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目的探讨孟鲁司特钠联合丙酸氟替卡松治疗儿童支气管哮喘的临床疗效,分析其对血清炎性因子及气道功能的影响。方法 90例支气管哮喘儿童随机分为对照组和观察组,每组45例。对照组患儿给予丙酸氟替卡松吸入气雾剂治疗,观察组患儿给予孟鲁司特钠片联合丙酸氟替卡松吸入气雾剂治疗,均连续治疗3个月。比较两组的总有效率、治疗前后炎性因子及气道功能指标水平。结果观察组的总有效率(93.33%)显著高于对照组(80.00%,P<0.05)。治疗3个月后,与治疗前相比,两组的肿瘤坏死因子α和白介素-6水平均显著降低(P<0.01),且观察组水平显著低于对照组(P<0.05或P<0.01);治疗后,两组的白介素-2、呼气峰值流速、用力肺活量、第一秒用力呼气量、25%肺活量最大呼气流量(MEF25)、MEF50和MEF75水平均显著高于治疗前(P<0.05或P<0.01),且观察组显著高于对照组(P<0.05或P<0.01);两组的不良反应发生情况比较,差异无统计学意义(P>0.05)。结论孟鲁司特钠联合丙酸氟替卡松治疗儿童支气管哮喘的临床疗效显著,可有效调节患儿血清的炎性因子水平,改善气道功能,具有一定的临床价值。
Objective To investigate the clinical efficacy of montelukast sodium combined with fluticasone propionate in the treatment of bronchial asthma in children and analyze its effects on serum inflammatory factors and airway function. Methods 90 children with bronchial asthma were randomly divided into control group and observation group, 45 cases in each group. Children in the control group were treated with fluticasone propionate inhalation aerosol, while those in observation group were treated with montelukast sodium tablets and fluticasone propionate inhalation aerosol. All patients were treated continuously for 3 months. The total effective rate was compared between the two groups before and after treatment of inflammatory cytokines and airway function indicators. Results The total effective rate (93.33%) in observation group was significantly higher than that in control group (80.00%, P <0.05). After 3 months of treatment, the levels of tumor necrosis factor alpha and interleukin-6 in the two groups were significantly decreased (P <0.01) and the levels in the observation group were significantly lower than those in the control group (P <0.05 or P <0.01) ); After treatment, the levels of interleukin-2, peak expiratory flow, forced vital capacity, forced expiratory volume in the first second, maximum expiratory flow rate of 25% MEF25, MEF50 and MEF75 in both groups were significantly higher than those before treatment P <0.05 or P <0.01), and the observation group was significantly higher than the control group (P <0.05 or P <0.01). There was no significant difference in adverse reactions between the two groups (P> 0.05). Conclusion Montelukast sodium combined with fluticasone propionate in children with bronchial asthma clinical significant effect, can effectively adjust the serum levels of inflammatory cytokines, improve airway function, has a certain clinical value.