孟鲁司特联合槐杞黄颗粒治疗儿童咳嗽变异性哮喘的临床疗效

目的 观察孟鲁司特联合槐杞黄颗粒预防和治疗儿童咳嗽变异性哮喘.方法 将90例咳嗽变异性哮喘患儿随机均分成对照组和治疗组.治疗组给予孟鲁司特、槐杞黄颗粒,对照组仅给予孟鲁司特.结果 治疗3月后,治疗组多项控制指标均优于对照组.结论 孟鲁司特联合槐杞黄颗粒能有效地减少咳嗽变异性哮喘发作次数,较好地控制临床症状,不良反应轻,生活质量明显提高.     

孟鲁司特钠联合复方福尔可定口服液治疗儿童咳嗽变异性哮喘的疗效观察

目的探索治疗儿童咳嗽变异性哮喘(CVA)的有效方法。方法应用孟鲁司特钠联合复方福尔可定口服液为治疗组,与单用孟鲁司特钠为对照组,观察其疗效。结果治疗组总有效率96.8%,高于对照组总有效率78.1%,χ2=4.94,P<0.05,差异具有统计学意义。结论孟鲁司特钠联合复方福尔可定口服液治疗(CVA)比单用孟鲁司特钠疗效好,值得临床推广。     

孟鲁司特联合小剂量IgG对反复发作的儿童过敏性紫癜的疗效评价

目的探讨在常规治疗基础上孟鲁司特联合小剂量IgG(丙种球蛋白)对于反复发作的儿童过敏性紫癜的临床疗效。方法将本院收治的108例反复发作的过敏性紫癜儿童随机分为常规治疗组、孟鲁司特组、联合治疗组。3组患者均给予常规治疗,孟鲁司特组、联合治疗组再给予孟鲁司特治疗,联合治疗组在此基础上增加小剂量丙种球蛋白治疗。比较3组患儿临床治疗的有效率及随访1年的复发率。结果常规治疗组、孟鲁司特组、联合治疗组患儿治疗的有效率分别为77.8%、94.4%、97.2%,复发率分别为25.0%、27.8%、2.8%;孟鲁司特组、联合治疗组临床治疗有效率显著高于常规治疗组(P<0.05),而联合治疗组的复发率显著低于小剂量孟鲁司特组(P<0.05)。结论孟鲁司特能够显著提高过敏性紫癜患儿的临床疗效,而丙种球蛋白能有效降低复发率,两者联合应用对于反复发作的儿童过敏性紫癜的疗效确切。     

72例小儿咳嗽变异性哮喘予孟鲁司特钠与酮替酚治疗的临床探讨

目的分析比较临床治疗小儿咳嗽变异性哮喘时分别给予孟鲁司特钠与酮替芬的临床疗效。方法选取我院在2007年3月至2012年3月间收治的168例小儿咳嗽变异性哮喘患儿,并将其随机平均分为A、B两组,A组患儿给予酮替芬治疗,B组患儿给予孟鲁司特钠治疗,并且对比分析两组患儿经过治疗后的临床效果。结果应用孟鲁司特钠治疗的B组患儿其临床治疗有效率为95.24%,明显优于应用酮替芬治疗的A组患儿的有效率73.81%;在治疗后复发率方面比较,B组患儿复发率为5.95%,也明显低于A组患儿的复发率15.48%。结论临床治疗小儿咳嗽变异性哮喘时应用孟鲁司特钠治疗,不仅可以提高临床效果,同时还可以有效降低复发,值得临床广泛应用。     

孟鲁司特钠治疗儿童哮喘80例临床分析

孟鲁司特钠（montelukats—Na）是一种半胱氨酰白三烯受体拮抗剂，用于儿童哮喘的预防治疗，美国等多个国家已用于哮喘的临床治疗，为评价孟鲁司特钠治疗哮喘的有效性，本研究对80例哮喘患儿进行临床验证，现报告如下。     

