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目的探讨孟鲁司特钠联合布地奈德治疗儿童咳嗽变异性哮喘(cough variant asthma,CVA)的临床效果及对肺通气功能的影响。方法选择2013年6月—2015年12月本院收治的115例CVA患儿作为研究对象,随机分为对照组50例和研究组65例。对照组采用布地奈德治疗,研究组采用孟鲁司特钠联合布地奈德治疗,对比两组儿童哮喘控制测试(C-ACT)评分、第一秒用力呼气容积(forced expiratory volume in 1 second,FEV1)、用力肺活量(forced vital capacity,FVC)、第一秒用力呼气量占用力肺活量比值(FEV_1/FVC)、呼气峰值流速(peak expiratory flow,PEF)变异率及不良反应发生情况。计量资料组间比较采用t检验,组内比较采用配对t检验,计数资料采用χ~2检验,P<0.05为差异有统计学意义。结果研究组与对照组治疗后日间、夜间C-ACT评分分别为(1.58±0.54)、(1.55±0.49)、(3.20±0.45)、(3.02±0.55)分,均较治疗前的(6.99±1.24)、(6.89±1.47)、(6.98±1.39)、(6.88±1.58)分明显改善,差异均有统计学意义(均P<0.05)。研究组治疗后FEV1、FVC、FEV_1/FVC、PEF变异率分别为(3.05±0.45)、(3.99±0.41)L、(74.52±6.35)%、(10.14±2.03)%,均优于对照组的(2.75±0.34)、(3.38±0.39)L、(67.89±5.74)%、(15.23±2.01)%,差异均有统计学意义(均P<0.05)。结论孟鲁司特钠联合布地奈德治疗儿童CVA效果显著,对患者肺通气功能具有积极影响,且不会增加对患者机体的损伤。
Objective To investigate the clinical effects of montelukast combined with budesonide in the treatment of children with cough variant asthma (CVA) and their effects on pulmonary ventilation. Methods A total of 115 CVA children admitted to our hospital from June 2013 to December 2015 were randomly divided into control group (n = 50) and study group (n = 65). The control group was treated with budesonide. The study group was treated with montelukast sodium and budesonide. The C-ACT scores, forced expiratory volume in 1 second , FEV1, forced vital capacity (FVC), FEV 1 / FVC, PEF variability and adverse reactions were measured. Measurement data were compared between groups using t test, the group was compared using paired t test, count data usingχ ~ 2 test, P <0.05 for the difference was statistically significant. Results The daytime and nighttime C-ACT scores of the study group and the control group were (1.58 ± 0.54), (1.55 ± 0.49), (3.20 ± 0.45) and (3.02 ± 0.55), respectively, ± 1.24), (6.89 ± 1.47), (6.98 ± 1.39) and (6.88 ± 1.58), respectively, with significant difference (all P <0.05). The variation rates of FEV1, FVC, FEV1 / FVC and PEF in the study group were (3.05 ± 0.45), (3.99 ± 0.41) L and (74.52 ± 6.35)%, (10.14 ± 2.03)%, respectively, (2.75 ± 0.34), (3.38 ± 0.39) L, (67.89 ± 5.74)% and (15.23 ± 2.01)%, respectively, with significant difference (all P <0.05). Conclusion Montelukast combined with budesonide treatment of children with CVA significant effect on patients with pulmonary ventilation has a positive impact, and does not increase the patient’s body damage.