孟鲁司特联合布地奈德治疗毛细支气管炎的临床疗效观察

目的：观察口服盂鲁司特联合布地奈德雾化吸入治疗毛细支气管炎的疗效。方法：将临床确诊为婴幼儿毛细支气管炎的90例患儿随机分为试验组48例和对照组42例，另选择健康体检儿40例作为正常对照组。对照组给予常规治疗，试验组在常规治疗基础上病初即给予孟鲁司特口服，≤6个月2mg／d，〉6个月4mg／d，睡前顿服，同时给予布地奈德混悬液1mL／次，每日2次雾化吸入，直到临床症状消失后停用，继续口服孟鲁司特1周停用。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，两组治疗前后外周血IgE、IL-4、Eos的变化并与正常对照组比较。结果：试验组有效率91．7％，对照组有效率69．0％，两组比较差异有统计学意义（χ^2=7．48，P〈0．01）。试验组在缓解喘憋、咳嗽、肺部哆音、心率及缩短住院时间等方面均优于对照组（P〈0．05）；治疗后试验组外周血IgE、IL-4、Eos水平均较治疗前明显下降（P〈0．01），且试验组较对照组下降明显（P〈0．05）。结论：孟鲁司特与布地奈德联合治疗毛细支气管炎，能显著提高疗效，降低药物不良反应发生率，值得在临床应用和推广。

Clinical Effect of Montelukast and Budesonide in Bronchiolitis

Objective： To observe the clinical effect of montelukast combined with budesonide in bronchiolitis. Methods： Ninety cases of children with capillarybronchitis were randomly divided into the experimental group （48 cases ） and the control group （42 cases）. 40 healthy children were selected as normal control group. Both the experimental group and the control group were given traditional therapy. The experimental group received montelukast （ 〈 6 months, 2 mg/d; 6 - 18 months, 4 mg/d, orally at bedtime） and budesonide suspension, 1 mL/time, twice a day till the symptoms were disappeared, then continued to take montelukast for one week. The disappearance time of symptoms and physical signs, the length of hospital stay and the cure rate were compared and analyzed between the two groups. And the changes of IgE, IL-4 and Eos in serum before and after treatment were observed. The difference was compared between the experimental group, the control group and the normal control group. Results： The cure rate of the experimental group was 91. 7%, and that of the control group was 69. 0%, The difference between these two groups was statistically significant （χ^2=7.48, P〈0.01 ）. The experimental group was superior to the control group in shortening the length of hospital stay, relieving and shortening the degree and the time of wheezing and coughs. Their differences were statistically significant （P〈0.05）. The expression levels of IgE, IL-4 and Eos in serum after treatment were significantly lower than those before treatment （P〈0.01）, especially in the experimental group （P〈0.05）. Conclusions： Combined therapy of montelukast and budesonide used for treatment of capillary bronchitis in children can significantly enhance clinical effect and reduce complications, so it deserved clinical application.