孟鲁司特联合氨溴索雾化防治儿童支气管哮喘

目的评价孟鲁司特钠与吸入氨溴索治疗儿童哮喘的疗效与不良反应。方法选择医院儿科收治的支气管哮喘患儿70例,随机分成治疗组和对照组各35例。治疗组:口服孟鲁司特片5 mg,每晚1次;氨溴索注射液30 mg雾化吸入,1日2次;疗程6个月。对照组:口服孟鲁司特片5 mg,每晚1次,疗程6个月。记录急性发作时喘息时间,每月急性发作次数及使用天数。结果治疗组近期控制、显效、有效及总有效率均明显优于对照组,有显著性差异(P<0.05)。治疗组随用药时间延长临床症状及各项指标有明显改善(P<0.05)。结论孟鲁司特钠与吸入氨溴索联合治疗儿童哮喘具有叠加抗炎作用,其疗效优于单用孟鲁司特,可作为儿童哮喘治疗及预防复发的一种理想的治疗方案。     

孟鲁司特治疗婴幼儿毛细支气管炎64例疗效分析

目的:探讨孟鲁司特治疗婴幼儿毛细支气管炎的疗效。方法:将临床确诊的128例婴幼儿毛细支气管炎患儿按照随机数表的方法分为常规治疗组和孟鲁司特治疗组各64例,孟鲁司特治疗组在常规治疗基础上于病程早期开始口服孟鲁司特2.5 mg/d,直到症状消失后1周停药。观察两组治疗后主要临床症状和体征消失时间、住院天数及治愈率。结果:孟鲁司特治疗组有效率为98.44%,常规治疗组的有效率为92.19%,两组比较差异有统计学意义(χ2=6.271,P<0.05)。孟鲁司特治疗组在缩短患儿住院时间,缓解喘憋、咳嗽、哮鸣音、湿啰音程度及持续时间等方面均明显优于常规治疗组(P<0.05)。结论:作为新型的非激素类抗炎药,孟鲁司特治疗婴幼儿毛细支气管炎有较好疗效,具有良好的临床应用价值。     

孟鲁司特钠联合玉屏风防治儿童哮喘发作60例

目的探讨孟鲁司特钠辅用玉屏风颗粒治疗及预防儿童哮喘发作的疗效。方法采用随机、平行对照研究方法,将180例患儿随机分为3组,均予常规治疗,A组（58例）给予布地奈德气雾剂预防复发,B组（62例）给予孟鲁司特钠口服预防复发,C组（60例）给予孟鲁司特钠和玉屏风颗粒口服预防复发,均连续用药6个月,随访6-18个月。结果3组患儿治疗后临床症状缓解时间及肺部体征消失时间、治疗前后IgE和T细胞亚群变化、治疗前后肺功能变化以及复发情况都有显著性差异（P〈0．05）或非常显著性差异（P〈0．01）,C组疗效较佳。结论孟鲁司特钠联合用玉屏风颗粒防治儿童哮喘发作有很好的疗效,且不良反应轻微,具有较好的临床价值。     

孟鲁司特与布地奈德治疗儿童咳嗽变异性哮喘的临床观察

目的 观察孟鲁司特与布地奈德治疗儿童咳嗽变异性哮喘(CVA)的临床疗效.方法 97例CVA患儿随机分为孟鲁司特组与布地奈德组.孟鲁司特组予孟鲁司特、特布他林片口服治疗,布地奈德组予布地奈德气雾剂、特布他林气雾剂治疗.结果 孟鲁司特组总有效率91.7%,布地奈德组总有效率95.9%,两组疗效比较无显著性差异.结论 孟鲁司...     

小儿咳喘灵颗粒与孟鲁司特钠联合应用治疗咳嗽变异性哮喘的临床疗效观察

目的探讨小儿咳喘灵颗粒与孟鲁司特钠联合应用在咳嗽变异性哮喘中的治疗效果。方法选择2013年6月至2015年4月我院治疗的118例咳嗽变异性哮喘患儿,随机分成对照组59例(孟鲁司特钠)和治疗组59例(小儿咳喘灵颗粒+孟鲁司特钠),对比两组的临床疗效,跟踪记录临床表现消失时间和复发率。结果治疗组临床总有效率(96.61%)、临床表现消失时间(4.52±0.76)d和复发率(3.39%)与对照组相比,P均<0.05,具有显著性优势,且两组均无明显不良反应。结论小儿咳喘灵颗粒与孟鲁司特钠联合应用治疗咳嗽变异性哮喘具有临床症状消退快、住院时间短、复发率低、疗效显著的特点。     

