孟鲁司特联合糖皮质激素治疗儿童咳嗽变异型哮喘疗效研究

目的：评估应用孟鲁司特联合糖皮质激素对咳嗽变异性哮喘患儿的疗效。方法：将我院2006年1月～2010年6月咳嗽变异性哮喘86例患儿随机分为对照组和观察组,各43例,对照组患儿吸入丙酸氟地卡松125μg/次,每天早晚各1次,观察组除予糖皮质激素吸入治疗外,同时睡前予口服孟鲁司特4 mg 1次,连续治疗8周,观察治疗前和治疗后咳嗽症状和咳嗽对患儿睡眠、日常行为的影响。结果：孟鲁司特联合糖皮质激素总有效率为95.35%,与对照组有效率（74.42%）比较差异有统计学意义（χ2=42.742,P〈0.05）,治疗前对照组和观察组症状评分比较差异无统计学意义（t=0.716,P〉0.05）,治疗后对照组和观察组症状评分比较差异有统计学意义（t=5.321,P〈0.05）,且未增加药物的副作用。结论：孟鲁司特联合糖皮质激素在咳嗽变异性哮喘患儿治疗中能有效提高治疗的有效率,明显改善患儿的临床症状,值得推广应用。

Therapeutic effect of Montelukast combined with Glucocorticoid on childhood cough variant asthma

Objective： To evaluate the therapeutic effect of the combined treatment by the oral Montelukast and inhaled Glucocorticoid on the childhood cough variant asthma.Methods： 86 cases children with cough variant asthma were selected in our hospital from January 2006 to June 2010 and divided into observation group and control group evenly.The control group only inhaled 125 μg Fluticasone propionate per time,twice a day with one in the morning and the other in the night.In the regular treatment with the inhaled Glucocorticoid,observation group was added with Montelukast orally taken 4 mg once daily before bedtime.After eight weeks with the continuous therapy,the clinical efficacy before and after treatment were compared in order to find out the influence of asthma symptom and asthma itself on the sleeping quality and daily behavior of sick children.Results： Total efficiency rate of Montelukast combined with Glucocorticoid was 95.35%,compared with the efficiency rate of control group（74.42%）,there were significant differences（χ2=42.742,P0.05）.The symptom score before treatment had little difference between two groups（t=0.716,P0.05）,but there were significant differences after treatment（t=5.321,P0.05）.Additionally it did not increase the side effect of the treatment.Conclusion： Montelukast combined with Glucocorticoid in the treatment of childhood with cough variant asthma can boost clinical efficacy greatly,and inprove symptom of sick children,deserves to be promoted and applied.