噻托溴铵干粉吸入剂联合舒利迭治疗小儿支气管哮喘急性发作的临床研究

目的 观察噻托溴铵干粉吸入剂联合舒利迭吸入剂治疗小儿支气管哮喘急性发作的临床疗效.方法 将2012年5月～2014年4月收治的95例支气管哮喘急性发作患儿为研究对象,随机分为治疗组（49例）和对照组（46例）,对照组患儿予抗炎、解痉及舒利迭吸入剂治疗,治疗组在对照组基础上加用噻托溴铵干粉吸入剂,对比两组患儿肺功能、临床症状消退时间,治疗14 d后判定临床疗效.结果 治疗3d后,两组患儿肺功能、动脉血气指标及气道炎性指标均较治疗前明显改善;治疗后两组FEV1为（1.61±0.32）L vs （1.48±0.30）L、PEF为（2.39±0.61） L/s vs（2.12±0.50） L/s、PaO2为（77.1±7.6） mmHg vs （73.4±7.2） mmHg、PaCO2为（36.6±4.9） mmHg vs （39.5±4.5） mmHg、IL-8为（37.2±9.3） μg/ml vs（44.3±10.8）μg/ml,差异均有统计学意义（P＜0.05）;用药后,治疗组与对照组气促、喘憋等症状消退时间分别为（94.7±14.3）h、（101.5±17.2）h,差异有统计学意义（t=2.1004,P=0.0384）;两组临床疗效比较差异有统计学意义（u=2.2498,P=0.0245）;治疗期间未见严重不良反应,两组不良反应发生率（24.5％ vs 15.2％）差异无统计学意义（x2＝1.275,P=0.259）.结论 噻托溴铵干粉吸入剂联合舒利迭治疗小儿支气管哮喘急性发作可改善肺通气与肺换气功能,减轻气道炎症反应,不良反应无明显增加,有助于提高临床疗效.

Clinical study of tiotropium inhalation combined with seretide in the treatment of acute attack of bronchial asthma in children

Objective To explore the clinical efficacy of tiotropium inhalation combined with seretide in the treatment of acute attack of bronchial asthma in children.Methods 95 children with acute attack of bronchial asthma from May,2012 to April, 2014 were enrolled in the study and randomly divided into treatment group（ 49 cases）and control group（46 eases）.The control group was given the treatment of anti-inflammatory, relieving spasm and seretide inhalation,based on which the treatment group was added with dry powder inhalation of tiotropium bromide.Then, pulmonary function, symptoms subsiding time and clinical effieacy of 2 groups after 14d of treatment were compared. Results After 3 days of treatment, the pulmonary function,arterial blood gas indexes and airway inflammatory indexes of both groups were significantly improved. FEV1 of 2 groups after treatment were （1.61±0.32）L and （1.48±0.30）L;the PEF were （2.39±0.61） L/s and （2.12±0.50） L/s;PaO2 were （77.1±7.6） mmHg and （73.4±7.2） mmHg; PaCO2 were （36.6±4.9） mmHg and （39.5±4.5） mmHg; and IL-8 were （ 37.2±9.3 ） μg/ml and （44.3±10.8 ） μg/ml; all the above differences were statistically significant （ P〈0.05 ）. After taking medication, two groups＇ symptoms （ such as shortness of breath and breath suppress） subsiding time were （ 94.7±14.3） h and （ 101.5± 17.2） h respectively, and the difference was statistically significant （ t = 2.1004, P= 0.0384） .Difference of clinical efficacy of the two groups was statistically significant （u = 2.2498 ,P= 0.0245 ）.During the treatment, no serious adverse reactions were found and the incidences of adverse reactions of two groups were （24.5% vs15.2% ）, so the difference was not statistically significant （X2= 1.275, P = O. 259）.Conclusion Tiotropium inhalation combined with seretide in the treatment of children with acute attack of bronchial asthma can improve the pulmonary ventilation function, reduce airway inflammation, and help to improve