Montelukast: new preparation. No current use in asthma

(1) Montelukast, an antiasthmatic drug belonging to the leukotriene antagonist family, has two indications in France: as adjunctive treatment for mild to moderate chronic asthma when regular inhaled steroid therapy and short-acting inhaled beta 2 stimulants "on demand" are inadequate; and in the prevention of effort-induced asthma. (2) The clinical file on montelukast contains no methodologically acceptable comparisons with reference treatments. (3) Several placebo-controlled trials have shown the efficacy of montelukast, with an improvement in clinical scores and respiratory function tests in chronic asthma; and prevention of effort-induced asthma. (4) In chronic asthma montelukast has not been compared with oral or inhaled long-acting beta 2 stimulants, or with sustained-release theophylline in patients inadequately controlled by steroid therapy. (5) In effort-induced asthma, only two trials have compared montelukast to salmeterol. On the basis of preliminary results the authors concluded that montelukast was superior in both studies. (6) Clinical trials showed no clear difference in the frequency of side effects in patients on montelukast and those on a placebo. However, montelukast may possibly be associated with the Churg and Strauss syndrome in rare cases. (7) Montelukast is an expensive drug.     

孟鲁司特钠对哮喘儿童肺功能的影响

目的 探讨孟鲁司特钠对学龄前哮喘患儿肺功能的影响.方法 对86例首次符合哮喘诊断标准的学龄前患儿给予孟鲁司特钠治疗4周(1次/d,4mg/次,睡前服).分别在治疗前、开始治疗后1周、治疗结束后进行随访,测定肺功能,并与健康对照组比较.结果 哮喘患儿治疗前肺功能明显低于对照组(P＜0.01).孟鲁司特钠治疗1周后,哮喘患儿肺功能与治疗前相比差异无显著性,治疗4周后,肺功能明显改善.结论 孟鲁司特钠用于学龄前儿童哮喘的治疗,对缓解症状和改善肺功能均能收到良好效果.     

Montelukast in the treatment of allergic rhinitis: an evidence-based review

Cysteinyl-leukotrienes (CysLTs) are endogenous mediators of inflammation and play an important role in allergic airway disease by stimulating bronchoconstriction, mucus production, mucosal oedema and inflammation, airway infiltration by eosinophils, and dendritic cell maturation that prepares for future allergic response. Montelukast inhibits these actions by blocking type 1 CysLT receptors found on immunocytes, smooth muscle and endothelium in the respiratory mucosa. Initially developed as a treatment for asthma, montelukast has more recently found use in the treatment of allergic rhinitis (AR). We conducted a systematic review of studies that have evaluated montelukast in the treatment of seasonal AR (SAR) and perennial AR (PAR), with and without concomitant asthma. Primary consideration was given to large, randomised, placebo-controlled, double-blind clinical trials in which AR endpoints were assessed and the use of concurrent treatments for AR was excluded. Eight such studies were found in the literature. The primary endpoint in these was daytime nasal symptom severity represented by a composite score derived from individual self-ratings of nasal congestion, rhinorrhoea, nasal pruritus and sneezing. Secondary endpoints have included these individual nasal symptom scores, additional scores for eye, ear and throat symptoms, the impact of rhinitis on quality of sleep, global evaluations of outcome by patients and physicians, and measures of the severity of concomitant asthma. A general outcome was that patients treated with montelukast had significantly greater improvements in their symptoms of SAR and PAR than did patients who were given a placebo. As monotherapy, montelukast exhibited efficacy similar to that of loratadine, but less than that of the intranasally administered corticosteroid fluticasone propionate. The use of montelukast in combination with antihistamines such as loratadine or cetirizine has generally resulted in greater efficacy than when these agents were used alone, and in some studies has produced results comparable with intranasally applied corticosteroids. In patients with AR comorbid with asthma, montelukast treatment has resulted in significant improvements in both, compared with placebo. Montelukast is well tolerated and has a favourable safety profile; adverse events have occurred at similar frequencies in patients taking either montelukast or placebo. Montelukast provides an effective and well tolerated oral treatment for allergic airway inflammation in patients with SAR or PAR without asthma, and in patients in whom AR is comorbid with asthma.     

