微创埋线联合孟鲁司特钠治疗小儿咳嗽变异性哮喘:随机对照研究

发布时间：2018-05-28 09:39

本文选题：小儿咳嗽变异性哮喘 + 微创埋线　；参考：《中国针灸》2017年03期

【摘要】：目的:比较微创埋线联合孟鲁司特钠与单纯孟鲁司特纳治疗小儿咳嗽变异性哮喘(CVA)的临床疗效差异。方法:将240例患儿随机分为观察组和对照组,每组120例。排除脱落病例后观察组101例、对照组105例纳入统计。对照组口服孟鲁司特钠咀嚼片,每次5mg,每日1次,睡前服用,治疗3个月;观察组在对照组治疗基础上采用微创埋线,穴取肺俞、膻中、定喘、足三里,第1个月埋线2次,以后每月埋线1次,共治疗3个月。两组均于治疗后9个月随访。观察两组患儿治疗前后咳嗽症状积分、血清免疫球蛋白(IgE、IgG、IgA)、血小板活化因子(PAF)水平,治疗前、治疗后、随访时肺大气道功能指标[最大呼气流速峰值(PEF)、第1s最大呼气量(FEV1)]、小气道功能指标[剩余25%肺活量时的用力呼气流速(MEF25%)、剩余50%肺活量时的用力呼气流速(MEF50%)、剩余75%肺活量时的用力呼气流速(MEF75%)、中段呼气流速(MEF25%~75%)]的变化情况,并评定两组总体疗效。结果:观察组总有效率为93.1%(94/101),优于对照组的87.6%(92/105,P0.05);观察组痊愈患儿咳嗽停止时间为(10.38±2.64)d,早于对照组的(10.72±2.60)d(P0.05);治疗后两组患儿咳嗽症状积分均较治疗前明显下降(均P0.05),且观察组优于对照组(P0.05);随访时观察组复发次数为(1.43±1.20)次,少于对照组的(1.91±1.71)次(P0.05)。2治疗后两组IgA、IgG较治疗前提高,IgE、PAF较治疗前降低,除对照组IgG外,其余各项指标治疗前后差异均有统计学意义(均P0.05),且观察组改善更显著(均P0.05)。3治疗后、随访时两组肺大气道功能指标均较治疗前明显升高(均P0.05);治疗后、随访时组间比较差异无统计学意义(均P0.05);4治疗后两组肺小气道功能各项指标与治疗前比较差异无统计学意义(均P0.05),随访时均较治疗前提高(均P0.05),且观察组优于对照组(均P0.05)。结论:微创埋线联合孟鲁司特钠治疗小儿CVA临床疗效确切,可改善机体免疫及微循环,在小气道功能改善等方面明显优于单纯口服孟鲁司特钠。
[Abstract]:Aim: to compare the clinical efficacy of minimally invasive catgut implantation combined with montelukast sodium and montelukast alone in the treatment of cough variant asthma in children. Methods: 240 children were randomly divided into observation group and control group, 120 cases in each group. The observation group (101 cases) and the control group (105 cases) were included in the statistics. The control group was treated with oral montelukast sodium chewable tablets, 5 mg per day, once a day, before bedtime for 3 months, while the observation group was treated with minimally invasive catgut embedding on the basis of the treatment in the control group. After that, embedding thread once a month for 3 months. Both groups were followed up 9 months after treatment. Before and after treatment, the scores of cough symptoms, the levels of serum IgGG, platelet activating factor (PAF), and the levels of IgG and PAF were observed before and after treatment. Pulmonary airway function index [maximum expiratory flow peak value (PEF), maximum expiratory volume (FEV1) at 1 s], small airway function index [forced expiratory flow rate at the remaining 25% vital capacity], forced expiratory flow rate at the remaining 50% vital capacity (MEF50), and the remaining 75% The changes of forced expiratory flow (MEF75) and MEF25 (MEF25) in vital capacity, The total curative effect of the two groups was evaluated. Results: the total effective rate of the observation group was 93.1 / 101g / 101g, which was better than that of the control group (87.6%), and the cough stopping time of the observation group was 10.38 卤2.64 days, earlier than that of the control group (10.72 卤2.60 d). After treatment, the cough symptom scores of the two groups were significantly lower than those of the control group (P 0.05), and the cough symptom scores of the observation group were significantly lower than those of the control group (P 0.05), and the cough stopping time of the observation group was 10.38 卤2.64 days earlier than that of the control group (P 0.05). The frequency of recurrence in the observation group was 1.43 卤1.20 times after follow-up, which was better than that in the control group (P 0.05). Compared with before and after treatment, the IgA IgG of the two groups was significantly lower than that of the control group (P 0.05 卤1.71). Except for the control group, there were significant differences in the other indexes before and after treatment (all P 0.05), and the improvement in the observation group was more significant (all P 0.05.3), and the difference between the two groups before and after treatment was significant (P 0.05.3, P < 0.05), but there were significant differences between the two groups before and after treatment (all P 0.05.3). At the follow-up, the pulmonary tract function in both groups was significantly higher than that before treatment (P 0.05). There was no significant difference in the pulmonary small airway function between the two groups after treatment (all P 0.05), and there was no significant difference between the two groups before treatment (all P 0.05, P 0.05), and the observation group was better than the control group (all P 0.05). Conclusion: minimally invasive catgut implantation combined with montelukast sodium is effective in the treatment of CVA in children. It can improve immunity and microcirculation, and is superior to montelukast alone in improving small airway function.
【作者单位】：郑州市中医院儿科;郑州市儿童医院;河南中医药大学第三附属医院儿科;
【基金】：河南省科技厅2013年科技攻关计划项目:132102310384 郑州市科技局2013年科技领军人才项目:131PLJRC672
【分类号】：R725.6

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