首页> 中文期刊>医学综述 >沙美特罗氟替卡松联合孟鲁司特治疗咳嗽变异性哮喘疗效观察

沙美特罗氟替卡松联合孟鲁司特治疗咳嗽变异性哮喘疗效观察

     

摘要

Objective To observe the effect of seretide combined with montelukast treating cough vari-ant asthma(CVA).Methods Total of 68 patients CVA from Baoding No.1 Central Hospital during Jun. 2013 and Jun.2014 were included in the study,and divided into observation group and control group accord-ing to random number table method.The 32 cases in the control group were given seretide(50 μg/250 μg, twice per day),and 36 cases in the observation group were given montelukast(10 mg,once per night) com-bined with seretide.The cough scores,VAS and pulmonary function indexes(FEV1%,FEV1/FVC,PEF) before and 1,2,4,8 weeks after treatment of the patients were recorded and efficacy of the two groups was compared.Results Before treatment and after 1,2,4,8 weeks of treatment,the cough scores in the observa-tion group were:( 4.63 ±1.01 ) scores, ( 2.58 ±0.82 ) scores, ( 1.62 ±0.58 ) scores, ( 0.34 ±0.09 ) scores,(0.00 ±0.00) scores in the control group were:(4.72 ±1.04) scores,(3.02 ±0.86) scores, (2.57 ±1.35) scores,(0.53 ±0.21) scores,(0.22 ±0.04) scores,and VAS in the observation group were:(7.51 ±1.33) scores,(3.56 ±1.05) scores,(2.24 ±1.02) scores,(0.34 ±0.12) scores,(0.00 ± 0.00) scores,in the control group were:(7.36 ±1.54) scores,(3.85 ±1.37) scores,(3.21 ±1.48) scores,(1.03 ±0.25) scores,(0.27 ±0.06) scores,and the observation group decreased more.The differ-ences between groups,time points and interaction of groups・ time points were statistically significant ( P <0.01).After 8 weeks,FEV1%,FEV1/FVC,PEF of the observation group were significantly higher than the control group[(88 ±5)%vs (82 ±4)%,(79 ±5) vs (71 ±5),(89.9 ±2.2) L/min vs (84.6 ±4.1) L/min], the differences were statistically significant(P<0.01).Conclusion Application of seretide combined with montelukast has significant clinical efficacy for CVA which improves the pulmonary function with less adverse actions and improved patient compliance.%目的:观察吸入沙美特罗氟替卡松联合孟鲁司特口服治疗咳嗽变异性哮喘( CVA)的效果以及应用价值。方法选取2013年6月至2014年6月保定市第一中心医院呼吸科门诊及住院的CVA患者68例,按照随机数字表法分为两组,对照组32例吸入沙美特氟罗替卡松粉剂(50μg/250μg),每日2次,观察组36例同时口服孟鲁司特10 mg,每晚1次。在治疗前、治疗1、2、4、8周后分别记录患者的咳嗽症状积分、视觉模拟评分(VAS),及治疗前和治疗8周后患者肺功能指标[第一秒用力呼气量( FEV1)占预计值百分比( FEV1%)、FEV1比用力肺活量( FEV1/FVC)和最大呼气峰流速( PEF)]变化情况,比较两组疗效。结果治疗前及治疗1、2、4、8周咳嗽症状积分、VAS观察组和对照组均呈逐渐下降趋势[咳嗽症状积分观察组:(4.63±1.01)分,(2.58±0.82)分,(1.62±0.58)分,(0.34±0.09)分,(0.00±0.00)分,对照组:(4.72±1.04)分,(3.02±0.86)分,(2.57±1.35)分,(0.53±0.21)分,(0.22±0.04)分, VAS 观察组:(7.51±1.33)分,(3.56±1.05)分,(2.24±1.02)分,(0.34±0.12)分,(0.00±0.00)分,对照组:(7.36±1.54)分,(3.85±1.37)分,(3.21±1.48)分,(1.03±0.25)分,(0.27±0.06)分],但观察组下降幅度更大。两组在组间、不同时点以及组间・不同时点间的交互作用差异均有统计学意义(P<0.01)。且治疗8周后肺通气功能FEV1%、FEV1/FVC、PEF观察组显著高于对照组[(88±5)%比(82±4)%、(79±5)比(71±5)、(89.9±2.2) L/min比(84.6±4.1) L/min],差异有统计学意义(P<0.01)。结论沙美特罗氟替卡松与孟鲁司特口服联合治疗CVA可有效改善患者的咳嗽症状,改善肺通气功能,不良反应少,患者的依从性提高。

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