孟鲁司特咀嚼片对咳嗽变异性哮喘患儿肺功能及炎症因子的影响

目的 研究孟鲁司特咀嚼片对咳嗽变异性哮喘(CVA)患儿肺功能及炎症因子的影响.方法 选取2015年2月至2016年3月在南京中医药大学附属八一医院儿科接受治疗的CVA患儿84例,根据随机数表法分为观察组和对照组各42例,对照组患儿给予丙酸氟替卡松治疗,早、晚各1次使用丙酸氟替卡松气雾剂吸入治疗,观察组则在对照组的基础上予以每晚口服孟鲁司特咀嚼片治疗.两组疗程均为12周,比较两组患儿的咳嗽缓解时间和消失时间,治疗前后的咳嗽评分、各项肺功能指标水平,以及血清免疫球蛋白-E(IgE)、白细胞介素-4(IL-4)、白细胞介素-5(IL-5)水平.结果 治疗后,观察组患儿的咳嗽缓解时间、消失时间分别为(4.2±1.4)d、(8.5±3.7)d,均明显低于对照组的(8.3±3.1)d、(12.9±2.9)d,差异均有统计学意义(P<0.05);治疗后两组患儿咳嗽评分均明显著低于治疗前,且观察组又明显低于对照组,差异均有统计学意义(P<0.05);治疗后观察组患者的呼气峰流速值(PET)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)水平分别为(6.7±1.2)L/min、(3.4±1.3)L、(2.4±0.9)L,均明显高于对照组的(5.8±1.0)L/min、(2.5±0.9)L、(1.9±0.7)L,差异均有统计学意义(P<0.05);治疗后观察组患者的血清IgE、IL-4、IL-5水平分别为(124.5±40.6)kU/L、(71.2±5.2)ng/mL、(10.2±0.4)ng/mL,均明显低于对照组的(177.1±41.9)kU/L、(88.7±7.5)ng/mL、(14.5±1.0)ng/mL,差异均有统计学意义(P<0.05).结论 孟鲁司特咀嚼片联合丙酸氟替卡松气雾剂吸入治疗CVA患儿的效果显著,孟鲁司特咀嚼片有利于改善患儿临床症状以及肺功能,同时可控制炎症反应水平,促进患儿早日康复.

Effect of montelukast sodium chewable tablet on lung function and inflammatory factors of children with cough variant asthma

Objective To study the effect of montelukast sodium chewable tablet on lung function and inflam-matory factors of children with cough variant asthma (CVA). Methods A total of 84 cases of children with CVA, who admitted to Department of Pediatrics of Bayi Hospital Affiliated to Nanjing University of Chinese Medicine from Febru-ary 2015 to March 2016, were selected and divided into the observation group and the control group according to ran-dom number table method, with 42 cases in each group. The control group was given fluticasone propionate aerosol inha-lation therapy one time at the morning and night, and the observation group was treated with oral montelukast sodium chewable tablet on the basis of the treatment of the control group every night. The treatment course of the two groups was 12 weeks. The cough remission time and disappearance time, cough score before and after treatment, pulmonary function indicators levels, serum levels of immunoglobulin-E (IgE), interleukin-4 (IL-4), interleukin-5 (IL-5) in the two groups were compared. Results After the treatment, the cough remission time and disappearance time of the observation group were (4.2 ± 1.4) d and (8.5 ± 3.7) d, respectively, which were significantly lower than (8.3 ± 3.1) d and (12.9 ± 2.9) d of the control group (P<0.05);the cough scores after the treatment were significantly lower than these before the treatment in the two group, and the cough score in the observation group was significantly lower than that in the control group (P<0.05);peak expiratory flow rate value (PET), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) level in the observation group were respectively (6.7 ± 1.2) L/min, (3.4 ± 1.3) L, (2.4 ± 0.9) L, which were significantly higher than corresponding (5.8 ± 1.0) L/min, (2.5 ± 0.9) L, (1.9 ± 0.7) L of the control group (P<0.05);the serum levels of IgE, IL-4, IL-5 in the observation group were respectively (124.5 ± 40.6) kU/L, (71.2 ± 5.2) ng/mL, (10.2 ± 0.4) ng/mL, which were significantly lower than (177.1 ± 41.9) kU/L, (88.7 ± 7.5) ng/mL, (14.5 ± 1.0) ng/mL in the control group (P<0.05). Conclusion The aerosol inhalation application of montelukast sodium chewable tablet combined with flutica-sone propionate has significant effect in the treatment of children with CVA, which can improve clinical symptoms and lung function, control inflammation levels, and promote the early recovery of children.