乙酰半胱氨酸联合丙酸倍氯米松雾化吸入治疗毛细支气管炎的临床效果-1

PAGE/r/nPAGE/r/n8/r/n炎的临床效果/r/n乙酰半胱氨酸联合丙酸倍氯米松雾化吸入治疗毛细支气管炎的临床效果/r/n史军然杜杰静高虹/r/n[摘要]目的探討乙酰半胱氨酸联合丙酸倍氯米松雾化吸入治疗毛细支气管/r/n20XX/r/n2/r/n～20XX/r/n2/r/n306/r/nA/r/n（106例/r/nB/r/n（100/r/n）和对照组（100/r/n。所有患儿均给予常规治疗措施。/r/nA/r/nB/r/nA/r/nB/r/nB/r/n（P0.05/r/n可缩短患儿的临床症状消失时间，提高临床治疗效果，不良反应少，安全性好，值得临床推广应用。/r/n[关键词]毛细支气管炎;雾化吸入;乙酰半胱氨酸;丙酸倍氯米松[Abstract]ObjectiveToinvestigatetheclinicaleffectof/r/n/r/ninhalationofAcetylcysteinecombinedwithBeclomethasoneDipropionateinthetreatmentofcapillarybronchitis.MethodsAtotalof306patientswithcapillarybronchitistreatedinourhospitalfromFebruary20XXtoFebruary20XXwereselectedastheresearchsubjects.Accordingtothesequenceofelectronicmedicalrecords，theyweredividedintotreatment-Agroup/r/n/r/n（n=106/r/n，treatment-Bgroup/r/n/r/n（n=100/r/n，andcontrolgroup（n=100）.Allchildrenweregivenroutine/r/ntreatment.In/r/n/r/nthe/r/n/r/ntreatment-A/r/n/r/ngroup/r/n，/r/n/r/naerosol/r/n/r/ninhalation/r/n/r/nof/r/n/r/nAcetylcysteine/r/ncombinedwithBeclomethasoneDipropionatewasused.Inthetreatment-B/r/ngroup，/r/naerosol/r/ninhalation/r/nof/r/nSalbutamol/r/ncombined/r/nwith/r/nBeclomethasoneDipropionatewasused.Inthecontrolgroup，aerosolinhalationofSalbutamol/r/n/r/nalone/r/n/r/nwas/r/n/r/napplied./r/n/r/nThe/r/n/r/ndisappearance/r/n/r/ntime/r/n/r/nof/r/n/r/npanting，/r/nwheezingsoundandthreeconcavesignsinthethreegroupswascompared.Thetreatmenteffectandtheoccurrenceofadversereactionswereobserved.ResultsThedisappearancetimeofpanting，wheezingsoundandthreeconcavesignsinthetreatment-Agroupwasshorterthanthat/r/nofthetreatment-Bgroupandthecontrolgro/r/np/r/nthedisappearancetime/r/nofpanting，wheezingsoundandthreeconcavesignsinthetreatment-Bgroupwasshorterthanthatinthecontrolgroup，thedifferenceswerestatisticallysignificant（P0.05）.Noseriousadverse/r/nreactionsoccurredduringthetreatmentofthethreegroupsofchildren.ConclusionAerosolinhalationofAcetylcysteinecombinedwithBeclomethasoneDipropionateinthetreatmentofcapillarybronchitiscanshortenthedisappearancetimeofclinical/r/nsymptoms，/r/nimprovethe/r/nclinical/r/ntreatment/r/neffectinfewadversereactionsandgoodsafety，/r/nwhichis/r/nworthyof/r/nclinicalpromotionandapplication./r/n[Key/r/nwords]/r/nCapillary bronchitis; Aerosol inhalation;/r/nAcetylcysteine;BeclomethasoneDipropionate/r/n2/r/n2～6/r/n、听诊呼气相延长、可闻及喘鸣、细湿啰音为主要临床表现;呼吸道合胞病毒/r/n（RSV）/r/n是引起毛细支气管炎最常见的病原/r/n[1]。婴幼儿呼/r/n危及生命[1]。如何迅速有效地控制缓解患儿急性期喘憋症状，减轻气道炎症反/r/n-3]雾化吸/r/n306/r/n资料与方法/r/n一般资料/r/n20XX/r/n2/r/n～20XX/r/n2/r/n306/r/nA/r/n（106/r/nB/r/n（100例）和对照组（100/r/nA/r/n64/r/n42/r/n3/r/n～2/r/nB/r/n56/r/n44/r/n3/r/n～2/r/n54/r/n46/r/n3/r/n～2/r/n（7.0±2.5）个月。