2021 年第 4 期 第 16 卷

布地奈德福莫特罗对咳嗽变异性哮喘患者气道阻力及咳嗽敏感性的影响

Effects of budesonide and formoterol on airway resistance and cough sensitivity in patients with cough variant asthma

作者：刘威威苏玉峰王欢李敏吴旭兰陈晓香

英文作者：Liu Weiwei Su Yufeng Wang Huan Li Min Wu Xulan Chen Xiaoxiang

单位：河北省廊坊市人民医院呼吸与危重症医学科065000

英文单位：Department of Respiratory and Critical Care Medicine the People′s Hospital of Langfang City Hebei Province Langfang 065000 China

关键词：咳嗽变异性哮喘；布地奈德；福莫特罗；气道阻力；咳嗽敏感性

英文关键词：Coughvariantasthma;Budesonide;Formoterol;Airwayresistance;Coughsensitivity

• 摘要：

• 目的 分析布地奈德福莫特罗吸入治疗对咳嗽变异性哮喘患者气道阻力及咳嗽敏感性的影响。方法 选取2018年8月至2020年3月河北省廊坊市人民医院收治的200例咳嗽变异性哮喘患者作为研究对象，采用随机数字表法随机分为A组（56例）、B组（69例）、C组（75例）。其中A组予布地奈德雾化吸入治疗，B组予福莫特罗雾化吸入治疗，C组予布地奈德福莫特罗吸入治疗，疗程均为24周。比较3组患者治疗前后症状、肺功能指标、血清炎症因子水平、气道阻力指标、咳嗽敏感性阈值。结果 治疗后，3组咳嗽症状评分均低于治疗前，且C组均低于A组、B组；3组莱斯特咳嗽问卷评分均高于治疗前，且C组均高于A组、B组；差异均有统计学意义（均P<0.05）。治疗后，3组最大呼气流量占预计值百分比、第1秒用力呼气容积占预计值百分比、用力肺活量占预计值百分比均高于治疗前，且C组均高于A组、B组，差异均有统计学意义（均P＜0.05）。治疗后，3组血清白细胞介素（IL）-2、肿瘤坏死因子α水平均低于治疗前，且C组均低于A组、B组；IL-10水平高于治疗前，且C组高于A组、B组，差异均有统计学意义(均P＜0.05)。治疗后，3组呼吸总阻抗、共振频率、5 Hz时呼吸阻力(R5)、R20水平低于治疗前，且C组均低于A组、B组［（0.29±0.06）kPa/（L·s）比（0.38±0.10）、（0.37±0.12）kPa/（L·s），（9.7±1.1）Hz比（11.2±1.9）、（11.2±1.9）Hz，（0.27±0.05）kPa/（L·s）比（0.36±0.10）、（0.37±0.09）kPa/（L·s），（0.22±0.06）kPa/（L·s）比（0.31±0.09）、（0.32±0.10）kPa/（L·s）］，差异均有统计学意义(均P＜0.05)。治疗后，3组辣椒素咳嗽激发2次时咳嗽敏感性阈值、辣椒素咳嗽激发≥5次时咳嗽敏感性阈值均高于治疗前，且C组均高于A组、B组［（1.95±0.51）比（1.46±0.38）、（1.53±0.34），（2.8±0.9）比（2.3±0.5）、（2.3±0.5）］，差异均有统计学意义(均P＜0.05)。结论 布地奈德福莫特罗吸入治疗能有效改善咳嗽变异性哮喘患者的临床症状，降低炎症因子水平、气道阻力及咳嗽敏感性。

• Objective To analyze the effects of budesonide and formoterol on airway resistance and cough sensitivity in patients with cough variant asthma(CVA). Methods From August 2018 to March 2020, 200 patients with CVA admitted to the People′s Hospital of Langfang City, Hebei Province were selected. The patients were randomly divided into group A (56 cases), group B (69 cases), and group C (75 cases). Group A was treated with budesonide aerosol inhalation, group B was treated with formoterol aerosol inhalation, and group C was treated with budesonide and formoterol inhalation. All patients were treated for 24 weeks. The symptom, lung function indexes, serum inflammatory factors levels, airway resistance indexes, cough sensitivity threshold were compared among the three groups before and after treatment. Results After treatment, the cough symptom scores of the three groups were lower than those before treatment, and that of group C was lower than that of group A and group B; Leicester cough questionnaire scores of the three groups were higher than those before treatment, and that of group C was higher than that of group A and group B(all P<0.05). After treatment, peak expiratory flow as a percentage of expected value, forced expiratory volume in 1 second as a percentage of expected value, and forced vital capacity as a percentage of expected value of the three group were higher than those before treatment, and those of group C were higher than those of group A and group B (all P<0.05). After treatment, serum levels of interleukins (IL)-2 and tumor necrosis factor-α of the three groups were lower than those before treatment, and those of group C were lower than those of group A and group B; IL-10 levels of the three group were higher than those before treatment, and that of group C was higher than that of group A and group B (all P<0.05). After treatment, the levels of total respiratory impedance, resonance frequency, respiratory resistance at 5 Hz (R5) and R20 were lower than those before treatment, and those of group C were lower than those of group A and group B［（0.29±0.06）kPa/（L·s） vs （0.38±0.10）,（0.37±0.12）kPa/（L·s）;（9.7±1.1）Hz vs （11.2±1.9）,（11.2±1.9）Hz;（0.27±0.05）kPa/（L·s） vs （0.36±0.10）,（0.37±0.09）kPa/（L·s）;（0.22±0.06）kPa/（L·s） vs （0.31±0.09）,（0.32±0.10）kPa/（L·s）］(all P<0.05). After treatment, cough sensitivity threshold at capsaicin cough provocation twice and cough sensitivity threshold at capsaicin cough provocation ≥ 5 times in the three groups were higher than those before treatment, and those in group C were higher than those in group A and group B［（1.95±0.51） vs （1.46±0.38）,（1.53±0.34）;（2.8±0.9） vs （2.3±0.5）,（2.3±0.5）］(all P<0.05). Conclusion Budesonide and formoterol inhalation therapy can effectively improve clinical symptoms in patients with CVA, and reduce inflammatory factors levels, airway resistance and cough sensitivity.