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目的探讨匹多莫德联合孟鲁司特治疗小儿咳嗽变异性哮喘(CVA)的临床疗效及对细胞免疫和肺功能的影响。方法选取2014年6月—2015年9月威海市中心医院收治的72例CVA儿童,随机分为对照组和观察组,各36例。对照组给予单纯口服孟鲁司特治疗,观察组在对照组治疗的基础上给予口服匹多莫德治疗,两组均连续治疗3个月,治疗后随访3个月。观察两组的临床疗效及随访情况,并比较两组患儿治疗前后细胞免疫功能和肺功能的改善情况。结果观察组患儿临床治疗总有效率为94.44%,明显高于对照组的83.33%,差异有统计学意义(P<0.05);治疗3个月后,观察组患者CD4~+、CD8~+水平和CD4~+/CD8~+比值分别为(42.85±4.93)%、(23.71±2.96)%、(1.80±0.27),与对照组比较差异有统计意义(P<0.05);观察组患儿咳嗽症状评分为(2.07±0.24)分,明显低于对照组;观察组患儿第1秒用力呼气量和峰值呼气流速分别为(3.95±0.38)L,(6.18±0.73)L/s,明显高于对照组,差异有统计学意义(P<0.05);观察组患儿随访期内哮喘平均发作次数、发作持续时间及呼吸道感染发生次数均明显低于对照组(P<0.05)。结论匹多莫德联合孟鲁司特治疗小儿CVA的疗效确切,能够有效改善患儿的细胞免疫功能和肺功能。
Objective To investigate the clinical efficacy of pidotimod combined with montelukast in the treatment of children with cough variant asthma (CVA) and its effects on cellular immunity and pulmonary function. Methods Seventy-two CVA children admitted to Weihai Central Hospital from June 2014 to September 2015 were randomly divided into control group and observation group, with 36 cases in each group. The control group was treated with montelukast alone, and the observation group was given pidotimod on the basis of the control group. Both groups were treated for 3 months continuously and were followed up for 3 months. The clinical efficacy and follow-up of the two groups were observed. The improvement of cellular immune function and pulmonary function before and after treatment were compared between the two groups. Results The total effective rate of clinical treatment in observation group was 94.44%, which was significantly higher than that in control group (83.33%), the difference was statistically significant (P <0.05). After 3 months of treatment, CD4 ~ +, CD8 + (42.85 ± 4.93)%, (23.71 ± 2.96)% and (1.80 ± 0.27), respectively, which were significantly different from those in the control group (P <0.05). The levels of CD4 ~ + / CD8 ~ The cough symptom score was (2.07 ± 0.24) points, which was significantly lower than that of the control group. The forced expiratory volume and peak expiratory flow rate in the observation group were (3.95 ± 0.38) L and (6.18 ± 0.73) L / s , Significantly higher than that of the control group (P <0.05). The mean number of asthma attacks, duration of episodes and number of respiratory infections during the follow-up period in the observation group were significantly lower than those in the control group (P <0.05). Conclusion Pidotimod montelukast treatment of children with CVA exact effect, can effectively improve children’s cellular immune function and lung function.