| Background The main clinical manifestations of PIBO are persistent coughing,wheezing,and breathing difficulties after acute lower respiratory infection,which lasts more than six weeks,There is no universally accepted formula for its treatment,and it does not work well.The disease seriously affects children’s physical health and quality of life.Purpose To investigate the efficacy of montelukast in children with post—infectious bronchiolitis obliterans.Methods Select the children were diagnosed with the PIBO in our hospital from September 2014 to May 2016,including 58 males and 12 females,aged from 3 months to 4 years,duration of 6 to 48 weeks.the two groups had no statistically significant differences in gender,age and duration.The children was divided into conventional inhalation group(group A)and montelukast combined with inhalation group(group B)according to treatment.Each group has 35 cases.The method of group A is that children in a quiet state using aircompression atomizer for inhalation treatment,and then rinse their face after completion.The drugs are,The drug for budesonide solution(manufacturer:Astra Zeneca.specifications: 2ml)1ml/time+ terbutaline solution(manufacturer: Astra Zeneca.specifications:2ml)1ml/time+isopropyl(manufacturers: Germany boehringer ingelheim.specifications:2ml)1 ml/time,2 times one day.Group B added Montelukast Sodium Tablets(manufacturers: Merck Sharp & Dohme Ltd.specifications: 4mg)on the basis of group A,4mg/d,before bedtime.Collect the clinical data of two groups after treatment for 1 months,3 months,6 months,including clinical manifestations(shortness of breath,persistent cough,wheezing,pulmonary rales),pulmonary function(VPTEF/VE,t PTEF/t E),chest CT.Result1.In group A,16 cases(45.7%)were effective and 19 cases(54.3 %)were invalid after treatment for 1 month;20 cases(57.1%)were effective and 15 cases(42.9%)were invalid after treatment for 3 months;26 cases(74.3%)were effective and 9 cases(25.7%)were invalid after treatment for 6 months.The difference was not statistically significant(P > 0.05)after the treatment of 1 month and 3 months;The difference was statistically significant(P < 0.05)after the treatment of 1 month and 6months.2.In group B,20 cases(57.1%)were effective and 15 cases(42.9 %)were invalid after treatment for 1 month;30 cases(85.7%)were effective and 5 cases(14.3%)were invalid after treatment for 3 months;33 cases(94.3%)were effective and 2 cases(5.7%)were invalid after treatment for 6 months.The difference was statistically significant(P < 0.05)after the treatment of 1 month and 3 months;The difference was statistically significant(P < 0.05)after the treatment of 1 month and 6 months.3.After 1 month,there was no significant difference in the improvement of clinical symptoms between the group A and group B(P>0.05);after 3 months and 6 months,the improvement of clinical symptoms of group B were better than group A,the difference was statistically significant(P < 0.05).4.In the chest CT of group A,2 cases(5.7%)were absorbed and 33cases(94.3 %)were not absorbed after treatment for 1 month;6 cases(17.1%)were effective and 29 cases(82.9%)were invalid after treatment for 3 months;15 cases(42.9%)were effective and 20 cases(57.1%)were invalid after treatment for 6 months.The difference was not statistically significant(P > 0.05)after the treatment of 1 month and 3 months;The difference was statistically significant(P < 0.05)after the treatment of 1month and 6 months.5.In the chest CT of group B,3 cases(8.6%)were absorbed and 32cases(91.4 %)were not absorbed after treatment for 1 month;7 cases(20.0%)were effective and 28 cases(80.0%)were invalid after treatment for 3 months;17 cases(48.6%)were effective and 18 cases(51.4%)were invalid after treatment for 6 months.The difference was not statistically significant(P > 0.05)after the treatment of 1 month and 3 months;Thedifference was statistically significant(P < 0.05)after the treatment of 1month and 6 months.6.After treatment for 1 month,3 months and 6 months,the difference was not statistically significant(P > 0.05)in the absorption of chest CT between group A and group B.7.In group A,the VPTEF/VE and t PTEF/t E of pulmonary function were20.40 ± 1.78 、 21.19 ± 1.65 before treatment;the VPTEF/VE and t PTEF/t E of pulmonary function were 21.20±1.60、22.09±1.46 after treatment for 3 months;the VPTEF/VE and t PTEF/t E of pulmonary function were 22.48±1.70、23.71±1.39 after treatment for 6 months.The difference was statistically significant(P < 0.05)after the treatment of 3months and before treatment;The difference was statistically significant(P < 0.05)after the treatment of 6 months and before treatment.8.In group B,the VPTEF/VE and t PTEF/t E of pulmonary function were21.16 ± 1.72 、 21.78 ± 1.72 before treatment;the VPTEF/VE and t PTEF/t E of pulmonary function were 22.23±1.89、23.00±1.88 after treatment for 3 months;the VPTEF/VE and t PTEF/t E of pulmonary function were 23.75±2.08、24.61±2.13 after treatment for 6 months.The difference was statistically significant(P < 0.05)after the treatment of 3months and before treatment;The difference was statistically significant(P < 0.05)after the treatment of 6 months and before treatment.9.Before treatment,The difference was not statistically significant(P >0.05)in the improvement of lung function between the group A and groupB;after the treatment of three months and six months,the improvement of lung function of group B was better than group A,and the difference was statistically significant(P < 0.05).Conclusion Montelukast Combined with inhalation therapy can improve the effect of children with PIBO. |
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