比较不同药物在防治儿童咳嗽变异性哮喘的疗效观察

目的 探讨不同的药物在治疗及预防儿童咳嗽变异性哮喘的疗效.方法 对120例咳嗽变异性哮喘（Cough variant asthma,CVA）患儿,按2：2：1比例随机分为治疗Ⅰ组、治疗Ⅱ组和对照组3组.比较3组治疗前、停药前和停药后12m,治疗前后肺功能的变化情况.结果 在取得临床缓解所需时间（T）、咳嗽症状恶化数、典型哮喘转化率和肺功能方面,治疗Ⅰ组和Ⅱ组均比对照组明显降低,但两组之间比较差异均无统计学意义（P＞0.05）.结论 孟鲁司特钠治疗及预防咳嗽变异性哮喘疗效肯定,副作用少,病人依从性好,值得临床推广.     

面罩储雾罐经鼻吸入糖皮质激素同步治疗小儿变应性鼻炎并哮喘

Objective To assess the effixacy of a nasally inhaled corticosteroid(ICS) through a spacer with mask aiming at simultaneou treatment of allergic rhinitis and asthma in children and make an analysis on the costs.Method A total of 72 children with allergic rhinitis (AR) and asthma were randomized into two groups.Experimental group received budesonide inhaler(400 μg/d) through the nose using a spacer attached to a face mask,control group children orally inhaled budesonide dry powder (400μg/d) plus a nasal spray of budesonide aquae(256μg/d).Result The patients were obsenred for 12 weeks.The symptom scores of rhinitis of both experimental group and control group declined(F=6.529 and 7.014,all P<0.01),symptom scores of asthma in both group were also reduced(F=4.132 and 4.950,P<0.01).The pulmonary function PEF(L/win)in both groups continuously increased(F=2.750 and 3.282,P<0.05).But the clinical scores,PEF value and FEVl all did not differ between the two groups at admission or at nearly all follow-up visits(P>0.05 for all).The proportion of dry nose was lower in experimental group than in the control group(5.6% vs.19.4%),but the difference was not statistically significant.The cost in the experimental group was lower than that in the control group(P<0.01).Condusion Nasal inhalation of ICS provides a therapeutic strategy for controlling AR and asthula in children,especially it result in higher compliance,lower costs,and fewer side effects.     

面罩储雾罐经鼻吸入糖皮质激素同步治疗小儿变应性鼻炎并哮喘

Objective To assess the effixacy of a nasally inhaled corticosteroid(ICS) through a spacer with mask aiming at simultaneou treatment of allergic rhinitis and asthma in children and make an analysis on the costs.Method A total of 72 children with allergic rhinitis (AR) and asthma were randomized into two groups.Experimental group received budesonide inhaler(400 μg/d) through the nose using a spacer attached to a face mask,control group children orally inhaled budesonide dry powder (400μg/d) plus a nasal spray of budesonide aquae(256μg/d).Result The patients were obsenred for 12 weeks.The symptom scores of rhinitis of both experimental group and control group declined(F=6.529 and 7.014,all P<0.01),symptom scores of asthma in both group were also reduced(F=4.132 and 4.950,P<0.01).The pulmonary function PEF(L/win)in both groups continuously increased(F=2.750 and 3.282,P<0.05).But the clinical scores,PEF value and FEVl all did not differ between the two groups at admission or at nearly all follow-up visits(P>0.05 for all).The proportion of dry nose was lower in experimental group than in the control group(5.6% vs.19.4%),but the difference was not statistically significant.The cost in the experimental group was lower than that in the control group(P<0.01).Condusion Nasal inhalation of ICS provides a therapeutic strategy for controlling AR and asthula in children,especially it result in higher compliance,lower costs,and fewer side effects.     

