舒利迭与吸入性糖皮质激素联合孟鲁司特钠治疗儿童中度持续性哮喘的疗效对比研究

目的：对比研究舒利迭（美沙特罗±丙酸氟替卡松）与吸入性糖皮质激素（丙酸氟替卡松）联合白三烯受体拮抗剂（孟鲁司特钠）治疗儿童中度持续性哮喘的临床疗效。方法：入选取2013年1月～2015年3月收治的82例中度持续性哮喘患儿为研究对象，随机分为A组、B组各41例，A组患儿给予舒利迭吸入治疗方案，B组患儿给予辅舒酮吸入联合孟鲁司特钠口服方案，比较两组患儿治疗4周和12周哮喘控制水平、儿童哮喘测试（C-ACT）评分、肺功能、外周血嗜酸性粒细胞计数水平等的差异，观察两组合并过敏性鼻炎的患儿鼻部症状改善情况。结果：治疗4周后A组和B组患儿哮喘控制总有效率（87.8%vs.73.2%）、C-ACT评分（23.13±2.75vs.21.47±2.24）、外周血嗜酸性粒细胞（EOS）计数（0.35±0.12vs0.22±0.11）×109及肺功能指标差异均有统计学意义；治疗12周后两组哮喘控制总有效率（100.0%vs.97.7%）、C-ACT评分（25.26±2.23vs.24.67±2.01）及各项肺功能指标差异均无统计学意义，但A组EOS计数显著高于B组（0.26±0.13vs.0.15±0.09）×109差异显著；治疗4周后，B组过敏性鼻炎患儿鼻部症状开始改善，12周后症状明显改善，A组过敏性鼻炎患儿鼻部症状无明显变化。结论：舒利迭与吸入性糖皮质激素联合孟鲁司特钠方案治疗儿童中度持续性哮喘3个月后疗效相当；前者能更快的缓解患儿临床症状、改善肺功能，后者对于合并过敏性鼻炎的患儿可更好缓解鼻部症状，进一步降低EOS水平。

A comparative study on efficacy between seretide and inhaled glucorticoid combined with montelukast sodium in the treatment of children with moderate persistent asthma

Objective To compare and investigate clinical efficacy between Seretide (Shateluo±fluticasone propionate) and inhaled glucocorticoid (fluticasone propionate) combined with leukotriene receptor antagonist (montelukast sodium)in treatment of children with moderate persistent asthma. Methods 82 children with moderate persistent asthma of January 2013 to March 2015 were selected as study objects and were randomized into A and group B according to random number ,each group with 41 cases, children in group A were given Seretide inhalation therapy, group B with inhaled fluticasone propionate+montelukast sodium orally, after 4 and 12 weeks medication, asthma control level, children asthmatic test (C-ACT) score, lung function and peripheral blood eosinophils (EOS)count level of 2 groups were noted and compared,besides,children with allergic rhinitis whose improve-ment of nasal symptoms of two group were compared. Results After 4 weeks’medication, total efficiency (87.8%vs. 73.2%) on asthma control,C-ACT score (23.13±2.75vs.21.47±2.24), peripheral EOS count (0.35±0.12vs.0.22±0.11) ×109 and pulmo-nary function indexes of two groups had significant difference. After 12 weeks’medication, total efficiency (100.0%vs.97.7%), C-ACT score (25.26±2.23vs.24.67±2.01) and pulmonary function indexes of two groups had no statistical significance, but A group whose EOS count was significantly higher than group B (0.26±0.13 vs. 0.15±0.09) ×109. After 4 weeks of treatment, chil-dren with allergic rhinitis in group B whose nasal symptoms began to improve, the symptoms improved obviously after 12 weeks, however,there were no significant changes in children of group A. Conclusion Seretide and inhaled glucocorticoid combined with montelukast sodium whose efficacies were similar after 3 months treatment for children with moderate persistent asthma, the former therapy can quickly relieve clinical symptoms, improve lung function,and the latter for children 3omplicated with allergic rhinitis can better relieve nasal symptoms simultaneously,further reduce peripheral EOS level.