pH value in two groups were significantly increased, but the PaCO2in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of TNF-α, hs-CRP, IL-4, IL-8, and IL-13 in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Fluticasone Propionate Inhaled Aerosol combined with Budesonide Suspension for inhalation has clinical curative effect in treatmeat of bronchial asthma in children, can improve lung function, and relieve inflammation reaction, which has a certain clinical application value.