抗胆碱能药物——噻托溴铵治疗儿童哮喘疗效观察  

Observation on curative effect of tiotropium bromide in treatment of children with asthma

作　　者：黄娟[1] 陈颖[1] 龙珍[1] 周小勤[1] 舒俊华[1] 陈霞[1] 戚虹[1] 张军[1] 

机构地区：[1]湖北省妇幼保健院儿科,湖北武汉430072

出　　处：《中国妇幼保健》2015年第13期2005-2008,共4页Maternal and Child Health Care of China

基　　金：湖北省科技厅自然科学基金〔2013CFB048〕

摘　　要：目的：观察抗胆碱能药物——噻托溴铵治疗儿童哮喘临床疗效。方法：选取2013年9月-2014年9月在该院哮喘门诊新诊断中度持续性哮喘患儿80例,随机分为对照组：丙酸氟替卡松气雾剂（辅舒酮）125μg/次,2次/d＋安慰剂1次/d;实验组：丙酸氟替卡松气雾剂（辅舒酮）125μg/次,2次/日＋噻托溴铵干粉吸入剂（思力华）18μg/次,1次/日,观察时间为12周。检测指标：1肺功能：第1秒用力呼气容积占预计值的百分比（FEV1%）、用力肺活量（FVC）及呼气峰流速占预计值的百分比（PEF%）。2严重哮喘发生率。3按需使用短效β2受体激动剂的次数、天数及夜间觉醒天数。4不良反应。结果：两组患儿在治疗第4周、第8周及第12周肺功能FEV1%、FVC及PEF%均较治疗前显著改善（P〈0.001）,差异有统计学意义;实验组肺功能又较对照组显著改善（第12周FEV1%,第4周、第8周FVC P〈0.05,余P〈0.001）,差异均有统计学意义。两组严重哮喘发生率分别36.3%和26.8%,差异无统计学意义（P〉0.05）。实验组按需使用短效β2激动剂次数及天数均较对照组显著下降（P〈0.05）,差异有统计学意义;夜间觉醒天数较对照组显著减少（P〈0.00）,差异有统计学意义。两组均无严重不良反应。结论：噻托溴铵能显著改善哮喘患儿肺功能,减少短效β2受体激动剂使用的次数及天数,减少夜间觉醒的天数,不良反应少,在儿童哮喘防治中具有良好的应用前景。Objective： To observe the clinical efficacy of tiotropium bromide in treatment of children with asthma. Methods： Eighty children diagnosed as moderate persistent asthma in outpatient department of asthma in the hospital from September 2013 to September 2014 were randomly selected and randomly divided into control group and experimental group; the children in control group were treated with fluticasone propionate aerosol （flixotide, 125 μg per time, twice a day） and placebo （once a day） ; the children in experimental group were treated with fluticasone propionate aerosol （flixotide, 125 μg per time, twice a day） and tiotropium bromide （ 18 μg per time, once a day） ; all the children were observed for 12 weeks. The detection indexes included pulmonary function （ FEV1%, FVC, and PEF% ）, the incidence rate of severe asthma, the frequency, number of days, and number of awakening days during the night of application of short-term β2 receptor agonist, and the adverse reactions. Results： FEV1%, FVC, and PEF% on the 4th, 8th, and 12th weeks after treatment in the two groups were statistically significantly improved compared with before treatment （ P〈0. 001 ） ; FEV1%, FVC, and PEF% after treatment in experimental group were significantly improved compared with control group （ FEV1% on the 12th week, FVC on the 4th and 8th weeks ： P〈 0. 05 ; the other indexes： P〈0. 001 ） . The incidence rates of severe asthma in the two groups were 36. 3% and 26. 8%, respectively, there was no statistically significant difference between the two groups （P〉0. 05 ） . The frequency and number of application days of short-term β2 receptor agonist in experimental group were statistically significantly lower than those in control group （ P〈0. 05 ） ; the awakening days during the night of application of short-term β2 receptor agonist in experimental group was stat!stically significantly lower than that in control group （P〈0. 00） . No serious adverse reaction was found in the two g

关 键 词：抗胆碱能药物 噻托溴铵 儿童 哮喘 

分 类 号：R725.6[医药卫生—儿科]