面罩储雾罐经鼻吸入糖皮质激素同步治疗小儿变应性鼻炎并哮喘

Objective To assess the effixacy of a nasally inhaled corticosteroid(ICS) through a spacer with mask aiming at simultaneou treatment of allergic rhinitis and asthma in children and make an analysis on the costs.Method A total of 72 children with allergic rhinitis (AR) and asthma were randomized into two groups.Experimental group received budesonide inhaler(400 μg/d) through the nose using a spacer attached to a face mask,control group children orally inhaled budesonide dry powder (400μg/d) plus a nasal spray of budesonide aquae(256μg/d).Result The patients were obsenred for 12 weeks.The symptom scores of rhinitis of both experimental group and control group declined(F=6.529 and 7.014,all P<0.01),symptom scores of asthma in both group were also reduced(F=4.132 and 4.950,P<0.01).The pulmonary function PEF(L/win)in both groups continuously increased(F=2.750 and 3.282,P<0.05).But the clinical scores,PEF value and FEVl all did not differ between the two groups at admission or at nearly all follow-up visits(P>0.05 for all).The proportion of dry nose was lower in experimental group than in the control group(5.6% vs.19.4%),but the difference was not statistically significant.The cost in the experimental group was lower than that in the control group(P<0.01).Condusion Nasal inhalation of ICS provides a therapeutic strategy for controlling AR and asthula in children,especially it result in higher compliance,lower costs,and fewer side effects.     

吸入布地奈德对婴幼儿哮喘干预的远期疗效观察

目的评价布地奈德对婴幼儿哮喘的远期疗效.方法对婴幼儿哮喘患儿130例,随机分为3组,A组:用雾化器吸入布地奈德雾化混悬液;B组:使用贮雾罐和面罩,吸入布地奈德气雾剂;对照组:不接受表面激素的吸入治疗.观察期为1年,在第4、12、24、48周随访,记录观察期间的临床症状评分及哮喘急性发作时药物使用的情况.结果与对照组相比,A组和B组明显降低了日间症状评分、夜间症状评分,有更多的无症状天数;显著减少了口服激素和吸入速效β2受体激动剂的需求,减少了哮喘的急性发作.而A组在观察期的第4、12周的治疗效果比B组更明显(p<0.05),两组在观察期的第24、48周的治疗指标的差异则无显著性(p>0.05).结论对于婴幼儿哮喘,吸入布地奈德治疗可使哮喘得到长期的稳定,而使用雾化器吸入布地奈德混悬液,是婴幼儿哮喘的首选吸入方式,吸入技术更易掌握,可以更好地减轻哮喘症状,更早地达到长期稳定.     

广州市儿童变应性疾病流行病学调查分析

目的 了解广州市城区儿童支气管哮喘(哮喘)、变应性鼻炎及湿疹等变应性疾病的流行状况,为今后儿童变应性疾病防治工作提供科学依据.方法 采用多阶抽样的方法抽取广州市社区0～14岁儿童4072名,通过变应性疾病国际通用的International Study of Asthma and Athergies in Childhood( ISAAC)调查书面问卷的核心问卷对儿童哮喘、变应性鼻炎及湿疹等变应性疾病患病情况进行调查,了解儿童变应性疾病的患病情况.采用SPSS 13.0软件进行统计学分析.结果 儿童哮喘患病率为2.09％,男女患病率之比为1.59:1.00,其中2～6岁儿童患病率最高,首次发作年龄＜3岁者占60.00％.变应性鼻炎患病率为7.83％,3岁后逐渐上升,以6～9岁儿童发病率较高.儿童湿疹患病率为7.22％,且随年龄增加逐渐降低.哮喘并变应性鼻炎占34.83％,并湿疹占19.10％.结论 广州市社区儿童变应性疾病患病率呈上升趋势.     

