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目的探讨舒利迭联合孟鲁司特治疗重度支气管哮喘的疗效及安全性。方法选择2011年6月——2013年6月我院收治的重度支气管哮喘患者74例,随机分为舒利迭组及联合组各37例,舒利迭组采用舒利迭治疗,50μg/250μg,2次/d,联合组在此基础上联合孟鲁司特治疗,10 mg/次,1次/晚,疗程为3个月,疗程结束时进行疗效的评价。比较两组治疗前后哮喘症状评分、肺功能,哮鸣音改善及不良反应情况。计量资料采用t检验,P<0.05为差异有统计学意义。结果治疗4周、8周时,联合组哮喘症状评分[(1.7±0.8)、(1.1±0.6)分]明显低于舒利迭组[(2.2±0.9)、(1.7±0.9)分],差异有统计学意义(P<0.05)。治疗后FVC、FEV1、PEF舒利迭组[(82.1±16.7)%、(79.6±10.2)%、(66.3±10.7)%]、联合组[(93.2±16.9)%、(87.0±12.5)%、(79.3±9.4)%]均比治疗前舒利迭组[(72.6±17.4)%、(76.6±11.2)%、(58.9±15.8)%]和联合组[(73.4±21.6)%、(79.7±12.8)%、(59.2±15.6)%]明显改善,但联合组改善程度优于舒利迭组,差异有统计学意义(P<0.05)。舒利迭组所有患者无明显不良反应发生,联合组有2例出现声音嘶哑,经对症处理后消失。结论舒利迭联合孟鲁司特具有协同增效作用,可较快的控制重度哮喘的临床症状,改善肺功能,且安全可靠,这为难治性哮喘提供了一个新的治疗途径。
Objective To investigate the efficacy and safety of seretide combined with montelukast in the treatment of severe bronchial asthma. Methods Seventy-four patients with severe bronchial asthma admitted to our hospital from June 2011 to June 2013 were randomly divided into two groups: seretide and combination group, 37 cases, and seretide group treated with seretide. 50 μg / 250 μg , 2 times / d. The combined group was treated with montelukast, 10 mg / time, once / night on the basis of the above. The course of treatment was 3 months. The curative effect was evaluated at the end of treatment. The scores of asthma symptoms, lung function, wheeze improvement and adverse reactions were compared between the two groups before and after treatment. Measurement data using t test, P <0.05 for the difference was statistically significant. Results The score of asthma in the combined group was significantly lower than that in the seretide group [(2.2 ± 0.9), (1.7 ± 0.9) points] at 4 weeks and 8 weeks after treatment [(1.7 ± 0.8), (1.1 ± 0.6) The difference was statistically significant (P <0.05). After treatment, FVC, FEV1 and PEF group [(82.1 ± 16.7)%, (79.6 ± 10.2)%, (66.3 ± 10.7)%] , (79.3 ± 9.4)%] were significantly higher than those in the pre-treatment group (72.6 ± 17.4%, 76.6 ± 11.2%, 58.9 ± 15.8%, and 73.4 ± 21.6% 79.7 ± 12.8%, (59.2 ± 15.6)%], but the improvement in the combined group was better than that in the seretide group. The difference was statistically significant (P <0.05). All patients in the Seretide group had no obvious adverse reactions, and 2 patients in the combined group had hoarseness and disappeared after symptomatic treatment. Conclusion The combination of seretide and montelukast has a synergistic effect, which can quickly control the clinical symptoms of severe asthma, improve lung function, and is safe and reliable, which provides a new therapeutic approach for refractory asthma.