两种方案治疗成人咳嗽变异性哮喘的临床疗效及对患者相关指标水平的影响  

Clinical Efficacy of Two Treatment Regimens in the Treatment of Cough Variant Asthma and its Effects on Related Indicators

作　　者：张瑾[1] 吕从改 高耐芬[1] 赵磊[3] ZHANG Jin;LYU Conggai;GAO Naifen;ZHAO Lei(Dept. of Respiratory Medicine, the Second Hospital of Shijiazhuang, Hebei Shijiazhuang 050051, China;Dept. of General Practice, the Second Hospital of Shijiazhuang, Hebei Shijiazhuang 050051, China;Dept. of Internal Medicine, the Fifth Hospital of Shijiazhuang, Hebei Shijiazhuang 050021, China)

机构地区：[1]石家庄市第二医院呼吸内科,河北石家庄050051 [2]石家庄市第二医院全科医学科,河北石家庄050051 [3]石家庄市第五医院内二科,河北石家庄050021

出　　处：《中国医院用药评价与分析》2020年第5期567-570,575,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：河北省医学科学研究重点课题计划(No.20191410)。

摘　　要：目的:探讨沙美特罗替卡松与布地奈德分别联合孟鲁司特钠治疗成人咳嗽变异性哮喘(cough variant asthma,CVA)的疗效及对患者相关指标水平的影响。方法:选取2018年石家庄市第二医院和石家庄市第五医院收治的CVA患者90例,根据随机数字表法分为沙美特罗替卡松组、布地奈德组及对照组,每组30例。沙美特罗替卡松组患者采用沙美特罗替卡松+孟鲁司特钠治疗,布地奈德组患者采用布地奈德+孟鲁司特钠治疗,对照组患者单用布地奈德,三组患者均治疗3个月。观察三组患者的临床疗效、咳嗽症状积分,治疗前后血清白细胞介素2(IL-2)、白细胞介素4(IL-4)、肿瘤坏死因子α(TNF-α)、免疫球蛋白E(IgE)、淀粉样蛋白A(SAA)、转化生长因子β1(TGF-β1)水平及肺功能指标[第1 s用力呼气容积(FEV1)、最大呼气流量(PEF)及FEV1占用力肺活量百分比(FEV1/FVC)]水平,比较三组患者不良反应发生情况的差异。结果:沙美特罗替卡松组、布地奈德组患者的总有效率分别为96.67%(29/30)、90.00%(27/30),均明显高于对照组的73.33%(22/30),差异有统计学意义(P<0.05)。治疗后1周,沙美特罗替卡松组、布地奈德组患者日间咳嗽症状积分和夜间咳嗽症状积分均明显低于对照组,差异有统计学意义(P<0.05);治疗后2周,三组患者评分日间咳嗽症状积分和夜间咳嗽症状积分的差异均无统计学意义(P>0.05)。治疗后,三组患者IL-4、TNF-α、IgE、SAA及TGF-β1水平明显低于治疗前,IL-2水平明显高于治疗前,差异均有统计学意义(P<0.05);治疗后,沙美特罗替卡松组、布地奈德组患者IL-4、TNF-α、IgE、SAA及TGF-β1水平明显低于对照组,IL-2水平明显高于对照组,差异均有统计学意义(P<0.05)。治疗后,三组患者FEV1、PEF及FEV1/FVC水平明显高于治疗前,且沙美特罗替卡松组、布地奈德组患者明显高于对照组,差异均有统计学意义(P<0.05)。沙美特罗替卡松组的血清IL-OBJECTIVE:To probe into the clinical efficacy of salmeterol and budesonide respectively combined with montelukast sodium in the treatment of cough variant asthma(CVA)and its effects on related indicators.METHODS:A total of 90 patients with CVA admitted into the Second Hospital of Shijiazhuang and the Fifth Hospital of Shijiazhuang in 2018 were extracted to be divided into the salmeterol group,the budesonide group and the control group via the random number table,with 30 cases in each group.Patients in the salmeterol group were treated with salmeterol and montelukast sodiumt,the budesonide group was given budesonide and montelukast sodium,and the control group received budesonide alone.All patients were treated for 3 months.The clinical efficacy,cough symptom scores,serum levels of interleukin-2(IL-2),interleukin-4(IL-4),tumor necrosis factor-α(TNF-α),immunoglobulin E(IgE),serum amyloid A(SAA),transforming growth factor-β1(TGF-β1)and pulmonary function indicators[forced expiratory volume(FEV1),maximum expiratory flow(PEF)and FEV1/forced vital capacity(FVC)at the end of the 1st second]of three groups were observed,differences of incidence of adverse drug reactions were compared.RESULTS:The total effective rates of the salmeterol group and the budesonide group were 96.67%(29/30)and 90.00%(27/30),significantly higher than 73.33%(22/30)of the control group,the difference was statistically significant(P<0.05).After treatment of one week,the scores of daytime cough symptom and nighttime cough symptom in the salmeterol group and budesonide group were significantly lower than those in the control group,the difference was statistically significant(P<0.05).After treatment of two weeks,there was no significant difference in scores of daytime cough symptom and nighttime cough symptom among three groups(P>0.05).After treatment,the levels of IL-4,TNF-α,IgE,SAA and TGF-β1 in three groups were significantly lower than those before treatment,and the levels of IL-2 were significantly higher than those before treatment,with st

关 键 词：咳嗽变异性哮喘 沙美特罗替卡松 孟鲁司特钠 肺功能 炎症因子 

分 类 号：R974[医药卫生—药品]