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目的:观察口服孟鲁司特联合布地奈德雾化吸入治疗毛细支气管炎的疗效。方法:将临床确诊为婴幼儿毛细支气管炎的90例患儿随机分为试验组48例和对照组42例,另选择健康体检儿40例作为正常对照组。对照组给予常规治疗,试验组在常规治疗基础上病初即给予孟鲁司特口服,≤6个月2 mg/d,>6个月4 mg/d,睡前顿服,同时给予布地奈德混悬液1 mL/次,每日2次雾化吸入,直到临床症状消失后停用,继续口服孟鲁司特1周停用。观察两组治疗后主要临床症状和体征消失时间、住院天数及治愈率,两组治疗前后外周血IgE、IL-4、Eos的变化并与正常对照组比较。结果:试验组有效率91.7%,对照组有效率69.0%,两组比较差异有统计学意义(χ~2=7.48,P<0.01)。试验组在缓解喘憋、咳嗽、肺部啰音、心率及缩短住院时间等方面均优于对照组(P<0.05);治疗后试验组外周血IgE、IL-4、Eos水平均较治疗前明显下降(P<0.01),且试验组较对照组下降明显(P<0.05)。结论:孟鲁司特与布地奈德联合治疗毛细支气管炎,能显著提高疗效,降低药物不良反应发生率,值得在临床应用和推广。
Objective: To observe the efficacy of oral montelukast combined with budesonide inhalation in the treatment of bronchiolitis. Methods: Ninety cases of infantile bronchiolitis were randomly divided into experimental group (48 cases) and control group (42 cases). Another 40 healthy children were selected as normal control group. The patients in the control group were given routine treatment. The patients in the experimental group were given montelukast orally at the beginning of the disease on the basis of routine treatment. The patients in the experimental group received ≤2 months of 2 mg / d,> 6 months of 4 mg / d, Germany suspension 1 mL / time, inhalation 2 times a day, until the clinical symptoms disappear after discontinuation of montelukast to continue oral administration of 1 week disabled. The main clinical symptoms and disappearance of signs, days of hospitalization and cure rate were observed after treatment. The changes of IgE, IL-4 and Eos in peripheral blood in two groups before and after treatment were observed and compared with those in normal control group. Results: The effective rate was 91.7% in the experimental group and 69.0% in the control group. There was significant difference between the two groups (χ ~ 2 = 7.48, P <0.01). The experimental group was better than the control group in alleviating wheezing, coughing, pulmonary rales, heart rate and shortening the length of hospital stay. The levels of IgE, IL-4 and Eos in the peripheral blood of the experimental group were significantly lower than those before treatment (P <0.01), and the experimental group decreased significantly compared with the control group (P <0.05). Conclusion: Montelukast combined with budesonide in the treatment of bronchiolitis can significantly improve the curative effect and reduce the incidence of adverse drug reactions, which is worthy of clinical application and promotion.