标题：布地奈德和沙丁胺醇治疗儿童咳嗽变异性哮喘疗效和安全性研究

      作者：周克亮，屈红军，李婷婷，庞玉生    (淮安市楚州中医院儿科，江苏 淮安 223200)

      卷次： 2017年28卷21期

      【摘要】 目的 探讨布地奈德和沙丁胺醇治疗儿童咳嗽变异性哮喘疗效和安全性。方法 将2014年10月至2016年10月期间淮安市楚州中医院儿科诊治的70例咳嗽变异性哮喘患儿根据随机数表法分为观察组和对照组，每组35例。对照组采用布地奈德吸入治疗，观察组采用布地奈德联合沙丁胺醇治疗，治疗周期均为4周。比较两组患儿的治疗效果、肺功能指标改善情况、血清炎性介质水平变化及不良反应发生情况。结果 观察组和对照组患儿的临床控制率(97.1% vs 80.0%)及治疗总有效率(62.9% vs 37.1%)比较，观察组均明显高于对照组，差异均有统计学意义(P<0.05)；治疗后，两组患儿的第1秒用力呼气容积(FEV1)、呼气峰流速值(PEF)均明显升高，且观察组和对照组的FEV1 [(2.27±0.30) L vs (1.93±0.30) L]及PEF [(4.57±0.99) L/s vs (3.88±0.79) L/s]比较，观察组改善程度明显优于对照组，差异均有统计学意义(P<0.05)；治疗后，两组患儿的免疫球蛋白E (IgE)、白介素-5(IL-5)均显著降低，白介素-10 (IL-10)显著升高，且观察组和对照组的IgE [(118.2±38.1) IU/mL vs (169.3±46.3) IU/mL]、IL-5 [(22.5±5.2) pg/mLvs (29.5±6.3) pg/mL]及 IL-10 [(38.2±8.2) pg/mL vs (26.6±7.4) pg/mL]比较，观察组改善程度明显优于对照组，差异均有统计学意义 (P<0.05)；观察组不良反应发生率为 14.3%，与对照组的 8.6%比较，差异无统计学意义 (P>0.05)。结论 布地奈德联合沙丁胺醇治疗儿童咳嗽变异性哮喘具有良好的疗效，且安全性较好。
      【关键词】 布地奈德；沙丁胺醇；哮喘；咳嗽变异性哮喘，疗效；安全性
      【中图分类号】 R725.6 【文献标识码】 A 【文章编号】 1003—6350（2017）21—3485—04

Efficacy and safety of budesonide combined with salbutamol in the treatment of children with cough variantasthma.
ZHOU Ke-liang, QU Hong-jun, LI Ting-ting, PANG Yu-sheng. Department of Pediatrics, Huai’an ChuzhouHospital of Traditional Chinese Medicine, Huai’an 223200, Jiangsu, CHINA
【Abstract】 Objective To investigate the efficacy and safety of budesonide combined with salbutamol in treat-ment of children with cough variant asthma. Methods Seventy children with cough variant asthma in Department ofPediatrics, Huai'an Chuzhou Hospital of Traditional Chinese Medicine from Oct. 2014 to Oct. 2016 were randomly divid-ed into the observation group and the control group according to the random number table, with 35 cases in each group.The control group was treated with budesonide, and the observation group was treated with budesonide combined withsalbutamol. The treatment cycle was 4 weeks. The therapeutic effect, the improvement of pulmonary function index, thelevel of serum inflammatory mediators and the incidence of adverse reactions were compared between the two groups.Results The clinical control rate and the total effective rate were 97.1%, 62.9% in the observation group versus 80.0%,37.1% in the control group (P<0.05). After treatment, forced expiratory volume in one second (FEV1) and peak expirato-ry flow (PEF) of the two groups were significantly increased, and the improvement in the observation group was signifi-cantly better than that in the control group (P<0.05), with (2.27±0.30) L in the observation group vs (1.93±0.30) L in thecontrol group for FEV1 and (4.57±0.99) L/s vs (3.88±0.79) L/s for PEF. After treatment, immunoglobulin E (IgE), inter-leukin (IL-5) of the two groups were significantly reduced and IL-10 significantly increased, and the improvement in ob-servation group was significantly better than that in the control group (P<0.05), with (118.2±38.1) IU/mL vs (169.3±46.3) IU/mL for IgE, (22.5±5.2) pg/mL vs (29.5±6.3) pg/mL for IL-5 and (38.2±8.2) pg/mL vs (26.6±7.4) pg/mL forIL-10. improved significantly better than the control group (P<0.05). The incidence of adverse reactions in the observa-tion group was 14.3%, as compared with 8.6% in the control group (P>0.05). Conclusion In children with cough vari-ant asthma, budesonide combined with salbutamol has significant curative effect and good safety.
      【Key words】 Budesonide; Salbutamol; Asthma; Cough variant asthma; Efficacy; Safety·论 著·doi:10.3969/j.issn.1003-6350.2017.21.015