目的 觀察扎魯司特聯(lián)合沙丁胺醇治療兒童支氣管哮喘的臨床療效。方法 選取2013年4月—2014年10月中國海洋石油南海西部醫(yī)院收治的支氣管哮喘患兒105例,隨機(jī)分為對照組(51例)和治療組(54例)。對照組將0.5 mL吸入用硫酸沙丁胺醇溶液用生理鹽水稀釋至2.5 mL,氧氣驅(qū)動霧化吸入,氧流量為6～8 L/min,吸入時間為3～5 min/次,3次/d。治療組在對照組的基礎(chǔ)上口服扎魯司特片,1片/次,2次/d。兩組均連續(xù)治療15 d。觀察兩組的臨床療效,同時比較兩組患兒治療前后的外周血腫瘤壞死因子(TNF-α)、白介素6(IL-6)、免疫球蛋白E(IgE)、一秒用力呼氣容積(FEV₁)/用力肺活量(FVC)、呼氣峰流量(PEF)的變化。結(jié)果 治療后,對照組和治療組的總有效率分別為72.55%、92.59%,兩組比較差異有統(tǒng)計學(xué)意義(P <0.05)。治療后,兩組患兒TNF-α、IL-6、IgE水平均較治療前顯著降低,FEV₁/FVC、PEF顯著升高,同組治療前后差異有統(tǒng)計學(xué)意義(P <0.05);且治療組這些觀察指標(biāo)的改善程度優(yōu)于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P <0.05)。結(jié)論 扎魯司特聯(lián)合沙丁胺醇治療兒童支氣管哮喘具有較好的臨床療效,可抑制炎癥因子的表達(dá),改善患兒肺功能,具有一定的臨床推廣應(yīng)用價值。

Objective To explore the clinical effects of zafirlukast combined with salbutamol in treatment of bronchial asthma of children. Methods Patients (105 cases) with bronchial asthma in the China Offshore Oil Nanhai Westen Hospital from April 2013 to October 2014 were randomly divided into control (n= 51) and treatment (n= 54) groups. Patients in control group were oxygen atomization inhaled with Salbutamol Sulfate Inhalation Solution 0.5 mL which was diluted to 2.5 mL with physiological saline, and the oxygen flow rate was 6 — 8 L/min, while the suction time was 3 — 5 min/time, three times daily. Patients in treatment group were po administered with Zafirlukast Tablets, 1 tablet/time, twice daily. Two groups were treated for 15 d. After treatment, the efficacy was evaluated, and the changes of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), immunoglobulin E (IgE), forced expiratory volume in one second (FEV₁)/ forced vital capacity (FVC), and peak expiratory flow (PEF) in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 72.55% and 92.59%, respectively, and there were differences between two groups (P < 0.05). After treatment, TNF-α, IL-6 and IgE in two groups were significantly reduced, while FEV₁/FVC and PEF in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And these indicators in treatment group improved better than those in the control group, with significant differences between two groups (P < 0.05). Conclusion Zafirlukast combined with salbutamol has good clinical effect in treatment of bronchial asthma of children, can inhibit the expression of inflammatory cytokines, and can improve lung function, which has a certain clinical application value.