三组患儿的性别、年龄等一般资料比较，差异无统计学意义/r/nP>0.05/r/n均知晓本研究情况并签署知情同意书。/r/n[1];②/r/n3/r/n～2/r/n囊性纤维化患儿;④先天性气道畸形患儿;⑤早产（孕龄/r/n方法/r/n三组患儿均给予常规监测病情变化、对症和支持等常规治疗措施。/r/nA/r/n（规格：3/r/n/r/nml∶0.3/r/n/r/ng，Zambon/r/n/r/nS.P.A/r/n司，进口药注册证号：Hxxxx，生产批号：xxxx/r/n，0.3g//r/n2/r/n氯米松（规格：2/r/nFarmaceutici/r/n证号：Hxxxx，生产批号：xxxx）治疗，0.8mg//r/n2/r/nB/r/n（规格：2/r/nml∶2.5mg，上海信谊/r/nmg//r/n2/r/n对照组患儿给予沙丁胺醇雾化吸入治疗。/r/n观察指标及评价标准/r/nA/r/nB/r/n（/r/n时间、肺部听诊喘鸣音消失时间、三凹征消失时间/r/n，观察三组患儿的治疗效果及不良反应发生情况。/r/n7d/r/n7d/r/n[4]/r/n。治疗总有效率/r/n=（治愈+显效+有效）例数/总例数×100%。/r/n统计学方法/r/nSPSS/r/n19.0/r/nt/r/nχ2/r/nP/r/n结果/r/n三组患儿喘息、喘鸣音及三凹征消失时间的比较/r/n三组患儿的喘息、喘鸣音及三凹征消失时间比较，差异有统计学意义（P/r/n三组患儿治疗总有效率的比较/r/n治疗A组患儿的治疗总有效率高于治疗B组和对照组，差异均有统计学意义/r/nP0.05/r/n（/r/n2/r/n。/r/n三组患儿的不良反应发生情况/r/n三组患儿治疗过程中未发生严重不良反应。3讨论/r/n2/r/nRSV/r/n质的患儿，反复喘息发作，有发展成为婴幼儿哮喘的可能/r/n[5-7]。雾化疗法具有重要意义[8-9]。雾化吸入治疗具有作用直接、迅速，操作简便，患儿无痛苦，/r/n（/r/n地奈德和丙酸倍氯米松/r/n、支气管扩张剂（吸入用异丙托溴铵、硫酸沙丁胺醇、硫酸特布他林/r/n雾化用祛痰药有吸入用乙酰半胱氨酸和氨溴索[10]。/r/nβ2/r/n[11-14]，是目前儿童喘息性疾病首/r/n78.0%，临床效果不理想。/r/nB/r/n[16]。本研究结果显示，使用丙酸倍氯/r/nB/r/nB/r/n（/r/nP0.05/r/nA/r/n（/r/n-SH）直接打断黏液糖蛋白中的双硫键/r/n（/r/nS-S/r/n，破坏/r/n（GSH）/r/n水平，依/r/nGSH/r/nA/r/nB/r/n（P/r/n值得临床推广应用。/r/n[参考文献]/r/n识/r/n20XX/r/n）[J].中华儿科杂志，20XX，53/r/n3/r/n：168-171./r/n胡波.盐酸氨溴索联合布地奈德治疗小儿支气管肺炎的临床疗效及其对C/r/n反应蛋白和白细胞计数的影响[J]./r/n70./r/n气管肺炎的疗效研究[J].山西医药杂志，20XX/r/n46（23/r/n：2906-2907./r/n.NCPAP/r/n气管炎临床效果观察[J].山东医药，20XX，57/r/n20/r/n：71-73./r/n因子水平的影响研究[J].中外医学研究，20XX/r/n17（25/r/n：41-43./r/n25-/r/nD3/r/n气管炎中的临床意义[J].中国当代医药，20XX，/r/n26（14/r/n：114-116./r/n[J].中国医药导报，20XX，15（18/r/n：72-7/r/n，91./r/n20XX/r/n）/r/n[J].临床儿科杂志，20XX，3/r/n（2/r/n：95-107./r/n制定专家组.雾化吸入疗法在呼吸疾病中的应用专家共识/r/n[J]/r/n.中华医学杂志，20X/r/n，96（34/r/n：2696-2708./r/n晋荣新，鄢毅/r/n.N-乙酰半胱氨酸与盐酸氨溴索治疗小儿支气管肺炎的疗效对比及其对免疫功能和临床症状的影响[J]./r/n120./r/n伍祥胡，梁霞，凌洁萍.异丙托溴铵溶液、沙丁胺醇、布地奈德混悬液联合雾化吸入治疗小儿毛细支气管炎的效果研究[J]./r/n3/r/n（4/r/n：114-115./r/n104/r/n[J].中国药物与临床，20X/r/n，18（6/r/n：1018-1020./r/nKose/r/nal.The/r/nefficacy/r/nof/r/nNebulizedSalbutamol/r/n，/r/nMagnesium/r/n/r/nSulfate/r/n，/r/nand/r/n/r/nSalbutamol/r/n/r/nMagnesium/r/n/r/nSulfatecombination/r/nin/r/nmoderate/r/nbronchiolitis[J].Eur/r/nJ/r/nPediat/r/nr/r/n20X/r/nX/r/n17/r/n（9/r/n：1157-1160./r/nCarsin/r/nal.Early/r/nhalt/r/nof/r/na/r/nrandomizedcontrolledstudywith3%HypertonicSalineinacutebronchiolitis[J].Respiration，20XX，94（3/r/n：251-257./r/n金英姬，張♘明.对雾化吸入激素治疗毛细支气管炎的看法/r/n[J]./r/n20XX，98/r/n（/r/n8/r/n：591./r/n李权恒，安淑华，李金英，等.丙酸倍氯米松雾化治疗毛细支气管炎的/r/n[J].中国全科医学，20XX，20（35/r/n：4438-4441./r/n宋宏玲.