布地奈德混悬液雾化吸入治疗儿童哮喘急性发作的疗效观察

目的 探讨布地奈德混悬液治疗儿童哮喘急性发作的临床疗效.方法 选择2011年1月至12月在本院哮喘门诊就诊,并确诊为哮喘急性发作的患儿140例为研究对象.按照就诊顺序,将其随机分为观察组(n=60,布地奈德混悬液+硫酸沙丁胺醇雾化溶液+异丙托溴铵气雾剂雾化吸入治疗)、对照组A(n=40,地塞米松静脉滴注+硫酸沙丁胺醇雾化溶液+异丙托溴铵气雾剂雾化吸入治疗)及对照组B(n=40,单纯静脉滴注地塞米松治疗).观察用药前、后患儿症状体征,包括呼吸困难、咳嗽、喘息及喘鸣音等改善情况,进行哮喘评分,记录上述症状体征消失时间,并进行相关统计学分析(本研究遵循的程序符合本院人体试验委员会制定的伦理学标准,得到该委员会批准,分组征得受试对象监护人的知情同意,并与其签署临床研究知情同意书).结果 治疗后1 h,观察组症状体征改善评分:呼吸困难得分为1.1分、咳嗽为1.1分、喘息为1.4分、喘鸣声为1.4分;对照组A分别为0.9分、0.7分、1.0分及0.9分;观察组症状体征改善评分显著优于对照组A,差异有统计学意义(P<0.05).观察组呼吸困难消失时间为1.9 d、咳嗽为4.1 d、喘息为3.0 d、喘鸣音为3.6 d;对照组A分别为3.9 d,8.0 d,5.8 d及8.0 d,对照组B分别为4.1 d,8.9 d,6.6 d及7.1 d,观察组较对照组A及对照组B的病程显著缩短,且组间比较,差异均有统计学意义(P<0.05).结论 对哮喘急性发作患儿,在雾化吸入支气管扩张剂的同时,加用布地奈德混悬液雾化吸入,对改善症状和缩短病程明显优于静脉滴注地塞米松+雾化吸入支气管扩张剂及单纯静脉滴注地塞米松.

Curative Effects of Budesonide Suspension Inhalation on Acute Attack of Asthma in Childhood

Objective To discuss curative effects of budesoni de suspension inhalation on acute attack of asthma in children. Methods From January to December 2011, a total of 140 children who were diagnosed as acute attack of asthma were included into this study. They were divi ded into three groups according to visiting sequence, observation group (n=6 0, budesonide suspension inhalation + atomization inhalation of salbutamol sulfate aerosol solution + ipratropium bromide aerosol therapy), control group A (n =40, intravenous infusion of dexamethasone+atomization inhalation of salbutamol sulfate aerosol solution+ipratropium bromide aerosol treatment), and control group B (n=40, intravenous infusion of dexamethasone only). The following items were observed, the symptoms before and after the treatment (dyspnea, cough, g asp and wheezing), asthmatic score, and symptom disappearance time. The study pr otocol was approved by the Ethical Review Board of Investigation in Human Being of Central Hospital of Dazhou. Informed consent was obtained from each participa te′s parents. Results The symptom improvement score after 1 hour of the treatment in observation group and control group A were the follo wing, dyspnea were 1.1, 0.9 score, cough were 1.1, 0.7 score, gasp were 1.4, 1. 0 score and wheezing were 1.4, 0.9 score, respectively. And the symptom improv ement scores after 1 h of treatment in observation group were better than those in con trol group A (P<0.05). The symptom disappearance time in observation group and control group A were the following, dyspnea were 1.9 d, 3.9 d, 4.1 d; cough were 4.1 d, 8.0 d, 8.9 d; gasp were 3.0 d, 5.8 d, 6.6 d and wheezing were 3.6 d , 8.0 d, 7.1 d ; respectively. And the course of diseases in observation group wer e significant shorter than those in control group A and B (P<0.05). Conclusions As for children with acute attack of asthma, inhaled bronchodilators combined with budesonide inhalation could improve symptoms and shorten the course of disease, which is significantly better than those treatment programs of intravenous infusion of dexamethasone + inhaled bronchodilators or intravenous infusion of dexamethasone only.