标题：匹多莫德联合孟鲁司特钠/布地奈德/福莫特罗对儿童咳嗽变异性哮喘肺功能及气道炎症的影响

      作者：赵娟丽 1，张会侠 1，刘建军 2    1.澄城县医院儿科，陕西 渭南 715200；2.神木市医院药剂科，陕西 榆林 719300

      卷次： 2021年32卷5期

      【摘要】 目的 探讨匹多莫德联合孟鲁司特钠/布地纳德/福莫特罗对儿童咳嗽变异性哮喘肺功能及气道炎症的影响，为患者诊疗提供依据。方法 回顾性分析2019年1月至2020年1月期间澄城县医院儿科收治的150例儿童咳嗽变异性哮喘的诊疗情况，按照治疗方法不同分为观察组、对照组1、对照组2各50例。对照组1采用布地奈德/福莫特罗吸入治疗，对照组2采用布地奈德/福莫特罗吸入联合孟鲁司特钠治疗，观察组采用匹多莫德联合孟鲁司特钠/布地奈德/福莫特罗吸入治疗，共治疗8周。治疗8周后，比较治疗效果及不良反应情况，记录治疗前及治疗8周后的肺功能、血清肿瘤坏死因子-α (TNF-α)、白细胞介素-4 (IL-4)、免疫球蛋白E (IgE)及全血嗜酸性粒细胞计数(EOS)变化。结果 观察组患儿的治疗总有效率为94.0%，明显高于对照组1的80.0%和对照组2的74.0%，差异均有统计学意义(P<0.05)；治疗后，三组患儿的呼气峰流速值(PEF)、肺活量(FVC)、第一秒时间用力呼出气体容量(FEV1)均明显升高，且观察组[(142.25±11.14) L/s、(3.95±0.62) L、(1.89±0.34) L]明显高于对照组2 [(131.21±10.31) L/s、(3.21±0.52) L、(1.52±0.36)L]和对照组 1 [(130.98±12.02) L/s、(3.30±0.41) L、(1.49±0.33) L]，差异均有统计学意义(P<0.05)；治疗后，三组患儿的TNF-α、IL-4、IgE、EOS表达水平均明显降低，且观察组[(65.13±5.17) ng/L、(76.12±6.13) ng/L、(71.12±8.23) U/mL、(0.89±0.21)×109]明显低于对照组 2 [(76.28±6.23) ng/L、(89.17±6.20) ng/L、(85.37±7.94) U/mL、(1.24±0.30)×109]和对照组1 [(77.52±4.02) ng/L、(90.12±5.79) ng/L、(86.12±6.47) U/mL、(1.26±0.12)×109]，差异均有统计学意义(P<0.05)；治疗后，三组患儿的不良反应发生率比较差异无统计学意义(P>0.05)。结论 孟鲁司特钠联合吸入布地纳德/福莫特罗/匹多莫德治疗儿童咳嗽变异性哮喘可有效改善患儿肺功能，降低气道炎症反应，改善患儿免疫功能，效果显著，安全性高，可在临床推广使用。
      【关键词】 咳嗽变异性哮喘；孟鲁司特钠；匹多莫德；布地奈德；福莫特罗；肺功能；气道炎症
      【中图分类号】 R725.6 【文献标识码】 A 【文章编号】 1003—6350（2021）05—0603—04

Effects of pidotimod combined with montelukast sodium and budesonide/formoterol on lung function and airwayinflammation in children with cough variant asthma.
ZHAO Juan-li 1, ZHANG Hui-xia 1, LIU Jian-jun 2. 1. Departmentof Pediatrics, the Hospital of Chengcheng County, Weinan 715200, Shaanxi, CHINA; 2. Department of Pharmacy, theHospital of Shenmu City, Shenmu 719300, Shaanxi, CHINA
【Abstract】 Objective To explore the effects of pidotimod combined with montelukast sodium and budenad/formoterol on lung function and airway inflammation in children with cough variant asthma, and provide evidence forthe diagnosis and treatment of patients. Methods A retrospective analysis of 150 children with cough variant asthmaadmitted to the Department of Pediatrics, Chengcheng County Hospital from January 2019 to January 2020 was conduct-ed. According to different treatment methods, they were divided into three groups, with 50 cases in each group. Controlgroup 1 was treated with budesonide/formoterol inhalation, control group 2 was treated with budesonide/formoterol inha-lation combined with montelukast sodium, and the observation group was treated with pidotimod combined montelukastsodium and budesonide/formoterol inhalation treatment for a total of 8 weeks. After 8 weeks of treatment, the therapeuticeffect and adverse reactions were compared. The changes of lung function, serum tumor necrosis factor-α (TNF-α), in-terleukin-4 (IL-4), immunoglobulin E (IGE) and eosinophil count (EOS) were recorded before and after 8 weeks oftreatment. Results The total effective rate of children in the observation group was 94.0% , which was significantlyhigher than 80.0% of control group 1 and 74.0% of control group 2 (P<0.05); after treatment, the peak expiratory flow rate(PEF), vital capacity (FVC), and forced expiratory air volume in the first second (FEV1) of the three groups of childrenwere significantly increased, and those in the observation group were (142.25±11.14) L/s, (3.95±0.62) L, (1.89±0.34) L, re-spectively, which were significantly higher than corresponding (131.21±10.31) L/s, (3.21±0.52) L, (1.52±0.36) L in thecontrol group 2 and corresponding (130.98±12.02) L/s, (3.30±0.41) L, (1.49±0.33) L in control group 1 (all P<0.05); theexpression levels of TNF-α, IL-4, IgE and EOS in the three groups of children were significantly reduced, and those in