布地奈德与丙酸倍氯米松雾化吸入治疗中重度支气管哮喘儿童的疗效分析  

The therapeutic effect of budesonide and beclomethasone propionate aerosol inhalation in children with moderate to severe bronchial asthma

作　　者：吴雄林 陈铁江[1] 王娇[1] 滕志华[2] WU Xionglin;CHEN Tiejiang;WANG Jiao;TENG Zhihua(Emergency department,Yiwu central hospital,Yiwu 322000,Zhejiang,China;Second affiliated hospital of Zhejiang university,Hangzhou 310009,Zhejiang,China)

机构地区：[1]义乌市中心医院急诊科,浙江义乌322000 [2]浙江大学医学院附属第二医院,浙江杭州310009

出　　处：《中国妇幼健康研究》2019年第11期1425-1429,共5页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨布地奈德与丙酸倍氯米松雾化吸入治疗中重度支气管哮喘儿童的疗效,为临床治疗提供依据。方法选取义乌市中心医院2017年10月至2019年1月收治的中重度支气管哮喘病儿童168例,采用随机数表法分为观察组(n=84)和对照组(n=84)。对照组给予丙酸倍氯米松雾化吸入治疗,观察组给予布地奈德雾化吸入治疗。比较两组患者治疗效果、各项临床症状消失时间,记录治疗前后肺功能指标、血清炎症细胞因子变化,统计不良反应发生率。结果观察组治疗后总有效率(96.43%)高于对照组(76.19%),差异有统计学意义(χ~2=14.558,P<0.01)。两组患者采取雾化治疗后第1秒用力呼气末容积(FEV1)、最大肺活量(FVC)、FEV1/FVC水平均明显升高,且观察组高于对照组,差异有统计学意义(t值分别为5.265、7.098、9.734,均P<0.01)。两组患者治疗后肿瘤坏死因子-α(TNF-α)、白细胞介素-5(IL-5)水平均明显下降,且观察组低于对照组,差异有统计学意义(t值分别为6.901、8.701,均P<0.01)。观察组患者的肺部鸣音、呼吸困难、咳嗽消失时间、住院时间均明显短于对照组,差异有统计学意义(t值分别为6.088、5.081、4.757、6.556,均P<0.01)。观察组治疗后不良反应总发生率(2.38%)明显低于对照组(11.90%),差异有统计学意义(χ~2=5.743,P<0.05)。结论布地奈德与丙酸倍氯米松雾化吸入均可治疗儿童中重度支气管哮喘急性发作,但布地奈德效果更为显著,能促进患者各项肺功能指标快速恢复,降低血清炎症因子水平和不良反应发生率,患者临床症状得到有效缓解,住院时间明显缩短,值得推广使用。Objective To investigate the efficacy of budesonide and beclomethasone propionate aerosol inhalation in the treatment of children with moderate to severe bronchial asthma and to provide evidence for clinical treatment.Methods 168 children with moderate to severe bronchial asthma admitted to our hospital during the period from October 2017 to January 2019 were randomly divided into the observation group(n=84)and the control group(n=84).The control group was treated with beclomethasone propionate aerosol inhalation,while the observation group was treated with Budesonide aerosol inhalation.The therapeutic effect and removal time of clinical symptoms were compared between the two groups.The changes of pulmonary function and serum inflammatory cytokines were recorded before and after the treatment.And the incidences of adverse reactions were collected.Results The total effective rate of the observation group(96.43%)was higher than that of the control group(76.19%),and the difference was statistically significant(χ2=14.558,P<0.01).The levels of forced end-expiratory volume(FEV1),maximal vital capacity(FVC)and FEV1/FVC increased remarkably in the first second after aerosol treatment in the patients of both groups,and those data in the observation group were significantly higher than those of the control group,the difference was statistically significant(t=5.265,7.098 and 9.734,respectively,P<0.01 for all).After the treatment,the levels of tumor necrosis factor-α(TNF-α)and interleukin-5(IL-5)were significantly decreased in the patients of both groups,and those data of the observation group were lower than those of the control group,and the difference was statistically significant(t=6.901,8.701,respectively,P<0.01 for both).The lung sounds,dyspnea,cough removal time and hospitalization time in the observation group were significantly shorter than those in the control group,the difference was statistically significant(t=6.088,5.081,4.757 and 6.556,respectively,P<0.01 for all).The total incidence of adverse reactions aft

关 键 词：布地奈德 丙酸倍氯米松 中重度支气管哮喘 炎症因子及肺功能 影响 

分 类 号：R725.6[医药卫生—儿科]