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目的探讨普米克令舒和万托林及甲强龙联合治疗毛细支气管的临床疗效。方法选取梧州市中医医院2014年10月—2016年10月收治的毛细支气管炎患儿74例,按照随机数学表法分为对照组和治疗组,每组37例。对照组患儿采用常规对症治疗,治疗组患儿在对照组基础上给予甲强龙、普米克令舒联合万托林治疗,两组患者均持续治疗1周。比较两组患儿症状消失时间、呼吸功能复常时间、药物治疗总时间、临床疗效及治疗前后炎性因子[肿瘤坏死因子α(TNF-α)、白介素6(IL-6)、白介素10(IL-10)]及肺功能[第1秒用力呼气容积(FEV_1)、用力肺活量(FVC)],观察患儿不良反应发生情况。结果治疗组患儿症状消失时间、呼吸功能复常时间及药物治疗总时间短于对照组(P<0.05)。治疗组患儿治疗总有效率高于对照组(P<0.05)。治疗前,两组患儿TNF-α、IL-6、IL-10及FEV_1、FVC比较,差异无统计学意义(P>0.05);治疗后,治疗组患儿TNF-α、IL-6、IL-10低于对照组,FEV_1、FVC高于对照组(P<0.05)。治疗组患儿药物不良反应发生率低于对照组(P<0.05)。结论采用普米克令舒和万托林及甲强龙联合治疗毛细支气管的临床疗效确切,可有效降低炎性反应,提高肺功能,药物起效快,且安全性好。
Objective To investigate the clinical efficacy of pulmicort respules and methotrexate and methylprednisolone in the treatment of bronchioles. Methods 74 patients with bronchiolitis admitted to Wuzhou Chinese Medicine Hospital from October 2014 to October 2016 were divided into control group and treatment group according to random number table method, with 37 cases in each group. Children in the control group were treated with conventional symptomatic treatment. Children in the treatment group were treated with methylprednisolone and pulmicortin plus vancomycin on the basis of the control group, and both groups were treated for 1 week. The time of symptom disappearance, respiratory function recovery time, total duration of drug treatment, clinical efficacy and the levels of inflammatory cytokines (TNF-α, IL-6, IL-10, IL-10)] and pulmonary function [forced expiratory volume 1 second (FEV_1), forced vital capacity (FVC)] were used to observe the adverse reactions in children. Results The symptom disappearance time, respiratory function recovery time and the total time of treatment in the treatment group were shorter than those in the control group (P <0.05). The total effective rate of treatment group was higher than that of control group (P <0.05). Before treatment, there was no significant difference in TNF-α, IL-6, IL-10, FEV 1 and FVC between the two groups (P> 0.05) IL-10 was lower than that of control group, FEV_1 and FVC were higher than those of control group (P <0.05). The incidence of adverse drug reactions in the treatment group was lower than that in the control group (P <0.05). Conclusions The combination of pulmicort and vanvlindol and methylprednisolone in the treatment of bronchioles has definite clinical curative effect, which can effectively reduce the inflammatory reaction, improve the pulmonary function, quick onset of drug action and good safety.