Montelukast in asthmatic patients 6 years-14 years old with an FEV1 > 75%

OBJECTIVES: Montelukast is a potent leukotriene receptor antagonist effective for treating asthma symptoms in adult and pediatric patients. The purpose of this analysis was to assess the clinical efficacy of montelukast, a potent leukotriene-receptor antagonist, in a subgroup analysis of patients aged 6 years-14 years with milder asthma, defined as a percentage predicted forced expiratory volume in 1 s (FEV1) > 75% using data from a clinical trial of pediatric patients with a broad range of asthma severities. RESEARCH DESIGN AND METHODS: The original previously published clinical trial was an 8-week multi-center, randomized, double-blind, parallel-group study conducted in 47 centers in the United States and Canada. The study compared the efficacy of once daily montelukast 5 mg to placebo in patients 6 years-14 years old with persistent asthma and an FEV1 ranging from 50% to 85% of predicted. A total of 87 patients in the montelukast group and 51 patients in the placebo group were selected from the original cohort of 336 patients based on percentage predicted FEV1 of > 75%. The primary endpoint was percentage change in FEV1 from baseline compared with placebo over 8 weeks of active treatment. RESULTS: Montelukast significantly improved the primary endpoint of percentage change in FEV1 compared with placebo (p = 0.005). Other efficacy endpoints were significantly improved on montelukast similar to efficacy in the original study. CONCLUSION: Montelukast significantly improved FEV1, clinic measured peak expiratory flow (PEF), reduced nocturnal awakenings, and improved quality of life in children with milder persistent asthma defined as an FEV1 > 75% of predicted.     

孟鲁司特治疗儿童轻、中度哮喘的临床观察

目的：观察孟鲁司特治疗儿童轻、中度哮喘的疗效。方法：163例轻、中度哮喘患儿随机分为两组,治疗组78例。每晚口服孟鲁司特5mg,疗程2周,对照组85例给予常规治疗,比较两组疗效。结果：两组的临床效果经比较差异无统计学意义（P〉0．05）。结论：孟鲁司特治疗轻、中度哮喘疗效较好,无不良反应,安全性好。     

沙美特罗替卡松粉复合吸入剂联合孟鲁司特治疗咳嗽变异性哮喘的疗效观察

目的探讨沙美特罗替卡松粉复合吸入剂联合孟鲁司特对咳嗽变异性哮喘（CVA）患者的临床疗效。方法100例CVA患者完全随机分为孟鲁司特组和联合治疗组各50例,孟鲁司特组给予孟鲁司特（默沙东公司,商品名：顺尔宁）10mg,每晚1次,疗程8周;联合治疗组吸人沙美特罗替卡松粉复合吸入剂（葛兰素史克公司,商品名：舒利迭）50μg／250μg,2次／d,口服孟鲁司特10mg,每晚1次,疗程均为8周。观察2组治疗前后临床症状、肺功能以及诱导痰中炎性细胞的变化。结果2组药物治疗后临床咳嗽症状改善明显,孟鲁司特组总有效率82％,联合治疗组总有效率94％,二者比较,差异有统计学意义（P〈0．01）;与孟鲁司特组比较,联合治疗组诱导痰中相关炎症细胞总数和嗜酸粒细胞百分比较治疗前减少明显（2．76±0．61vs3．02±0．55;10．2±2．9vs14．8±3．5,P〈0．05）,肺通气功能（FEV1,FEV1预计值和FEV1／FVC）改善明显（P〈0．05）,联合治疗组疗效优于孟鲁司特组。结论沙美特罗替卡松粉复合吸入剂联合孟鲁司特治疗CVA具有较好的疗效。     

Montelukast: a review of its therapeutic potential in asthma in children 2 to 14 years of age

