面罩储雾罐经鼻吸入糖皮质激素同步治疗小儿变应性鼻炎并哮喘  

Simultaneous treatment of asthma and allergic rhinitis in children with a nasally inhaled glucocorticosteroid

作　　者：孙丽红[1] 陈爱欢[1] 吴婕翎 林俊宏[1] 肖雪葵[1] 余颖华[1] 

机构地区：[1]广州医学院第一附属医院广州呼吸疾病研究所,510120 [2]广东省妇女儿童医院儿科

出　　处：《中华儿科杂志》2009年第7期544-547,共4页Chinese Journal of Pediatrics

摘　　要：目的探讨采用面罩储雾罐方式给药，经鼻吸入布地奈德（BUD）气雾剂同步治疗小儿变应性鼻炎并哮喘的临床疗效与成本。方法将72例中～重度变应性鼻炎并轻～中度持续性哮喘的患儿随机分为实验组和对照组，实验组经面罩储雾罐鼻吸入BUD气雾剂400μg/d，对照组经口吸入BUD干粉剂400μg/d联合使用BUD鼻喷雾剂256μg/d。进行哮喘和鼻炎的症状评分，监测第1秒时间肺活量（FEV，）、晨起呼气峰流速值（PEF），并进行治疗成本比较。结果经过12周的临床观察，实验组和对照组的鼻炎症状评分明显下降（F=6．529和7．014，P均〈0．01），两组的哮喘症状评分不断减低（F=4．132和4．950，P均〈0．01），实验组和对照组的肺通气功能指标PEF（L／min）逐渐升高（F=2．750和3．282，P均〈0．05）。但两组间的症状评分、FEV，和PEF在入选时与治疗后的多次随访中比较，差异无统计学意义。实验组鼻腔干燥等副反应的发生率（5．6％）低于对照组（19．4％），但差异无统计学意义。平均治疗费用：实验组（244．0±12．8）元，对照组（403．2±17．6）元，差异有统计学意义（P〈0．01）。结论面罩式储雾罐经鼻吸入糖皮质激素可同时有效控制小儿变应性鼻炎和哮喘，并有依从性高、副作用少、花费低等优点，适用于轻-中度持续性哮喘合并变应性鼻炎患儿。Objective To assess the efficacy of a nasally inhaled corticosteroid （ICS） through a spacer with mask aiming at simultaneous treatment of allergic rhinitis and asthma in children and make an analysis on the costs. Method A total of 72 children with allergic rhinitis （AR） and asthma were randomized into two groups. Experimental group received budesonide inhaler （400 μg/d） through the nose using a spacer attached to a face mask, control group children orally inhaled budesonide dry powder （400μg/d） plus a nasal spray of budesonide aquae （256 μg/d）. Result The patients were observed for 12 weeks. The symptom scores of rhinitis of both experimental group and control group declined（ F = 6. 529 and 7. 014,all P 〈 0. 01 ）, symptom scores of asthma in both group were also reduced（ F = 4. 132 and 4. 950 ,P 〈 0. 01 ）. The pulmonary function PEF （L/min） in both groups continuously increased（ F = 2. 750 and 3.282,P 〈 0. 05 ）. But the clinical scores, PEF value and FEV1 all did not differ between the two groups at admission or at nearly all follow-up visits （P 〉 0. 05 for all）. The proportion of dry nose was lower in experimental group than in the control group （5.6% vs. 19.4% ） , but the difference was not statistically significant. The cost in the experimental group was lower than that in the control group （P 〈 0.01 ）. Conclusion Nasal inhalation of ICS provides a therapeutic strategy for controlling AR and asthma in children, especially it result in higher compliance, lower costs, and fewer side effects.

关 键 词：哮喘 鼻炎 投药 吸入 治疗 

分 类 号：R562.25[医药卫生—呼吸系统] R765.21[医药卫生—内科学]