多因素干预毛细支气管炎后喘息疗效观察  

Clinical Observation of Multifactorial Intervention on Wheezing after Bronchiolitis

作　　者：林建军[1] 徐勇[1] 樊慧苏[1] 吕建飞[1] 雷后兴[1] 胡利娅 黄淑美 刘春香[1] 付小丽[1] 

机构地区：[1]浙江省丽水市人民医院,浙江丽水323000 [2]浙江省青田县中医院,浙江丽水323900

出　　处：《儿科药学杂志》2014年第12期15-18,共4页Journal of Pediatric Pharmacy

基　　金：2011年丽水市医学重点学科科技项目;项目编号2011ZDXK010

摘　　要：目的:观察多因素干预毛细支气管炎后喘息的临床疗效。方法:收集我院门诊及住院符合毛细支气管炎诊断标准的122例患儿,随机分为对照组27例、干预Ⅰ组28例、干预Ⅱ组32例、干预Ⅲ组35例。四组均给予常规的抗病毒、抗炎、解痉、平喘、必要时吸痰等对症治疗。临床治愈后,对照组无干预措施;干预Ⅰ组予以雾化吸入布地奈德混悬液,每日1次,疗程1个月;干预Ⅱ组予以睡前口服孟鲁司特钠咀嚼片,1次/天,疗程3个月;干预Ⅲ组在干预Ⅰ组和干预Ⅱ组治疗基础上加用匹多莫德口服液口服,一次1支,疗程2个月。随访6个月、12个月,记录患儿咳嗽消失时间、喘息消失时间、气促发作时间、肺部体征消失时间、全身应用糖皮质激素时间、再次住院时间。结果:6个月时随访,干预Ⅰ组、干预Ⅱ组、干预Ⅲ组咳嗽消失时间、喘息消失时间、气促发作时间、肺部体征消失时间、全身应用糖皮质激素时间、再次住院时间较对照组缩短(P<0.01)。干预Ⅲ组咳嗽消失时间、喘息消失时间、气促发作时间、肺部体征消失时间、全身应用糖皮质激素时间、再次住院时间较干预Ⅰ组、干预Ⅱ组明显缩短(P<0.01)。12个月随访,干预Ⅰ组、干预Ⅱ组、干预Ⅲ组咳嗽消失时间、喘息消失时间、气促发作时间、肺部体征消失时间、全身应用糖皮质激素时间、再次住院时间较对照组缩短(P<0.01)。干预Ⅲ组咳嗽消失时间与干预Ⅰ组、干预Ⅱ组比较差异无统计学意义(P>0.05),但喘息消失时间、气促发作时间、肺部体征消失时间、需全身糖皮质激素治疗时间、再次住院时间较干预Ⅰ组、干预Ⅱ组明显缩短(P<0.01)。干预Ⅲ组喘息次数(0.8±0.3)次,低于对照组的(3.4±0.7)次、干预Ⅰ组的(1.7±0.4)次和干预Ⅱ组(1.6±0.3)次(P<0.05);干预Ⅲ组哮喘发生率11.43%,低于对照组的62.96%、干预Ⅰ组的32.14%和干预Ⅱ组21.88%(P<0.05Objective： To observe the effect of multifactorial intervention in children with wheezing after bronchiolitis. Methods： One hundred and twenty-two children who met the criteria of bronchiolitis in our hospital were randomly divided into four groups,including control group（ n = 27）,the intervention group Ⅰ（ n = 28）,the intervention group Ⅱ（ n = 32）,the intervention group Ⅲ（ n = 35）.Four groups were given conventional symptomatic treatment including anti-viral,anti-inflammatory,antispasmodic treatment. After clinical cure,the control group was given no intervention; intervention group Ⅰ was given atomizing inhalation of budesonide,once a day for 1 month; the intervention group Ⅱ was given LTs receptor antagonist（ montelukast sodium） once a day for 3 months; the intervention group Ⅲ was given pidotimod for 2 months additionally. Six months and twelve months follow-up were taken. The time of cough,wheezing,shortness of breath,pulmonary signs disappearance,using systemic corticosteroids,and hospital stay were recorded.Results： After 6 months＇ treatment,the time of cough,wheezing,shortness of breath,pulmonary signs disappearance,using systemic corticosteroids,and hospital stay in intervention group Ⅰ,Ⅱ,Ⅲ were significantly shortened than that of the control group（ P〈0. 01）. These indicators in intervention group Ⅲ were significantly shortened than that of intervention group Ⅰ and Ⅱ（ P〈0. 01）.After 12 months ＇ treatment,the time of cough,wheezing,shortness of breath,pulmonary signs disappearance,using systemic corticosteroids,and hospital stay in intervention group Ⅰ,Ⅱ,Ⅲ were significantly shortened than the control group（ P〈0. 01）. The coughing time in intervention group Ⅰ,Ⅱ and Ⅲ showed no significant difference（ P〉0. 05）,but the time of wheezing,shortness of breath,pulmonary signs disappearance,using systemic corticosteroids,and hospital stay in intervention group Ⅲ were significantly shortened than that of the intervention gr

关 键 词：毛细支气管炎 布地奈德 孟鲁司特 匹多莫德 

分 类 号：R725.6[医药卫生—儿科]