Montelukast is a cysteinyl leukotriene receptor antagonist which is used as a preventive treatment for persistent asthma in patients > or =2 years of age. In children aged 6 to 14 years montelukast (5 mg/day) treatment resulted in a significant increase in FEV(1) (forced expiratory volume in 1 second, primary clinical outcome) during an 8-week randomized, double-blind trial. Moreover, significant improvements were observed for a range of secondary endpoints assessing symptoms, exacerbation rates, beta-agonist usage and quality of life. Concomitant administration of montelukast (5 mg/day) and inhaled budesonide (200 microg twice daily) resulted in a trend towards an increase in FEV(1) (p = 0.06, primary endpoint) and a statistically significant reduction in both as-needed beta(2)-agonist usage and the percentage of days with asthma exacerbations compared with budesonide plus placebo. No significant differences were observed in asthma-related quality of life between the two groups. During clinical trials both improvements in lung function and reductions in as-needed beta(2)-agonist usage were generally observed within 1 day after initiation of therapy in children 2 to 14 years of age with persistent asthma. Data from a randomized, nonblind trial in 6- to 11-year-old children and a 6-month extension to this trial suggest that both compliance to therapy and patient satisfaction are greater for montelukast than for either inhaled sodium cromoglycate or inhaled beclomethasone. In addition, patients and parents preferred oral montelukast over sodium cromoglycate. In 2- to 5-year-old children with persistent asthma, montelukast (4 mg/day) treatment resulted in significant improvements in a range of outcomes, such as as-needed beta(2)-agonist usage, symptom scores and percentage of days with asthma symptoms, as assessed during a randomized, double-blind trial primarily designed to assess tolerability. Data from small randomized, double-blind trials suggest that montelukast reduces exercise-induced bronchoconstriction in 6- to 14-year-old children. Montelukast is generally well tolerated. The frequency of adverse events in montelukast-treated children of all ages was comparable to that in patients receiving placebo. CONCLUSION: Oral montelukast has shown efficacy as a preventive treatment for asthma during clinical trials in children aged 2 to 14 years. The drug offers benefits over more standard therapies such as inhaled sodium cromoglycate and nedocromil in terms of compliance and convenience. In addition, the drug offers significant benefits when added to inhaled corticosteroids (according to secondary endpoints). Montelukast offers an effective, well tolerated and convenient treatment option for children with asthma.     

Effect of montelukast on the pharmacokinetics and pharmacodynamics of warfarin in healthy volunteers

Montelukast, a cysteinyl leukotriene receptor antagonist, is being developed for the treatment of asthma and related diseases. This study was designed to evaluate whether montelukast at clinically used dosage levels would interfere with the anticoagulant effect of warfarin. In a two-period, double-blind, randomized crossover study, 12 healthy male subjects received a single oral dose of 30 mg warfarin on the 7th day of a 12-day treatment with montelukast, 10 mg daily by mouth, or a placebo. Montelukast had no significant effect on the area under the plasma concentration-time curves and peak plasma concentrations of either R- or S-warfarin. However, slight but statistically significant decreases in time to peak concentration of both warfarin enantiomers and in elimination half-life of the less potent R-warfarin were observed in the presence of montelukast. These changes were not considered as clinically relevant. Montelukast had no significant effect on the anticoagulant effect of warfarin, as assessed by the international normalized ratio (INR) for prothrombin time (AUC0-144 and INR maximum). The results of this study suggest that a clinically important interaction between these drugs is unlikely to occur in patients requiring concomitant administration of both drugs.     

孟鲁司特钠治疗呼吸道合胞病毒毛细支气管炎的疗效研究

目的观察孟鲁司特治疗毛细支气管炎的疗效和预防喘息反复发作的效果。方法将2009年1月—2011年6月我科住院的呼吸道合胞病毒毛细支气管炎患儿100例随机分为两组,每组各50例。两组均给予常规治疗,治疗组加用孟鲁司特口服至症状及体征消失后1周,随访1年。结果治疗7d后两组疗效比较差异有统计学意义(P<0.05);且喘息反复发作病例数低于对照组,差异有统计学意义(P<0.01)。结论孟鲁司特治疗毛细支气管炎疗效显著,能预防喘息反复发作。     

加用孟鲁司特治疗支气管哮喘疗效观察

目的:探讨孟鲁司特治疗支气管哮喘的临床疗效.方法:将57例支气管哮喘患者随机分为治疗组(30例)和对照组(27例).2组均予以解痉平喘、吸氧等常规治疗,治疗组加用孟鲁司特咀嚼片,总疗程 1个月,观察疗效.结果:治疗组总有效率93.33%,对照组总有效率77.78%,2组比较有显著性差异(P＜0.05).结论:孟鲁司特治...