标题：孟鲁司特钠联合丙卡特罗治疗慢性咳嗽的疗效及对患儿肺功能及血清 IL-4、TNF-α、Ig E及EOS水平的影响

      作者：李静珊 1，孙佳 2，李忠亮 1    大连九洲世纪医院药剂科 1、呼吸内科与危重症医学科 2，辽宁 大连 116400

      卷次： 2020年31卷11期

      【摘要】 目的 观察孟鲁司特钠联合丙卡特罗治疗慢性咳嗽的疗效，并探讨其对患儿肺功能及血清白细胞介素-4 (IL-4)、肿瘤坏死因子-α (TNF-α)、免疫球蛋白E (IgE)及嗜酸性粒细胞(EOS)的影响。方法 选取2018年1月至 2019年 6月大连九洲世纪医院收治的慢性咳嗽患儿 120例，按照随机数表法分为研究组和对照组，每组 60例。对照组给予丙卡特罗治疗，研究组给予孟鲁司特钠联合丙卡特罗治疗，疗程8周。比较两组患儿的临床疗效、临床症状体征改善情况、不良反应，以及治疗前后的肺功能及血清 IL-4、TNF-α、IgE及EOS水平。结果 研究组患儿的治疗总有效率为95.0%，明显高于对照组的78.3%，差异有统计学意义(P<0.05)；治疗前两组患儿的症状体征积分比较差异均无统计学意义(P>0.05)；治疗后，两组患儿的症状体征积分较治疗前均降低，且研究组的症状体征积分明显低于对照组，差异均有统计学意义(P<0.05)；治疗前，两组患儿的肺总量(FVC)、呼气峰流量(PEF)、第1秒末用力呼气量百分比(FEV1)，IL-4、TNF-α、IgE及EOS比较差异均无统计学意义(P>0.05)；治疗后，两组患儿的FVC、PEF、FEV1均较治疗前升高，血清 IL-4、TNF-α、IgE及EOS均较治疗前降低，且研究组患儿的FVC、PEF、FEV1明显高于对照组，血清IL-4、TNF-α、IgE及EOS明显低于对照组，差异均有统计学意义(P<0.05)；研究组和对照组患儿的不良反应发生率分别为15.0%和10.0%，差异无统计学意义(P>0.05)。结论 孟鲁司特钠联合丙卡特罗治疗慢性咳嗽可以有效改善患儿临床症状，降低患儿的血清炎症因子及IgE、EOS水平，提高肺功能，治疗小儿慢性咳嗽有较好疗效。
      【关键词】 慢性咳嗽；孟鲁司特钠；丙卡特罗；肺功能；免疫球蛋白；嗜酸性粒细胞；炎性因子；疗效
      【中图分类号】 R725.6 【文献标识码】 A 【文章编号】 1003—6350（2020）11—1401—04

Therapeutic effect of montelukast sodium combined with procaterol on chronic cough and its effect on lungfunction and serum levels of IL-4, TNF-α, IgE, and EOS in children.
LI Jing-shan 1, SUN Jia 2, LI Zhong-liang 1.Department of Pharmacy 1, Department of Respiratory Medicine and Critical Care Medicine 2, Dalian Jiuzhou CenturyHospital, Dalian 116400, Liaoning, CHINA
【Abstract】 Objective To observe the effect of montelukast sodium combined with procaterol on lung functionand to study the serum interleukin-4 (IL-4), tumor necrosis factor-α (TNF-α), immunoglobulin E (IgE), and eosinophils(EOS) in children with chronic cough. Methods A total of 120 children with chronic cough who were admitted to Da-lian Jiuzhou Century Hospital from January 2018 to June 2019 were selected and divided into study group and controlgroup according to the random number table method, with 60 children in each group. The control group was treated withprocaterol, and the study group was treated with montelukast sodium combined with procaterol, with 8 weeks as a courseof treatment. The clinical effect, improvement of clinical symptoms and signs, adverse reactions, lung function, levels ofserum IL-4, TNF-α, IgE, and EOS before and after treatment were compared. Results The total effective rate of chil-dren in the study group was 95.0%, which was significantly higher than 78.3% of the control group (P<0.05). Before treat-ment, there was no difference in the scores of symptoms and signs between children in the two groups (P>0.05); after treat-ment, the scores of symptoms and signs of children in both groups were significantly lower than those before treatment,and the symptom and sign scores of the study group were significantly lower than those of the control group (P<0.05). Be-fore treatment, there were no statistically significant differences in forced vital capacity (FVC), peak expiratory flow(PEF), forced expiratory volume in one second (FEV1), IL-4, TNF-α, IgE, and EOS between the two groups (P>0.05); af-ter treatment, the FVC, PEF, FEV1 of the two groups were significantly higher than those before treatment, and IL-4,TNF-α, IgE, EOS were significantly lower than those before treatment (P<0.05); the FVC, PEF, FEV1 of the study groupwere significantly higher than those of the control group, while serum IL-4, TNF-α, IgE, and EOS were significantly low-er than those of the control group (P<0.05). The incidence of adverse reactions was 15.0% in the study group and 10.0% inthe control group, and the difference was not statistically significant (P>0.05). Conclusion Montelukast sodium com-bined with procaterol for treating chronic cough can effectively improve clinical symptoms, reduce the levels of inflamma-tory factors and IgE, EOS in children with chronic cough, and improve the lung function of children
      【Key words】 Chronic cough; Montelukast sodium; Procaterol; Lung function; Immunoglobulin; Eosinophils; In-flammatory factors; Therapeutic effect