匹多莫德联合孟鲁司特对咳嗽变异性哮喘患儿细胞免疫功能影响及疗效观察.docVIP

匹多莫德联合孟鲁司特对咳嗽变异性哮喘患儿细胞免疫功能影响及疗效观察 　　[摘要] 目的 探讨匹多莫德联合孟鲁司特对咳嗽变异性哮喘（CVA）患儿细胞免疫功能的影响及疗效。 方法 选取2013年1月～2014年4月在温州医科大学附属义乌医院儿科门诊就诊的CVA患儿84例，随机分为联合组和对照组。两组患儿均按照全球哮喘防治创议（GINA）制订的方案进行治疗。联合组患儿予以匹多莫德联合孟鲁司特，其中孟鲁司特钠咀嚼片5 mg/次，1次/d，连用3个月。匹多莫德颗粒0.4 mg/次，2次/d，2周后改为0.4 g/d，共连用3个月。对照组患儿予以单纯的孟鲁司特治疗，剂量、方法与疗程与联合组相同。观察并比较两组患儿治疗前和治疗3个月后细胞免疫功能指标的变化，并比较其临床疗效及药物不良反应情况。 结果 治疗3个月后，两组患儿CD4+水平和CD4+/CD8+比值[（42.84±4.92）%、（1.81±0.26）、（37.82±4.52）%、（1.37±0.21）]较前[（32.87±3.93）%、（1.06±0.17）、（33.02±4.02）%、（1.08±0.19）]均有不同程度上升（t = 2.87、3.58、2.29、2.45，P 0.05）。 结论 匹多莫德联合孟鲁司特治疗CVA患儿的效果显著，且安全性较佳，其作用机制可能与其能纠正患儿外周血T淋巴细胞亚群紊乱，上调血清CD4+水平和CD4+/CD8+比值，下调CD8+水平，激活并增强其细胞免疫功能密切相关。 　　[关键词] 咳嗽变异性哮喘；匹多莫德；孟鲁司特；细胞免疫功能 　　[中图分类号] R725.622.5 [文献标识码] A [文章编号] 1673-7210（2015）01（b）-0082-04 　　[Abstract] Objective To discuss the influence and curative effect of Montelukast and Pidotimod on cellular immune function of children with cough variant asthma （CVA）. Methods Eighty four cases of children with CVA collected by the Yiwu Hospital Affiliated to Wenzhou Medical University from January 2013 to April 2014 were selected and divided into combination group and control group at random. The children in two groups were both given the medical treatment in accordance with the therapeutic regimen created by Global Initiative for Asthma （GINA）. The children in combination group were given Pidotimod and Montelukast， Montelukast was 5 mg per time once a day for 3 months， and Pidotimod was 0.4 g per time twice a day， which was changed to 0.4 g per day for 3 months. The children in control group were only given Montelukast， the dose， method and courses were the same as the combination group. The changes of cellular immune function of children in two groups before and after 3 months medical treatment were observed， and the curative effect and drug adverse reaction （DAR） were carried on as well. Results After 3 months medical treatment treatment， CD4+ level and CD4+/CD8+ ratio of peripheral blood of children in two groups [（42.84±4.92）%， （