The Efficacy Of Budesonide Suspension Solution On Cough Variant Asthma In Children

CVA is a special type of asthma, chronic cough is the only and main clinical manifestations. The cough often aggravates at night or early morning, antibiotics do not work. CVA is one of the most important reasons of the children with chronic cough, it is a big problem to children and families, and leads to unreasonable application of drugs such as antibiotics. In recent years as awareness of the CVA and level of diagnosis, the incidence was rising year by year. CVA is also characterized by chronic airway inflammation, BHR and the degree of airway remodeling as CA. Therefore, its treatment also takes similar strategy, anti-inflammatory is in the first place, glucocorticoids have powerful anti-inflammatory effects of non-specific, while the inhalation has direct effect on the respiratory tract and it can avoid the serious systemic side effects of medication, so ICS has been the first-line drug of CVA. However, children and adults are different, especially young children (≤5years), its cognition is limited, the PDI and dry powder devices can not be the proper use, so the use of solution by atomization compression pump or application of PDI with the spacer mask are advocated. In the clinic, budesonide suspension and fluticasone are common and safe, but the efficacy of the two drugs on cough variant asthma in children and the compare between them are very few, therefore this research is to study the budesonide suspension in treatment for children with cough variant asthma and compare the differences between budesonide and fluticasone.Methods: Selected 80 children who had been diagnosed cough variant asthma in our out-patient, aged≤5 years old, and had decided to assess inhaled corticosteroid by a doctor. But we should remove some people who was allergic to budesonide and fluticasone, had applied leukotriene modifiers two weeks ago, had applied ICS or system corticosteroid two weeks ago, asthma. Fifty cases were assigned in the test group and thirty cases in the control group randomly, budesonide was inhaled by atomization compression pump in the test group, and fluticasone was applied with the spacer mask in the control group. Before the medication and one week, three weeks, five weeks, seven weeks after it the patient went to the hospital for a visit, five times in all, and the first visit the parents of the patient (the child) signed agreement in the paper, the researcher directed the parents to record the daily card according to the patients'symptoms, and then gave the first daily card to the parents, took back the daily card last time and gave the next daily card at every visit. The contents of the daily card contains the scores of self-symptoms, self-evaluation of patients'conditions, record about that the patient complied with the doctor,s instruction or not, accompanying medicine. The scores of self-symptoms record as follows, if the patients, cough frequency are none or below three times a day or night, it is calculated zero, if there three to five times of cough episodes, calculated one, six to ten times, calculated two, above ten times, calculated three, if the severity of the patients, cough are light, it is calculated zero, if slight it is calculated one, obvious, but activity or sleep are not affected, calculated two, obvious and affect activity or sleep, calculated three. And the parents should assess the patients, conditions, control, activity is not limited, there is no cough at night, no emergency medicine use or call, part of control, there is one of these three symptoms a week, none of control:there are two or there of these three symptoms a week. Every visit the researcher calculated the average scores about the day and night cough as follows, the day cough scores, the all scores of the patients, cough frequency and severity divide the days, the night cough scores is also like this. Then gave the patient physical examination and checked her or him had complied with the doctors'instruction or not, checked the method of applying the medicine was right or not, recorded accompanying medicine.Results: Three cases of the test group quited for other reasons, the remaining 77 cases complied with the prescribed medication, recorded self- symptom scores seriously, and achieved every visit. In a word, they had a better compliance. The sexes,ages and severity of the disease of two groups before the medication had no significant difference, from the first visit to the fourth visit the disease control rate of test group were significantly higher than control group, It showed that the patients'conditions of test group were always better than control group significantly. The day and night cough scores of test group were significantly lower than control group from the first visit to the fourth visit except the day cough scores of the first visit ,it showed that cough reduction of test group was significantly better than control group in corresponding period. In test group every visit cough scores were significantly lower than the previous from the first visit to the third visit, while there was no significant difference between the third and the fourth visit, it explained that in test group cough reduction was significantly better in the visit than the previous except the fourth visit. However, in control group the day and night cough scores of the second visit were significantly lower than the first visit, and the fourth visit were significantly lower than the third visit too, it showed that cough reduction was significantly better in the visit than the previous in corresponding period,while there were no significantly differences among others.In the research, the cough of the patients were control at first, but it became severe when they suffer respiratory infection, certainly, we gave them antibiotics, but it was one of the most important reasons to effect the control of disease.And there was no adverse events both test group and control group during the medication.Conclusions: both the application of budesonide by atomization compression pump and the use of fluticasone with the spacer mask in treatment of young childrens'(≤5 years old) cough variant asthma are effective. However, budesonide are superior to fluticasone on the day and night cough reduction and control of the disease, and budesonide is earlier to achieve complete control of cough than fluticasone.But budesonide is expensive, therefore, we can apply budesonide by atomization compression pump to control symptoms rapidly in the acute phase of young children cough variant asthma, and then use fluticasone with the spacer mask to maintain treatment.