酮替芬联合沙美特罗/丙酸氟替卡松治疗咳嗽变异性哮喘疗效观察  

Therapeutic effect of ketotifen plus inhaled salmeterol xinafoate/fluticasone propionate on cough variant asthma

作　　者：王东安[1] 孙洁民[1] 杨硕[1] 罗光伟[1] 张念[1] 

机构地区：[1]武汉市第一医院呼吸内科,武汉430022

出　　处：《中华实用诊断与治疗杂志》2014年第4期405-406,共2页Journal of Chinese Practical Diagnosis and Therapy

基　　金：武汉市卫计委科研立项资助项目(WX13C01)

摘　　要：目的探讨酮替芬联合沙美特罗/丙酸氟替卡松治疗咳嗽变异性哮喘的疗效和安全性。方法咳嗽变异性哮喘患者104例随机分为3组,均吸入沙美特罗/丙酸氟替卡松50/250μg,2次/d,治疗7d后A组继续吸入沙美特罗/丙酸氟替卡松50/250μg,2次/d;B组在A组基础上同时给予富马酸酮替芬1mg/次,2次/d,口服;C组在A组基础上同时给予复方甲氧那明胶囊2粒/次,3次/d,口服;3组疗程均为8周。观察3组治疗2、8周后咳嗽症状总评分及治疗8周后第1秒用力呼气容积(forced expiratory volume in one second,FEV1)占预计值百分比(FEV1%)、呼气峰值流速(peak expiratory flow,PEF)水平变化。结果治疗2、8周后3组咳嗽症状总评分均低于基线值(P<0.01),B、C组治疗后咳嗽症状总评分低于A组(P<0.05),B组与C组比较差异无统计学意义(P>0.05);3组治疗8周后FEV1%和PEF均高于基线值(P<0.05),但治疗后3组间比较差异无统计学意义(P>0.05);C组不良反应发生率(10.00%)高于A组(2.78%)、B组(2.63%)(P<0.05)。结论沙美特罗/丙酸氟替卡松联合富马酸酮替芬及复方甲氧那明治疗咳嗽变异性哮喘效果优于单用沙美特罗/丙酸氟替卡松,但联合富马酸酮替芬治疗较联合复方甲氧那明不良反应轻。Objective To evaluate the therapeutic effect and safety of ketotifen plus inhaled salmeterol xinafoate/ fluticasone propionate in the treatment of cough variant asthma. Methods A total of 104 cough variant asthma patients inhaled salnaeterol xinafoate/fluticasone propionate （50/250μg, twice a day） and were randomly divided into 3 groups. Seven clays late, group A received inhaling of salnaeterol xinafoate/fluticasone propionate （50/250 μg, twice a day） {or 8 weeks. In addition to the treatnaent in group A, group B received oral administion of ketotifen 1 nag per time, twice a day, and group C received compound naethoxyphenamine 2 capsules per time, 3 times a day, totally for 8 weeks. These three groups were compared total cough score after treatment for 2 and 8 weeks, and the forced expiratory volume in one second percentage （FEV1 %） and peak expiratory flow （PEF） after treatment for 8 weeks. Results The total cough scores were significantly lower in three groups than the baseline value after treatment for 2 and 8 weeks （P〈0.01） and lower in group B and C than that in group A（P〈0.05）, and there was no significant difference between group B and group C （P〈0.05）. FEV1 and PEF were significantly higher after treatment for 8 weeks in three groups than the baseline values （P〈0.05）, and there were no significant differences in three groups （P〈0.05）. The incidence rate of adverse reaction was 10.00% in group C, significantly higher than that in group A （2. 78%） and group C （2.63%） （P〈0.05）. Conclusions Salnaeterol xinafoate/fluticasone propionate plus ketotifen or compound methoxyphenanaine is superior to salnaeterol xinafoate/fluticasone propionate for cough variant asthma. The combination of ketotifen has milder adverse reaction than the combination of compound methoxyphenamine.

关 键 词：咳嗽变异性哮喘 酮替芬 沙美特罗替卡松 复方甲氧那明 咳嗽症状评分 

分 类 号：R725.6[医药卫生—儿科]