孟鲁司特联用布地奈德吸入防治儿童哮喘合并变应性鼻炎

目的：观察在吸入糖皮质激素（布地奈德）的基础上联合应用白三烯受体拮抗剂（孟鲁司特）对儿童哮喘伴变应性鼻炎的防治作用。方法：74例轻、中度支气管哮喘伴变应性鼻炎患儿随机分为治疗组和对照组各37例，进行3个月的治疗，观察组吸入布地奈德每天400μg，一个月后减至每天200μg，治疗组在此基础上加用孟鲁司特每天5mg。记录患儿的哮喘症状评分、变应性鼻炎症状评分、按需吸入β2受体激动剂的次数及测定气道反应性。结果：治疗后两组患儿的哮喘症状评分、变应性鼻炎症状评分及气道高反应性均明显改善。治疗组治疗后夜间哮喘症状评分及变应性鼻炎症状评分为0分及（0.30±0.36）分，对照组治疗后夜间哮喘症状评分及变应性鼻炎症状评分为（0.41±0.36）分及（1.29±0.54）分，两组比较差异有显著意义（P〈0.01）；按需吸入β2受体激动剂的次数治疗组为（1.84±0.04）喷，对照组为（2.97±0.03）喷，两组比较差异有显著性（P〈0.05）。结论：在吸入糖皮质激素的基础上联合应用白三烯受体拮抗剂可显著提高对儿童哮喘伴变应性鼻炎的疗效。

Effects of Leukotriene Receptor Antagonist and Inhaled Corticosteroid on Asthmatic Children with Allergic Rhinitis

Objective：To evaluate the therapeutic effects of leukotriene receptor antagonist （Montelukast） in combination with inhaled corticosteroid （Budesonide）on asthmatic children with allergic rhinitis. Methods：Seventy-four mild to moderate asthmatic children with allergic rhinitis were randomly divided into treating group and control group. Thlrty-seven children in control group were treated only with budesonide inhalation （400 μg/d for one month,then reduced to 200 μg/d） for 3 months. On the basis of inhalation, the other thirty-seven children in treating group were added montelukast 5 mg/d orally. Daytime and night asthma symptom scores, allergic rhinitis symptom score and doses of inhaled terbutaline as rescue drug were recorded. Bronchial responsiveness were measured before and after the treatment. Results：After treatment, there was much better improvement in scores of asthma symptoms and allergic rhinitis symptoms and bronchial responsiveness in both groups. Night asthma symptom score , allergic rhinitis symptom score after treatment and average doses of inhaled β2 agonist per week in treating group were significantly lower than those in control group. There was no significant difference in bronchial responsiveness between the two groups.Conclusion：On the basis of low dose inhaled corticosteroid, orally leukotriene receptor antagonist significantly improves the therapeutic efficacy of asthmatic children with allergic rhinitis.