孟鲁司特对咳嗽变异性哮喘FEF25%～75%FVC及FeNO影响.doc

孟鲁司特对咳嗽变异性哮喘FEF25%～75%FVC及FeNO影响 　　【摘要】 目的 评价应用孟鲁司特联合沙美特罗替卡松粉吸入剂治疗咳嗽变异性哮喘（CVA）对肺功能指标、呼出气一氧化氮（FeNO）的影响和疗效。方法 80例CVA患者， 随机分为治疗组和对照组， 各40例。治疗组给予孟鲁司特联合沙美特罗替卡松粉吸入剂治疗， 对照组单纯使用沙美特罗替卡松粉吸入剂治疗。对两组临床治疗效果、肺功能指标及FeNO进行比较。结果 治疗组总有效率100%高于对照组85%（P0.05）；用力呼出气量为25%～75%肺活量时的平均流量与用力肺活量的比值（FEF25%～75%/FVC）、FeNO明显改善， 与对照组比较， 差异有统计学意义（P0.05）。结论 孟鲁司特联合沙美特罗替卡松粉吸入剂治疗CVA疗效显著， 可明显改善气道高反应性及减轻气道炎症。 　　【关键词】 孟鲁司特；沙美特罗替卡松；咳嗽变异性哮喘；肺功能；呼出气一氧化氮 　　【Abstract】 Objective To evaluate influence and curative effect of montelukast combined with salmeterol flonase powder inhalation in the treatment of cough variant asthma （CVA） for pulmonary function indexes and fractional exhaled nitric oxide （FeNO）. Methods A total of 80 CVA patients were randomly divided into treatment group and control group， with 40 cases in each group. The treatment group received montelukast combined with salmeterol flonase powder inhalation for treatment， and the control group received single administration of salmeterol flonase powder inhalation. Clinical effects， pulmonary function indexes， and FENO of the two groups were compared. Results The treatment group had higher total effective rate as 100% than 85% of the control group （P0.05）. They had remarkable improvements in FeNO and ratio between average flow rate of forced expiratory flow as 25%～75% of vital capacity and forced vital capacity （FEF25%～75%/FVC）. The differences with the control group had statistical significance （P0.05）. Conclusion Montelukast combined with salmeterol flonase powder inhalation provides remarkably curative effect in treating CVA， and it can obviously improve bronchial hyperresponsiveness and relieve airway inflammation. 　　【Key words】 Montelukast； Salmeterol flonase； Cough variant asthma； Pulmonary function； Fractional exhaled nitric oxide 　　咳嗽变异性哮喘是常见的慢性咳嗽原因之一， 表现为气道高反应性及气道慢性炎症， 早期肺功能表现为小气道功能下降。临床上治疗药物较多， 效果差异较大。孟鲁司特是目前治疗咳嗽变异性哮喘的常用药物。并取得了较好的临床疗效。孟鲁司特通过拮抗白三烯受体， 改善气道炎性介质释放发挥治疗作用， 但对小气道功能影响鲜有报道。该研究就孟鲁司特对咳嗽变异性哮喘患者的气道炎性指标和肺功能的影响进行观察， 现将结果报告如下。 　　1 资料与方