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目的:比较三种雾化吸入方案治疗婴幼儿急性喘息的临床疗效,探究更快缓解喘息症状的治疗方案。方法:将179例急性喘息婴幼儿随机分A、B、C 3组,A组每8 h 1次雾化吸入硫酸特布他林溶液2.5 mg和异丙托溴铵溶液0.25 mg;B组在A组基础上加用布地奈德混悬液0.5 mg,2次/天雾化吸入;C组在A组基础上加用布地奈德混悬液1 mg,每8 h 1次雾化吸入。治疗3~5 d后比较各组治疗前后临床症状、体征变化及速效β2受体激动剂(SABA)和全身型激素使用情况。结果:治疗30 min后,C组喘息急性发作评分改善较A、B两组更加显著(Z=-4.26及Z=-3.45,P<0.01),A、B两组比较差异无统计学意义(Z=1.17,P>0.05)。治疗3 d及5 d后三组间评分比较差异无统计学意义(H=2.86及H=0.60,P>0.05)。三组速效β2受体激动剂和全身激素使用情况比较差异无统计学意义(χ2=1.74及χ2=0.95,P>0.05)。结论:对于轻中度喘息急性发作婴幼儿,小剂量吸入型糖皮质激素(ICS)雾化吸入治疗不能明显提高疗效,早期大剂量使用ICS能够更快地缓解症状,但对后续疗效的提高没有明显促进作用。
OBJECTIVE: To compare the clinical efficacy of three kinds of nebulization regimens in the treatment of acute wheezing in infants and young children, and to explore the treatment options for faster relief of wheezing symptoms. Methods: A total of 179 acute asthmatic infants and young children were randomly divided into three groups: A, B and C groups. In group A, inhalation of terbutaline sulfate 2.5 mg and ipratropium bromide 0.25 mg every 8 h; Group A was given budesonide suspension 0.5 mg twice daily for aerosolization. Group C was given Budesonide 1 mg aerosol once every 8 hours. After 3 to 5 days of treatment, the clinical symptoms and signs of each group were compared before and after treatment, and the use of fast-acting beta 2 receptor agonist (SABA) and systemic hormones were compared. Results: After 30 minutes of treatment, the improvement of asthma exacerbation score in group C was more significant than those in groups A and B (Z = -4.26 and Z = -3.45, P <0.01). There was no significant difference between A and B groups Z = 1.17, P> 0.05). There was no significant difference in scores between the three groups after 3 and 5 days of treatment (H = 2.86 and H = 0.60, P> 0.05). Three groups of fast-acting β2 receptor agonist and systemic hormone use difference was not statistically significant (χ2 = 1.74 and χ2 = 0.95, P> 0.05). CONCLUSIONS: For mild to moderate wheezing acute attack infants, low-dose inhaled glucocorticoid (ICS) nebulization does not significantly improve efficacy, and early use of high-dose ICS can relieve symptoms more quickly, but there is no improvement in subsequent efficacy Significantly promote the role.