摘要
目的探究布地奈德+沙丁胺醇联合肺部康复训练对儿童重度支气管哮喘急性发作的应用价值。方法前瞻性选取2018年1月至2019年12月唐山市妇幼保健院收治的儿童重度支气管哮喘急性发作患儿108例,按照随机数字表法分为对照组(n=54)和观察组(n=54),其中对照组给予布地奈德、沙丁胺醇治疗,观察组在对照组基础上实施肺部康复训练。连续治疗1个月后比较临床症状消失时间、肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)及FEV1/FVC]、血清炎症因子[白细胞介素(IL)-6、IL-18及肿瘤坏死因子-α(TNF-α)]及呼出气一氧化氮水平、不良反应发生情况。结果观察组咳嗽、呼吸困难、肺部啰音、喘息等临床症状消失时间(6.34±1.56)、(1.76±0.80)、(3.24±1.03)、(2.65±0.87)d,均短于对照组[(8.12±2.15)、(3.83±1.02)、(4.51±1.32)、(3.84±1.11)d],差异均有统计学意义(P<0.05)。与治疗前比较,治疗后两组患儿肺功能改善情况均改善,且观察组FEV1、FVC、FEV1/FVC为(0.82±0.25)L、(1.20±0.42)L、(68.33±13.71),均高于对照组[(0.66±0.18)L、(1.02±0.37)L、(64.71±12.15)],差异均有统计学意义(P<0.05)。与治疗前比较,治疗后患儿血清炎症因子及呼出气一氧化氮水平下降,且观察组IL-6、IL-18、TNF-α、一氧化氮水平为(67.21±6.58)pg/mL、(227.56±18.35)pg/mL、(0.90±0.17)ng/L、(12.32±2.97)ppb,均低于对照组[(79.82±7.21)pg/mL、(285.36±20.16)pg/mL、(1.21±0.15)ng/L、(16.03±3.28)ppb],差异均有统计学意义(P<0.05)。对照组与观察组不良反应发生率(14.81%vs.11.11%)比较,差异无统计学意义(P>0.05)。结论布地奈德+沙丁胺醇治疗联合肺部康复训练可显著提高儿童重度支气管哮喘急性发作患儿肺功能,改善血清炎症因子水平,降低呼出一氧化氮水平,从而加快患儿康复,安全性更高。
Objective To explore the application value of budesonide+salbutamol combined with pulmonary rehabilitation training in children with severe bronchial asthma acute attack.Methods A total of 108 children with severe bronchial asthma acute attack who were admitted to Tangshan Maternal and Child Health Hospital from January 2018 to December 2019 were prospectively selected and divided into the control group(n=54)and the observation group(n=54)according to the random number table method.The control group was treated with budesonide and salbutamol.The observation group received pulmonary rehabilitation training on the basis of the control group.The clinical symptoms disappeared time,pulmonary function indicators[forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1)and FEV1/FVC],serum inflammatory factors[interleukin(IL)-6,IL-18 and tumor necrosis factor-α(TNF-α)]and exhaled nitric oxide levels,and the incidence of adverse reactions were compared after 1 month of continuous treatment.Results The disappearance time of cough,dyspnea,pulmonary rales,wheezing and other clinical symptoms in the observation group were(6.34±1.56)d,(1.76±0.80)d,(3.24±1.03)d,and(2.65±0.87)d,which were shorter than those in the control group[(8.12±2.15)d,(3.83±1.02)d,(4.51±1.32)d,(3.84±1.11)d],the differences were statistically significant(P<0.05).Compared with before treatment,the improvement of lung function in the two groups were improved after treatment,and the FEV1,FVC,FEV1/FVC in the observation group were(0.82±0.25)L,(1.20±0.42)L,(68.33±13.71),which were higher than those in the control group[(0.66±0.18)L,(1.02±0.37)L,(64.71±12.15)],and the differences were statistically significant(P<0.05).Compared with before treatment,the levels of serum inflammatory factors and exhaled nitric oxide decreased after treatment,and the levels of IL-6,IL-18,TNF-αand nitric oxide in the observation group were(67.21±6.58)pg/mL,(227.56±18.35)pg/mL,(0.90±0.17)ng/L,(12.32±2.97)ppb,all lower than the control group[(79.82±7.21)pg/mL,(285.36±20.16)pg/mL,(1.21±0.15)ng/L,(16.03±3.28)ppb],the differences were statistically significant(P<0.05).There was no difference in the incidence of adverse reactions between the control group and the observation group(14.81%vs.11.11%)(P>0.05).Conclusion Budesonide+salbutamol combined with pulmonary rehabilitation training can significantly improve lung function,improve serum inflammatory factors and reduce the level of exhaled nitric oxide in children with severe bronchial asthma acute attack,thus accelerating the recovery of patients with safety.
作者
刘艳丽
刘晓佳
杨晓莹
张慧玉
黄光举
杨志娟
LIU Yan-li;LIU Xiao-jia;YANG Xiao-ying(Department of Pediatrics,Tangshan Maternal and Child Health Care Hospital,Tangshan Hebei 063000,China)
出处
《临床和实验医学杂志》
2022年第14期1545-1548,共4页
Journal of Clinical and Experimental Medicine
基金
河北省2020年度医学科学研究课题计划(编号:20201473)。
