小儿咳嗽变异型哮喘不同疗法与预后前瞻性研究  

A prospective study on different therapies and prognosis of cough variant asthma in children.

作　　者：蔡幸生[1] 余华斐[2] 卢道奋[1] 王萍 

机构地区：[1]广东省揭阳市人民医院儿科,522000 [2]广东省揭阳市人民医院医务科,522000

出　　处：《中国实用儿科杂志》2001年第9期543-545,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的　探讨小儿咳嗽变异型哮喘 (CVA)的疗法与预后。方法　 84例CVA患儿随机分成对照组、吸入糖皮质激素组 (I C组 )、口服沙丁胺醇和酮替酚组 (S K组 )、口服氨茶碱和扑尔敏组 (A C组 )。对照组仅予止咳、祛痰、抗感染等治疗。I C组予丙酸倍氯米松气雾剂吸入 ,每次 10 0 μg ,每日 2次。S K组予口服沙丁胺醇 <5岁每次0 5～ 1mg ,≥ 5岁每次 2mg ,均为每日 3次 ;酮替酚 <3岁每次 0 5mg ,每日 2次 ,≥ 3岁每次 1mg ,每日 1～ 2次 ;沙丁胺醇在咳嗽消失后继续服用 2周停药。A C组口服氨茶碱每次 4～ 5mg/kg ,扑尔敏每次 0 1mg/kg ,均为每日 3次。各组疗程均为 6个月。随访半年至 4年 6个月。结果　用药 2周治疗有效率、平均止咳天数I C组、S K组、A C组间无显著性差异 ,但均明显优于对照组 (P <0 0 1)。一个疗程结束后CVA复发率I C组低于S K组和A C组 (均为P <0 0 5 )。S K组与A C组无显著性差异 (P >0 0 5 )。CVA转化为哮喘发生率I C组低于S K组和A C组 (均为P <0 0 5 ) ,明显低于对照组 (P <0 0 1) ;S K组与A C组无显著性差异 (P >0 0 5 ) ,但均低于对照组(P <0 0 5 )。药物副作用发生率I C、S K、A C组间无显著性差异 (P >0 0 5 )。结论　吸入糖皮质激素、口服沙丁胺醇和酮替酚、氨茶碱和扑?Objective To explore the therapy and prognosis of c hildren with cough variant asthma(CVA).Methods The eighty-four cases with CVA were randomly divided into control group,inhalant corticosteroid group(I-C group),oral salbutamol and kote tifen group(S-K group),oral aminophylline and chlorpheniramine group(A-C group ).The control group was treated only by antitussives,expectorants and antibiotic s.I-C group was adminstered by inhalation of beclomathasone dipropionate with 1 00μg twice daily.S-K group was administered by oral salbutamol and kotetifen.T he doses of salbutamol was 0 5～1mg thrice daily in patients under 5 years old, 2 mg thrice daily in patients over 5.The doses of kotetifen was 0 5mg twice daily in patients undey 3,1mg 1～2 times daily in patients over 3.Salbutamol was disu s ed after 2 weeks of cough-free.A-C group was adminstered by oral aminophylline with 4～5mg/kg thrice daily and chlorpheniramine with 0 1mg/kg 3 times daily.E v ery course of treatment was 6 months in all groups.The patients were followed up from 6 months to 4 years and 6 months.Results After 2 weeks of administration,the effective rates in I-C group,S-K group and A-C group were 100%,95 45% and 90 48%,respectively(P >0 05),while control group was 30%,which was significantly lower than other g roups(P<0 01).Mean days of cough being controlled hadn't significant differ ence in I-C group,S-K group and A-C group(P>0 05),while control group wa s significantly longer than other groups(P<0 01).After one coure of treatme nt,the recurrent rates of CVA in S-K group and A-C group were 50% and 47 62%, respectively(P>0 05),while I-C group was 19 05%,lower than S-K and A-C groups(P<0 05,respectively).The ocurrence of asthma in I-C,S-K,A-C and c ontrol groups were 9 52%,40 91%,38 10% and 75%,respectively(I-C group vs S- K and A-C groups,P<0 05;I-C group vs control groups,P<0 01;S -K group vs A-C group,P>0 05,S-K and A-C groups vs control group,P< 0 05).

关 键 词：咳嗽变异型哮喘 预后 儿童 治疗 

分 类 号：R725.622.5[医药卫生—儿科]