短程小剂量口服激素在婴幼儿喘息急性期联合降阶梯治疗方案中的作用研究

目的：前期研究表明，与目前常用的静脉激素及抗生素治疗方案相比，由泼尼松＋阿奇霉素＋妥洛特罗贴剂＋氯雷他定＋孟鲁司特钠组成的联合降阶梯治疗方案对婴幼儿喘息具有更好的疗效。在此基础上，本研究将进一步探讨作为联合降阶梯治疗方案组分之一的泼尼松在其中的作用。方法：选取2011年10—12月来我院哮喘门诊就诊的婴幼儿喘息患儿，共计100例，随机分为泼尼松组和对照组各50例。泼尼松组用药方案：泼尼松0．5mg／（kg·d）×3d，每天1次晨顿服；阿奇霉素10mg／（kg·d）×3d，每天1次口服；妥洛特罗贴剂0．5mg／d（1贴）×7d；氯雷他定糖浆3mL／d×14d，每天1次口服；孟鲁司特钠4mg／d×14d，每天1次口服。对照组除无泼尼松外，其他药物用法用量同泼尼松组。结果：（1）两组在治疗第3天和第7天咳嗽、喘息、哮呜音症状均较治疗前好转。（2）泼尼松组在治疗第3天咳嗽、哮呜音症状评分以及临床疗效均优于对照组（P〈0．05）。结论：短程小剂量口服激素是婴幼儿喘息急性期联合降阶梯治疗方案的有效组分之一。

Effect of Low-Dose and Short-Term Oral Corticosteroid in the Combine-Counter Gradient Therapy for Infants Wheezing

Objective： Previous studies suggested combine-counter gradient therapy with prednisone, azithromycin, tulobuterol patch, loratadine and montelukast has better efficacy than intravenous corticosteroid and antibiotics. This study is to evaluate the efficacy of prednisone in the combine-counter gradient therapy for infants wheezing. Methods： Random allocation was taken to averagely divide 100 out-patients from October 2011 to December 2011 into two groups： combine-counter gradient therapy were received as the prednisone group. The treatment protocol of the prednisone group was oral prednisone 0.5 mg/（kg . d）, qd for three days; azithromycin 10 mg/（kg . d）, qd for three days; tulobuterol patch 0.5 mg/d for seven days; loratadine 0. 3 mL/（kg . d）, qd for fourteen days. ; montelukast 4 mg/d, qd for fourteen days. The control group abolished prednisone, the rest of drugs were the same as the prednisone group. Results： （ 1 ） The prednisone group and the control group after treatment for three days and seven days all had therapeutic effect on respiratory symptoms （ cough, wheeze, wheezing sound） . （2） Comparisons of the two groups： cough, wheezing sound symptoms and clinical efficacy after treatment for three days were statistically significant different （P〈0.05）. Conclusions： According to our research, low-dose and short-term oral prednisone should be chosen as one of the main medicine of the combine-counter gradient therapy.