联合用药降阶梯治疗婴幼儿喘息急性发作的效果观察
[摘要]目的 觀察联合用药降阶梯疗法治疗婴幼儿喘息急性发作的临床效果。方法 选取2015年2月～2017年2月就诊于我中心儿科门诊的103例急性喘息发作的婴幼儿作为研究对象，随机分为两组，均采取综合治疗。观察组52例，采用降价梯疗法，口服泼尼松0.5 mg/（kg·d），3 d；按需雾化吸入硫酸沙丁胺醇溶液（2.5 mg/次）、异丙托溴胺溶液（125 μg/次）7 d；口服孟鲁斯特4 mg/d，14 d。对照组51例，采取日常门诊常见的治疗方法，雾化吸入布地奈德混悬液联合或按需雾化吸入沙丁胺醇溶液及异丙托溴胺溶液治疗至稳定期（2周）。评估两组患儿不同时间点症状体征的评分，观察两组患儿用药后2 h、3 d、5 d、7 d各症状体征改善情况及其消失天数、随访1个月内喘息复发的次数。结果 观察组喘息、咳嗽、哮鸣音改善分值明显高于对照组（P<0.05），其消失时间明显短于对照组（P<0.05），观察组1个月内喘息复发次数显著低于对照组，差异均有统计学意义（P<0.05）。两组患儿均无药物不良反应。结论 联合用药降阶梯疗法治疗婴幼儿喘息急性发作的患儿疗效显著、安全可靠。
[关键词]喘息；婴幼儿；联合用药降价梯；临床效果
[中图分类号] R72 [文献标识码] A [文章编号] 1674-4721（2018）2（b）-0065-03
Effect observation of drug combination de-escalation in the treatment of acute attack of wheezing in infants
CHEN Ai-qing ZHANG Jun-ling
Department of Pediatrics，the Second Community Health Service Center，Guanzhuang，Chaoyang District，Beijing 100070，China
[Abstract]Objective To observe the clinical effect of drug combination de-escalation in the treatment of acute attack of wheezing in infants.Methods From February 2015 to February 2017，103 infants with acute attack of wheezing in outpatient department of pediatrics in our center were selected as research objects.They were randomly divided into two groups.The comprehensive treatment was applied in both groups.In the observation group（n=52），de-escalation therapy was used，0.5mg/（kg·d） Prednisone for oral administration for 3 d，Salbutamol Sulfate solution for aerosol inhalation as required （2.5 mg each time），Ipratropium Bromide solution （125 μg each time for 7 d），and oral administration of 4 mg/d Montelukast for 14 d.In the control group （n=51），common treatments in clinic were used，like aerosol inhalation of Budesonide Suspension combined with or Inhalation of Salbutamol solution and Ipratropium Bromide solution as required to the stable period （2 weeks）.The scores of symptoms and signs at different time points in the two groups were evaluated.The improvement of symptoms and signs 2 h，3 d，5 d，7 d after medication，disappearing time，and recurrent frequency of wheezing within one month follow up were observed.Results In the observation group，the scores of improving wheezing，cough，and wheezing rale were higher than those in the control group （P<0.05）.The disappearing time of these symptoms and signs was shorter compared with that in the control group （P<0.05）.The recurrent frequency in the observation group within one month follow up was significantly lower than that in the control group，the difference was statistically significant （P<0.05）.There was no drug adverse reaction in the two groups.Conclusion Drug combination de-escalation in the treatment of acute attack of wheezing in infants is remarkable on effect，safe and reliable.