目的 研究孟魯斯特聯(lián)合布地奈德和特布他林治療哮喘急性發(fā)作的臨床療效。方法 選取2012年5月-2014年5月商洛市中心醫(yī)院收治的支氣管哮喘急性發(fā)作患者100例,隨機(jī)分為對照組和治療組,每組各50例。對照組在對癥治療的基礎(chǔ)上給予霧化吸入布地奈德氣霧劑,0.5 mg/次,3次/d;同時口服硫酸特布他林片,2.5 mg/次,3次/d。治療組在對照組基礎(chǔ)上口服孟魯司特鈉咀嚼片,10 mg/次,1次/d。兩組均連續(xù)治療7 d。觀察兩組的臨床療效,比較兩組癥狀消失時間、哮喘發(fā)作頻率、肺功能改善情況。結(jié)果 治療后,對照組和治療組的總有效率分別為88.0%、98.0%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05)。治療組的咳嗽消失時間、濕啰音消失時間、喘息消失時間、哮鳴音消失時間、日間和夜間發(fā)作頻率具顯著短于對照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05)。治療后,兩組患者FEV1占預(yù)計(jì)值的百分比(FEV1%Pred)、用力吸氣肺活量(FVC)、呼氣流量峰值(PEF)均顯著升高,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05);且治療后治療組FEV1%Pred、FVC、PEF高于對照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05)。結(jié)論 孟魯斯特聯(lián)合布地奈德和特布他林治療哮喘急性發(fā)作具有較好的臨床療效,可有效改善哮喘急性發(fā)作患者的肺功能和臨床癥狀,具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical efficacy of montelukast combined with budesonide and turbutaline in treatment of acute attack of asthma. Methods Patients (100 cases) with acute attack of asthma in Shangluo Central Hospital from May 2012 to May 2015 were randomly divided into control and treatment groups, and each group had 50 cases. The patients in the control group were atomization inhaled with Budesonide Aerosol on the basis of symptomatic treatment, 0.5 mg/time, three times daily, and they were also po administered with Terbutaline Sulphate Tablets, 2.5 mg/time, three times daily. The patients in the treatment group were po administered with Montelukast Sodium Chewable Tablets on the basis of the control group, 10 mg/time, once daily. Two groups were treated for 7 d. After treatment, the efficacy was evaluated, and symptoms disappearing time, frequency of asthma attack, and the improvement of lung function in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 88.0% and 98.0%, respectively, and there were differences between two groups (P < 0.05). After treatment, cough disappeared time, moist rales disappeared time, wheezing disappeared time, wheezing sound disappeared time, attack frequency of daytime and nighttime in the treatment group were shorter than those in the control group, and there were differences between two groups (P < 0.05). After treatment, FEV1%Pred, FVC, and PEF in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, FEV1%Pred, FVC and PEF in the treatment group were higher than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Montelukast combined with budesonide and turbutaline has distinct clinical effect in treatment of acute attack of asthma, and can effectively improve lung function and clinical symptoms of acute asthma patients, which has certain clinical application value.