小儿咳嗽变异型哮喘不同疗法与预后  

Different Treatments and Prognoses of Cough Variant Asthma in Children

作　　者：赵凤珍[1] 高捷[1] 刘竞元[2] 韩秀红[1] 王亚兵[1] 孙慧[1] 

机构地区：[1]华北煤炭医学院附属医院儿科,唐山063000 [2]北京中医药大学,04级英语班北京100102

出　　处：《中国医药导刊》2011年第12期2049-2050,共2页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨小儿咳嗽变异型哮喘(CVA)的疗法与预后。方法:CVA患儿79倒随机分成A组(吸入糖皮质激素组).B组(口服氨茶碱和扑尔敏组)、C组(口服沙丁胺醇和酮替芬组)、D组(对照组)。A组予丙酸倍氯米松定量气雾剂吸入,每次100μg,每日2次。B组给予氨茶碱片每次4-5mg/kg,每日3次;扑尔敏每天0.35mg/kg,分3-4次。C组给予沙丁胺醇,每次0.1m/kg,每日2-3次,咳嗽消失后2周停药,酮替芬<3岁每次0.5mg,≥3岁每次1mg,每日均为2次。D组给予止咳、祛痰、抗感染等治疗。各组疗程均为6个月。随访时间半年至4年7个月。结果:用药2周有效率A、B、C组间无显著性差异(P>0.05),但均明显优于D组(P<0.01)。CVA复发率A组(20%)低于B组(45%),但两者在统计学上无显著性差异(P>0.05),可能与样本小有关,A组与C组及D组有显著性差异(P<0.05).B组与C组无显著性差异(P>0.05)。CVA转化为哮喘发生率A组低于B组及C组(P<0.05),明显低于D组(P<0.01)。B组与C组无显著性差异(P>0.05)。药物副作用发生率A、B、C组间无显著性差异(P>0.05)。结论:吸入糖皮质激素、口服氨茶碱和扑尔敏、口服沙丁胺醇和酮替芬对控制CVA对咳嗽症状均有较好疗效,但对预防CVA复发、CVA转化为哮喘,吸入糖皮质激素疗效优于氨茶碱和扑尔敏、沙丁胺醇和酮替芬。Objective：To investigate different teratments and their prognoses in Cough Variant Asthma（CVA） in children. Methods：Seventy-nine CVA children were randomly assigned into Group A（group of inhaled corticosteriods）.Group B（group of oral phyllioe and chlorpheniramine）,Group C（group of oral salbutamol and ketotifen）,and Group D（control group）.Group A received inhaled beclometasone dipropionate extrafine aerosol,100μg per time,twice a day.Group B received aminophylline tablets,4-5mg/kg per time,3 times daily;and chlorpheniramine 0.35mg/kg per day,3 or 4 times a day.Group C received salbutamol 0.1mg/kg a time.2 or 3 times daily,until 2 weeks after cough disappeared;and also ketotifen twice a day.0.5mg per time in children under 3 years old,and 1mg a time in children more than or equal to 3 years old.Group D received treatments to relive cough,eliminate phlegm and anti-infection. All patients received 6 months＇ treatment and also follow-up viaried from 6 months to 4 years and 7 months.Results：No significant differences were observed in effecitve rates after 2 weeks of treatment among groups A,B and C（P0.05）.but they all significantly lower than that in Group D（P0.01）.CVA relapse rate in Group A（20%） was lower than Group B（45%）.but there was no statisticaly significance in their difference（P0.05）.which was probably due to the small sample.CVA relapse rate in Group A was significantly different from that in Group C or Group D（P0.05）;and the rates of CVA relapse in Groups B and C were not significantly different（P0.05）. The occurrence rale of asthma developed from CVA in Group A was lower than that in Group B or Group C（P0.05）.and siginificantly lower than that in Group D（P0.01）.No significant difference was found between the occurrence rates of asthma in Groups B and C （P0.05）.There were no significant differences of side effect occurrence rates among groups A.B and C（P0.05）.Conclusion：All the three therapies,namely inhaled corticosteroids,oral amin

关 键 词：咳嗽变异型哮喘 哮喘 疗法 预后 

分 类 号：R725.6[医药卫生—儿科]