2020 年第 11 期 第 15 卷

孟鲁司特钠片联合布地奈德混悬液治疗支气管哮喘的效果及对患者气道炎症反应的影响

The effect and its influence on airway inflammation in patients of montelukast combined with budesonide in the treatment of bronchial asthma

作者：孙晓丽张湘华曹晓玮

英文作者：Sun Xiaoli Zhang Xianghua Cao Xiaowei

单位：石家庄市第一医院呼吸科050000

英文单位：Department of Respiration Shijiazhuang No.1 Hospital Shijiazhuang 050000 China

关键词：支气管哮喘；孟鲁司特；布地奈德；嗜酸粒细胞阳离子蛋白；脂质过氧化物；呼出气一氧化

英文关键词：Bronchialasthma；Montelukast;Budesonide;Eosinophilcationicprotein;Lipidperoxide;Fractionalexhalednitricoxide

• 摘要：

• 目的 探讨孟鲁司特钠片联合布地奈德混悬液治疗支气管哮喘的效果及对患者血清嗜酸粒细胞阳离子蛋白（ECP）、脂质过氧化物（LPO）、呼出气一氧化氮（FeNO）表达的影响。方法 选取2017年1月至2019年6月石家庄市第一医院收治的91例支气管哮喘患者为研究对象，按照随机数字表法分为对照组（45例）和观察组（46例）。在常规治疗基础上，对照组给予布地奈德混悬液2 ml+3 ml 0.9%氯化钠注射液雾化吸入治疗，15 min/次，2次/d；观察组在对照组基础上给予孟鲁司特钠片10 mg/次，1次/d口服治疗。比较2组临床疗效，咳嗽缓解时间、胸闷缓解时间、肺部哮鸣音消失时间、喘息缓解时间，治疗前后血清ECP、LPO、FeNO表达水平和不良反应发生率。结果 治疗后，观察组治疗有效率明显高于对照组［93.5%（43/46）比77.8%（35/45）］，咳嗽缓解时间、胸闷缓解时间、肺部哮鸣音消失时间、喘息缓解时间均明显短于对照组［（4.7±1.0）d比（5.7±1.3）d、（4.6±1.1）d比（5.8±1.3）d、（5.2±1.3）d比（6.6±1.3）d、（3.8±1.4）d比（4.7±1.3）d］，差异均有统计学意义（均P＜0.05）。治疗后，2组血清ECP、LPO、FeNO表达含量均低于治疗前，且观察组均低于对照组，差异均有统计学意义（均P＜0.05）。2组皮疹、恶心、声嘶、头痛、咽喉不适等不良反应发生率比较差异均无统计学意义（均P＞0.05）。结论 孟鲁司特钠片联合布地奈德混悬液能够提高支气管哮喘的治疗效果，促进症状改善，减轻气道炎症反应，降低血清ECP、LPO、FeNO表达水平，且不会增加不良反应。

• Objective To investigate the therapeutic effect of montelukast sodium combined with budesonide suspension and its effect on bronchial asthma, eosinophil cationic protein (ECP), lipid peroxide (LPO) and fractional exhaled nitric oxide (FeNO). Methods Totally 91 patients with bronchial asthma admitted to Shijiazhuang No.1 Hospital from January 2017 to June 2019 were selected. According to the random number table method, the patients were divided into control group (45 cases) and observation group (46 cases). On the basis of routine treatment, the control group was given budesonide suspension 2 ml + 0.9% saline 3 ml atomization inhalation, 15 min/time，twice a day; the observation group was given montelukast sodium tablets 10 mg/time, once a day, on the basis of the control group. The clinical efficacy, the cough relief time, chest distress relief time, lung chirp disappearance time, wheeze relief time, serum ECP, LPO and FeNO levels and adverse reactions were compared between the two groups. Results The total effective rate of the observation group was higher than that of the control group［93.5%（43/46） vs 77.8%（35/45）］; after treatment, the cough relief time, chest distress relief time, lung murmur disappearance time and wheeze relief time of the observation group were shorter than those of the control group［（4.7±1.0）d vs （5.7±1.3）d, （4.6±1.1）d vs （5.8±1.3）d,（5.2±1.3）d vs （6.6±1.3）d, （3.8±1.4）d vs （4.7±1.3）d］(all P＜0.05). After treatment, the levels of serum ECP, LPO and FeNO in the two groups were lower than those before treatment; the levels of observation group were lower than those of control group(all P＜0.05). There was no significant difference in the incidence of rash, nausea, hoarseness, headache and throat discomfort between the two groups (all P＞0.05). ConclusionThe combination of montelukast sodium tablets and budesonide suspension can improve the curative effect of bronchial asthma, promote the improvement of symptoms, reduce airway inflammation, reduce the expression levels of serum ECP, LPO and FeNO, and does not increase the adverse reactions.