| Objective: The research aimed to analysis and compare the clinical efficacy of inhaling budesonide combined with terbutaline,inhaling budesonide combined with terbutaline and ipratropium bromide for the treatment of patients with pediatric asthma in acute episode and chronic persistent respectively,evaluate the improvement condition of clinical symptoms?lung function and adverse reactions to provide clinical evidence for treatment pediatric asthma.Methods: Patients with pediatric asthma in acute episode During the period from Dec.2015 to Aug.2016,74 patients ages 6 to 10 years with moderate asthma in acute episode were chosen from Women and Children's Health Care Hospital of Linyi,and were randomly divided into 2 groups,namely,control group and treatment group.Based on routine treatments such as oxygen therapy and cough expectorant,patients in control group received the following treatments: Patients with weight below 20 kg were given budesonide 1.0 mg and terbutaline 2.5 mg.The others with weight over 20 kg were given budesonide 1.0 mg and terbutaline 5.0 mg.While for patients in treatment group,patients below 20 kg were given budesonide 1.0 mg,terbutaline 2.0 mg and ipratropium bromide 0.25 mg;Those some over 20 kg were given budesonide 1.0 mg,terbutaline 2.5 mg and ipratropium bromide 0.5 mg.The medicines were delivered in every 6 hours and one week was set as a course of treatment.In this process,total effective rate,clinical score,the hospitalization time,disappearance time of clinical symptoms,heart rate and respiratory rate were observed.The lung function indexes and laboratory indexes were tested and the clinical efficacy was compared between the 2 groups.Patients with pediatric asthma in chronic persistent 73 children ages 6 to 10 years with asthma in chronic persistent were randomly divided into treatment group and control group.Aerosol medicines and doses of the 2 groups were the same as the treatment group and control group in acute episode,in this case,medicines were given 2 times a day and seven days was set as a course of treatment.Disappearance time of clinical symptoms,the hospitalization time,total effective rate,the incidence of nocturnal asthma,heart rate and respiratory rate and nocturnal asthma were observed as well.The lung function index and laboratory indexes were detected in order to compare the clinical efficacy.Results: Patients with pediatric asthma in acute episode 1.The total effective rate of treatment group below 20 kg and over 20 kg(93.75% and 95.24%)was higher than that of control group(50% and 58.82%),and the difference was statistically significant(p<0.05).2.For patients both below 20 kg and above 20 kg in treatment group,the disappearance time of clinical symptoms and length of hospital stay were shorter than those in the other group(p<0.05).3.After treatment,except wheezing score resulting from pediatric patients over 20 kg,all the other clinical scores in the treatment group were considerably lower than those in the other group(p<0.05).4.There was no significant difference in lung function index between the two groups before treatment(p>0.05).However,after treatment,FEV1%?FVC%?PEF% and FEV1/FVC% in treatment group were considerably higher than those of the other group(p<0.05).Except FVC% index from pediatric patients below 20 kg,all the other lung function index in the treatment group were improved obviously after treatment(p<0.05).5.There was no significant difference in laboratory indexes between the two groups before treatment(p>0.05).After treatment,except EOS% index resulting from pediatric patients over 20 kg,other laboratory indexes of the treatment group were lower than those of control group(p<0.05).6.There was no significant difference in heart and respiratory rate between the two groups before treatment(p>0.05).After treatment,heart rate and respiratory rate in treatment group were considerably lower than those of the other group(p<0.05).Patients with pediatric asthma in chronic persistent 1.The total effective rate in the treatment group below 20 kg and over 20 kg(94.12% and 100%)were higher than those in the control group(57.89% and 76.47%)(p<0.05).2.For patients in treatment group with weights less than 20 kg,the disappearance time of clinical symptoms and length of hospital stay were shorter than those in the other group(p<0.05).While,in terms of patients in treatment group with weights more than 20 kg,the disappearance time of cough and length of hospital stay were shorter than those in the other group(p<0.05).3.There was no significant difference in lung function index between the two groups before treatment(p>0.05).After treatment,except FEV1% index resulting from pediatric patients below 20 kg,the other lung function indexes in the treatment group were higher than those in the other group(p<0.05).After treatment,FEV1/FVC% in treatment group and PEF% resulting from pediatric patients below 20 kg were improved obviously(p<0.05).4.There was no significant difference in laboratory indexes between the two groups before treatment(p>0.05).After treatment,CRP in treatment group and EOS% index resulting from pediatric patients over 20 kg were lower than those of control group(p>0.05).After treatment,Ig E?CRP and EOS% indexes of the treatment group were decreased obviously(p<0.05).5.There was no significant difference in heart rate and respiratory rate between the two groups before treatment(p>0.05).After treatment,heart rate and respiratory rate in treatment group were considerably lower than those of the control group(p<0.05).6.The nocturnal attack rate in treatment group below 20 kg and over 20 kg(17.65% and 20%)were lower than those in the control group(52.63% and 52.94%)(p<0.05).Conclusion: 1.The curative effect of inhaling budesonide combined with terbutaline and ipratropium bromide for pediatric asthma in acute episode is better than that of inhaling budesonide combined with terbutaline,as it can shorten disappearance time of clinical symptoms?mitigate airway inflammatory and improve lung function with less adverse reaction.2.The curative effect of inhaling budesonide combined with terbutaline and ipratropium bromide for pediatric asthma in chronic persistent is better than that of inhaling budesonide combined with terbutaline,as it can shorten disappearance time of clinical symptoms,reduce the nocturnal attack rate and improve lung function.3.It is inhaling budesonide combined with terbutaline and ipratropium bromide served as the best treatment for pediatric asthma in both acute episode and chronic persistent due to its high effectiveness and less adverse reaction. |
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