| 摘要: |
| 目的：探讨丙酸氟替卡松（Flu）、孟鲁斯特钠（Mon）、酮替芬（Ket）三种药物不同联合用药方案治疗咳嗽变异性哮喘（CVA）的临床效果。方法：选取2016年6月至2018年6月我院就诊的245例CVA患儿为研究对象，采用随机数字表法将245例患儿随机分为Flu组、Mon组、Ket组、Flu+Mon组、Flu+Ket组、Mon+Ket组、Flu+Mon+Ket组7组，每组各35例，治疗8周及12周后进行效果评价，评价指标包括肺功能指标（FEV1%、PEF%）、咳嗽症状评分、不良反应发生情况及咳嗽复发情况。结果：治疗8周后，各组患儿肺功能指标（FEV1%、PEF%）均有所改善，咳嗽症状评分均有所降低，三种药物联合用药均优于单种药物及两种药物联合应用。治疗12周后，除Ket组外，其他组别患儿肺功能指标（FEV1%、PEF%）及咳嗽症状评分差异不明显。不良反应发生率监测显示，联合用药并不增加不良反应发生率。咳嗽复发率监测显示，Ket组患儿咳嗽复发率明显高于其他组（P<0.05）。结论：本研究认为，Flu、Mon、Ket三种药物均可用于儿童咳嗽变异性哮喘的治疗，用药方案为治疗前8周，推荐三种药物联合应用，可获得最佳的治疗效果；8~12周，推荐Flu或Mon单独用药，可获得与三种药物联合用药相似的治疗效果，但不推荐单独使用Ket |
| 关键词: 咳嗽变异性哮喘 联合用药 儿童 临床效果 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2020.03.006 |
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| 基金项目: |
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| Clinical Comparison of Fluticasone Propionate, Montelukast Sodium and Ketotifen in Different Combination Regimens in the Treatment of Cough Variant Asthma in Children |
| Dong Jijun, Yang Minggang, Li Bing |
| (Jingzhou Maternal and Child Health Hospital, Hubei Jingzhou 434020, China) |
| Abstract: |
| Objective: To investigate the clinical effects of fluticasone propionate (Flu), montelukast sodium (Mon) and ketotifen (Ket) in the treatment of cough variant asthma (CVA) in Children. Methods: Totally 245 patients with CVA admitted into our hospital from Jun. 2016 to Jun. 2018 were extracted to be divided into the Flu group, Mon group, Ket group, Flu+Mon group, Flu+Ket group, Mon+Ket group and Flu+Mon+Ket group via the random number table, with 35 cases in each group. The effects were evaluated after 8 weeks and 12 weeks of treatment. The evaluation indexes mainly included lung function (FEV1%, PEF%), cough symptom score, adverse drug reactions and recurrence of cough. Results: After 8 weeks of treatment, the lung function index (FEV1%, PEF%) of each group was improved, the cough symptom score was decreased, and the combination of three drugs was superior to the single drug and the combination of two drugs. After 12 weeks of treatment, except for the Ket group, there were no significant differences in lung function index (FEV1%, PEF%) and cough symptom score among other groups. Adverse drug reactions monitoring showed that drug combination did not increase the incidence of adverse drug reactions. The recurrence rate of cough in children in the Ket group was significantly higher than that in the other groups (P<0.05). Conclusion: This study indicates that Flu, Mon and Ket can be used in the treatment of CVA in children. The recommended regimen is: in the first 8 weeks, the combination of three drugs can obtain the best therapeutic effects. From 8 to 12 weeks, Flu or Mon alone can achieve similar therapeutic effects as the combination of three drugs, but Ket alone is not recommended. |
| Key words: cough variant asthma drug combination children clinical effects |
