2022 年第 2 期 第 17 卷

三药联合治疗对咳嗽变异性哮喘患儿免疫功能和气道炎症因子水平及肺功能的影响

Effects of three-drug combination therapy on immune function, airway inflammation levels and lung function in children with cough variant asthma

作者：周炳文王莎莎颜世军

英文作者：Zhou Bingwen Wang Shasha Yan Shijun

单位：中国人民解放军东部战区总医院秦淮医疗区儿科，南京210000

英文单位：Department of Pediatrics Eastern Theater Command General Hospital Qinhuai Medical Treatment Area of the Chinese People′s Liberation Army Nanjing 210000 China

关键词：小儿咳嗽变异性哮喘；孟鲁司特钠；西替利嗪；布地奈德

英文关键词：Coughvariantasthmainchildren;Montelukastsodium;Cetirizine;Budesonide

• 摘要：

• 目的  观察孟鲁司特钠、西替利嗪与布地奈德三药联合治疗对咳嗽变异性哮喘（CVA）患儿免疫功能、气道炎症因子水平及肺功能的影响。方法  选取2018年9月至2021年2月中国人民解放军东部战区总医院秦淮医疗区收治的CVA患儿104例，按照随机数字表法分为观察组与对照组，每组52例。对照组给予常规基础治疗联合布地奈德吸入治疗，观察组在对照组的基础上增加孟鲁司特钠与盐酸西替利嗪治疗。比较2组患儿治疗前后免疫功能、炎症因子水平、肺功能、咳嗽积分及不良反应情况。结果  治疗后，观察组免疫球蛋白E、白细胞介素4、呼出气一氧化氮、嗜酸性粒细胞水平、日间和夜间咳嗽积分均低于对照组，第1秒用力呼气容积、用力肺活量和呼气峰值流量水平均高于对照组［（3.0±0.7）L比（2.3±0.6）L、（4.2±0.6）L比（3.5±0.8）L、（3.8±0.9）L/s比（3.2±0.8）L/s］，差异均有统计学意义（均P<0.05）。2组不良反应发生率差异无统计学意义（P>0.05）。结论  孟鲁司特钠、西替利嗪与布地奈德三药联合治疗可改善CVA患儿免疫功能、有效缓解气道炎症反应，从而改善肺功能，且安全性良好。

• Objective To observe the effects of combined treatment of montelukast sodium, cetirizine and budesonide on immune function, airway inflammation levels and lung function in children with cough variant asthma(CVA). Methods Totally 104 children with CVA treated in Eastern Theater Command General Hospital Qinhuai Medical Treatment Area of the Chinese People′s Liberation Army from September 2018 to February 2021 were enrolled. Patients were randomly divided into observation group and control group, with 52 cases in each group. The control group was given conventional symptomatic treatment combined with budesonide inhalation, and the observation group was given montelukast sodium and cetirizine hydrochloride on the basis of the control group. The immune function, inflammatory factor levels, pulmonary function, cough score and adverse reactions before and after treatment were compared between the two groups. Results After treatment, the levels of immunoglobulin E, interleukin-4, exhaled nitric oxide, eosinophils, daytime and nighttime cough scores in the observation group were lower than those in the control group, and the levels of forced expiratory volume in the first second, forced vital capacity and peak expiratory flow in the observation group were higher than those in the control group［（3.0±0.7）L vs （2.3±0.6）L, （4.2±0.6）L vs （3.5±0.8）L, （3.8±0.9）L/s vs （3.2±0.8）L/s］(all P<0.05). There was no statistically significant difference in the occurrence of adverse reactions between the two groups(P>0.05). Conclusions The combination of montelukast sodium, cetirizine and budesonide can improve the immune function in children with CVA, and effectively alleviate the airway inflammation, so as to improve the lung function, and has good safety.