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目的:对比研究舒利迭(美沙特罗±丙酸氟替卡松)与吸入性糖皮质激素(丙酸氟替卡松)联合白三烯受体拮抗剂(孟鲁司特钠)治疗儿童中度持续性哮喘的临床疗效。方法:入选取2013年1月~2015年3月收治的82例中度持续性哮喘患儿为研究对象,随机分为A组、B组各41例,A组患儿给予舒利迭吸入治疗方案,B组患儿给予辅舒酮吸入联合孟鲁司特钠口服方案,比较两组患儿治疗4周和12周哮喘控制水平、儿童哮喘测试(C-ACT)评分、肺功能、外周血嗜酸性粒细胞计数水平等的差异,观察两组合并过敏性鼻炎的患儿鼻部症状改善情况。结果:治疗4周后A组和B组患儿哮喘控制总有效率(87.8%vs.73.2%)、C-ACT评分(23.13±2.75vs.21.47±2.24)、外周血嗜酸性粒细胞(EOS)计数(0.35±0.12vs0.22±0.11)×109及肺功能指标差异均有统计学意义;治疗12周后两组哮喘控制总有效率(100.0%vs.97.7%)、C-ACT评分(25.26±2.23vs.24.67±2.01)及各项肺功能指标差异均无统计学意义,但A组EOS计数显著高于B组(0.26±0.13vs.0.15±0.09)×109差异显著;治疗4周后,B组过敏性鼻炎患儿鼻部症状开始改善,12周后症状明显改善,A组过敏性鼻炎患儿鼻部症状无明显变化。结论:舒利迭与吸入性糖皮质激素联合孟鲁司特钠方案治疗儿童中度持续性哮喘3个月后疗效相当;前者能更快的缓解患儿临床症状、改善肺功能,后者对于合并过敏性鼻炎的患儿可更好缓解鼻部症状,进一步降低EOS水平。
OBJECTIVE: To compare the efficacy and safety of seretide (metostatl fluticasone propionate propionate) and inhaled glucocorticoid (fluticasone propionate) in combination with leukotriene receptor antagonist (montelukast sodium) in the treatment of moderate persistent asthma in children Clinical efficacy. Methods: Totally 82 children with moderate persistent asthma admitted to our hospital from January 2013 to March 2015 were randomly divided into group A (41 cases) and group B (41 cases). Patients in group A received inhaled seretide The patients in group B were given oral Fu Lu Shu ketone inhalation combined with montelukast sodium oral treatment, the two groups of children treated for 4 weeks and 12 weeks of asthma control, children asthma test (C-ACT) score, pulmonary function, peripheral blood Eosinophil count and other differences between the two groups were observed in children with allergic rhinitis symptoms of nasal improvement. Results: After 4 weeks of treatment, the total effective rate of asthma control (87.8% vs 73.2%), C-ACT score (23.13 ± 2.75vs.21.47 ± 2.24), peripheral blood eosinophil (EOS ) (0.35 ± 0.12vs0.22 ± 0.11) × 109 and pulmonary function indicators were statistically significant; after 12 weeks of treatment, the total effective rate of two groups of asthma control (100.0% vs.97.7%), C-ACT score 25.26 ± 2.23vs.24.67 ± 2.01) and all the indexes of pulmonary function had no statistical significance, but the count of EOS in group A was significantly higher than that in group B (0.26 ± 0.13 vs.0.15 ± 0.09) × 109; After treatment, the nasal symptoms of children with allergic rhinitis in group B began to improve, and the symptoms improved significantly after 12 weeks. The symptoms of nasal symptoms in children with allergic rhinitis in group A did not change significantly. Conclusion: The effect of seretide and inhaled glucocorticoids combined with montelukast sodium on children with moderate persistent asthma after 3 months has the same effect. The former can relieve clinical symptoms in children more quickly and improve lung function. Children with allergic rhinitis can better relieve nasal symptoms and further reduce EOS levels.