吸入丙酸氟替卡松治疗儿童咳嗽变异性哮喘研究

目的：观察并比较不同疗程丙酸氟替卡松吸入治疗儿童咳嗽变异性哮喘的疗效、复发率及安全性。方法101例咳嗽变异性哮喘患儿随机分为A、B、C三组,三组均采用丙酸氟替卡松气雾剂吸入治疗,治疗疗程分别为2月、6月、9月。治疗期间随访评价疗效及治疗依从性。停药后随访6个月评价记录咳嗽变异性哮喘复发情况。治疗前后行骨密度、血皮质醇测定及心电图检查评价其安全性。结果三组患儿咳嗽症状均得到有效控制,疗效差异无统计学意义(H=5．2894,P=0．0710)。 A组停药6个月复发率高于B、C组(χ2=4．8581,P=0．0275；χ2=4．4826,P=0．0342),B、C组停药后复发率差异无统计学意义(χ2=0．0222,P=0．8814)。三组治疗前后骨密度、血皮质醇水平差异无统计学意义,心电图检查无异常,未发生声音嘶哑、口腔念珠菌病等局部不良反应。结论丙酸氟替卡松吸入治疗儿童咳嗽变异性哮喘效果良好,且中长疗程方案(6个月)不仅疗效更好,停药复发率更低。

Inhalation fluticasone propionate in treatment of children with cough variant asthma

Objective To observe and compare the clinical efficacy,recurrence rate and safety of differ-ent courses of inhalation fluticasone propionate in treatment of children with cough variant asthma. Methods A total of 101 children with cough variant asthma in our hospital were randomly divided into three treatment groups,all with the same therapy drug -fluticasone propionate and with the treatment time of two months, six months and nine months respectively. Clinical efficacy and treatment compliance were followed up during the treatment. After discontinuation,observation for the relapse of cough was followed up for 6 months. In inhalation therapy before and after,bone mineral density( BMD) and blood cortisol,electrocardiogram were monitored re-spectively to observe its safety. Results Three groups of children with cough were all get effective control,with no significant difference(H=5. 2894,P=0. 0710). The two months treatment group(A group)was more easy to relapse than the six months treatment group( B group) and the nine months treatment group( C group) after drug withdrawal,statistically significant(χ2 =4. 858 1,P=0. 027 5;χ2 =4. 482 6,P=0. 034 2). But after drug with-drawal,there was no significant difference in the rate of relapse in B and C group(χ2 =0. 022 2,P=0. 881 4). There were few changes in laboratory values about morning serum cortosol concentrations. There was no signifi-cant decrease in BMD after treatment. No other adverse events were observed in this study. Conclusion Flutica-sone propionate inhalation treating children cough variant asthma has good effection. A long period of treatment scheme(6 months)has better curative effect and lower recurrence rate after drug withdrawal.