面罩储雾罐经鼻吸入糖皮质激素同步治疗小儿变应性鼻炎并哮喘

Objective To assess the effixacy of a nasally inhaled corticosteroid(ICS) through a spacer with mask aiming at simultaneou treatment of allergic rhinitis and asthma in children and make an analysis on the costs.Method A total of 72 children with allergic rhinitis (AR) and asthma were randomized into two groups.Experimental group received budesonide inhaler(400 μg/d) through the nose using a spacer attached to a face mask,control group children orally inhaled budesonide dry powder (400μg/d) plus a nasal spray of budesonide aquae(256μg/d).Result The patients were obsenred for 12 weeks.The symptom scores of rhinitis of both experimental group and control group declined(F=6.529 and 7.014,all P<0.01),symptom scores of asthma in both group were also reduced(F=4.132 and 4.950,P<0.01).The pulmonary function PEF(L/win)in both groups continuously increased(F=2.750 and 3.282,P<0.05).But the clinical scores,PEF value and FEVl all did not differ between the two groups at admission or at nearly all follow-up visits(P>0.05 for all).The proportion of dry nose was lower in experimental group than in the control group(5.6% vs.19.4%),but the difference was not statistically significant.The cost in the experimental group was lower than that in the control group(P<0.01).Condusion Nasal inhalation of ICS provides a therapeutic strategy for controlling AR and asthula in children,especially it result in higher compliance,lower costs,and fewer side effects.     

面罩储雾罐经鼻吸入糖皮质激素同步治疗小儿变应性鼻炎并哮喘

目的 探讨采用面罩储雾罐方式给药,经鼻吸入布地奈德(BUD)气雾剂同步治疗小儿变应性鼻炎并哮喘的临床疗效与成本.方法 将72例中～重度变应性鼻炎并轻一中度持续性哮喘的患儿随机分为实验组和对照组,实验组经面罩储雾罐鼻吸入BUD气雾剂400g/d,对照组经口吸入BUD干粉剂400μg/d联合使用BUD鼻喷雾剂256μg/d.进行哮喘和鼻炎的症状评分,监测第1秒时间肺活量(FEV1)、晨起呼气峰流速值(PEF),并进行治疗成本比较.结果 经过12周的临床观察,实验组和对照组的鼻炎症状评分明显下降(F=6.529和7.014,P均<0.01),两组的哮喘症状评分不断减低(F=4.132和4.950,P均<0.01),实验组和对照组的肺通气功能指标PEF(L/min)逐渐升高(F=2.750和3.282,P均<0.05).但两组间的症状评分、FEV1和PEF在入选时与治疗后的多次随访中比较,差异无统计学意义.实验组鼻腔干燥等副反应的发生率(5.6%)低于对照组(19.4%),但差异无统计学意义.平均治疗费用:实验组(244.0±12.8)元,对照组(403.2±17.6)元,差异有统计学意义(P<0.01).结论 面罩式储雾罐经鼻吸入糖皮质激素可同时有效控制小儿变应性鼻炎和哮喘,并有依从性高、副作用少、花费低等优点,适用于轻～中度持续性哮喘合并变应性鼻炎患儿.     

面罩储雾罐经鼻吸入糖皮质激素同步治疗小儿变应性鼻炎并哮喘

Objective To assess the effixacy of a nasally inhaled corticosteroid(ICS) through a spacer with mask aiming at simultaneou treatment of allergic rhinitis and asthma in children and make an analysis on the costs.Method A total of 72 children with allergic rhinitis (AR) and asthma were randomized into two groups.Experimental group received budesonide inhaler(400 μg/d) through the nose using a spacer attached to a face mask,control group children orally inhaled budesonide dry powder (400μg/d) plus a nasal spray of budesonide aquae(256μg/d).Result The patients were obsenred for 12 weeks.The symptom scores of rhinitis of both experimental group and control group declined(F=6.529 and 7.014,all P<0.01),symptom scores of asthma in both group were also reduced(F=4.132 and 4.950,P<0.01).The pulmonary function PEF(L/win)in both groups continuously increased(F=2.750 and 3.282,P<0.05).But the clinical scores,PEF value and FEVl all did not differ between the two groups at admission or at nearly all follow-up visits(P>0.05 for all).The proportion of dry nose was lower in experimental group than in the control group(5.6% vs.19.4%),but the difference was not statistically significant.The cost in the experimental group was lower than that in the control group(P<0.01).Condusion Nasal inhalation of ICS provides a therapeutic strategy for controlling AR and asthula in children,especially it result in higher compliance,lower costs,and fewer side effects.