口服匹多莫德联合布地奈德雾化吸入治疗儿童咳嗽变异性哮喘的临床效果

摘要

目的 探讨口服匹多莫德联合布地奈德雾化吸入治疗儿童咳嗽变异性哮喘(CVA)的临床效果.方法 纳入62例CVA患儿,随机分为对照组30例及观察组32例,两组均给予布地奈德雾化吸入及抗感染等常规治疗,观察组同时加服匹多莫德颗粒.比较治疗前及治疗4周后两组患儿肺功能 [1 s用力呼气容积(FEV1)、呼气流量峰值(PEF)、FEV1/用力肺活量比值(FEV1/FVC)]、炎症因子白细胞介素-5(IL-5)、血清淀粉样蛋白A(SAA)、降钙素原(PCT)水平、细胞免疫功能(CD4 +、CD8 +、CD4 +/CD8 +),并比较治疗4周后两组的疗效及随访6个月内的复发情况.结果 治疗4周后,两组FEV1、PEF、FEV1/FVC、CD4 +、CD4 +/CD8 +均较治疗前升高(P<0.05),IL-5、SAA、PCT水平及CD8+较治疗前降低(P<0.05),观察组FEV1、PEF、FEV1/FVC、CD4+、CD4+/CD8+均高于对照组(P<0.05),IL-5、SAA、PCT水平及CD8+低于对照组(P<0.05).观察组总有效率高于对照组(P<0.05),而两组的复发率比较,差异无统计学意义(P>0.05).结论 口服匹多莫德联合布地奈德雾化吸入治疗儿童CVA,能更好地控制患儿临床症状,改善免疫功能及肺功能,降低炎症因子水平,无明显不良反应.%Objective To explore the clinical efficacy of oral administration of polimod combined with inhalation of budesonide for cough variant asthma(CVA) in children.Methods Sixty-two children with CVA were randomly divided into control group(n=30) and observation group(n=32).Both groups received conventional therapy including inhalation of budesonide and anti-infection therapy. And the observation group was orally administrated polimod granule at the same time.Before and after 4 weeks of treatment,the lung function [including forced expiratory volume in one second(FEV1),peak expiratory flow(PEF) and FEV1/forced vital capacity ratio (FEV1/FVC)], inflammatory factors[including interleukin-5(IL-5),serum amyloid A(SAA) and procalcitonin(PCT)] levels,and cellular immune function (CD4+,CD8+and CD4+/CD8+) were compared between the two groups.The efficacy at 4 weeks after treatment and the recrudesce during 6-month follow-up were also compared between the two groups.Results After 4 weeks of treatment,FEV1,PEF,FEV1/FVC,CD4 +and CD4 +/CD8 +were higher and the levels of IL-5,SAA,PCT and CD8 +were lower in both groups compared to the levels before treatment (all P<0.05).In the observation group,FEV1,PEF,FEV1/FVC,CD4 +and CD4 +/CD8 +were higher and the levels of IL-5,SAA,PCT and CD8 +were lower than those in the control group(all P<0.05).The total effective rate of the observation group was higher than that of the control group(P <0.05),but there was no significant difference in the recrudesce rate between the two groups (P >0.05). Conclusion For the children with CVA,oral administration of polimod combined with inhalation of budesonide can achieve better control of clinical symptoms,improvement of immune function and lung function,and decreased levels of inflammatory factors,without severe adverse reactions.