目的 探討孟魯司特鈉聯(lián)合布地奈德對(duì)小兒哮喘的療效及其對(duì)細(xì)胞免疫的影響。方法 選取延安大學(xué)附屬醫(yī)院2017年1月-2019年1月120例哮喘患兒為研究對(duì)象，根據(jù)隨機(jī)法將患兒分為對(duì)照組和觀察組，每組60例。對(duì)照組患兒將吸入用布地奈德混懸液1.0 mg采用2.0 mL生理鹽水溶解后以氧氣為驅(qū)動(dòng)力進(jìn)行霧化吸入治療，流量控制在6 L/min以內(nèi)，2次/d，15 min/次。觀察組患兒在對(duì)照組的基礎(chǔ)上口服孟魯司特鈉咀嚼片，5 mg/次，1次/d。兩組連續(xù)治療2周。觀察兩組患者的臨床療效，同時(shí)比較兩組治療前后的、癥狀評(píng)分、肺功能指標(biāo)及免疫功能指標(biāo)水平。結(jié)果 治療后，對(duì)照組總有效率為78.33%，顯著低于觀察組的93.33%（P<0.05）。治療后，兩組日間及夜間癥狀評(píng)分均顯著降低（P<0.05），且觀察組顯著低于對(duì)照組（P<0.05）。治療后，兩組第1秒用力呼氣容積（FEV₁）、用力肺活量（FVC）、呼氣峰流速（PEF）和FEV₁/FVC水平均明顯升高（P<0.05），且觀察組各肺功能指標(biāo)均顯著優(yōu)于對(duì)照組（P<0.05）。治療后，兩組CD3⁺、CD4⁺和CD4⁺/CD8⁺水平均顯著升高（P<0.05），且觀察組CD3⁺、CD4⁺和CD4⁺/CD8⁺水平明顯高于對(duì)照組（P<0.05）。結(jié)論 孟魯司特鈉聯(lián)合布地奈德可有效改善患兒臨床癥狀及肺功能，正向調(diào)節(jié)機(jī)體免疫水平，療效確切，在小兒哮喘治療中具有較高的應(yīng)用價(jià)值。

Objective To investigate the effect of montelukast sodium combined with budesonide on childhood asthma and its effect on cellular immunity. Methods A total of 120 asthmatic children from January 2017 to January 2019 in the Affiliated Hospital of Yan'an University were selected as the research objects. According to the random method, the children were divided into the control group and the observation group, with 60 patients in each group. In the control group, 1.0 mg of Budesonide Suspension for Inhalation was inhaled, and 2.0 mL of normal saline was dissolved, followed by atomization inhalation therapy driven by oxygen. The flow rate was controlled within 6 L/min, twice daily, and 15 min/time. Children in the observation group were po administered with Montelukast Sodium Chewable Tablets on the basis of the control group, 5 mg/time, once daily. Patients in two groups were treated continuously for 2 weeks. The clinical efficacy in two groups was observed, and the levels of symptom scores, lung function indicators, and immune function indicators before and after treatment were compared. Results After treatment, the total effective rate of the control group was 78.33%, which was significantly lower than 93.33% of the observation group (P<0.05). After treatment, the daytime and nighttime symptom scores of two groups were significantly decreased (P<0.05), and the observation group was significantly lower than those in the control group (P<0.05). After treatment, the levels of FEV₁, FVC, PEF, and FEV₁/FVC in two groups were significantly increased (P<0.05), and the pulmonary function indexes in the observation group were significantly better than those in the control group (P<0.05). After treatment, the levels of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ in two groups were significantly increased (P<0.05), and the levels of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ in the observation group were significantly higher than those in the control group (P<0.05). Conclusion Montelukast sodium combined with budesonide can effectively improve the clinical symptoms and lung function of children, positively regulate the immune level of the body, with an exact effect, and has a high application value in the treatment of asthma in children.

R974

中華國(guó)際科學(xué)交流基金會(huì)專(zhuān)項(xiàng)基金資助項(xiàng)目（Z2018LSXB009）