Study On The Efficacy Of Three Different Schemes Of Budesonide In Recurrent Wheezing Children Under 5 Years Old

Objectives:To explore the curative effect of three different inhalation Budesonide(BUD)methods which includes the daily low dose atomization inhalation group,the intermit-ent high dose early atomization inhalation group and the intermittent general dose preemptive atomization inhalation group in the treatment of recurrrent wheezing children under 5 years old,providing the basis for early selection of appropriate interv-ention regimen for them.Methods:We studied 160 children who were diagnosed wheezing during January 2015 to June 2016,whose age was between the 12 and 59 months,and had positive values on the modified API.Children were randomly divided into three groups according to admission time sequence: daily low dose atomization inhalation group(daily group)54 cases,intermittent high dose early atomization inhalation group(early group)53cases and intermittent general dose preemptive atomization inhalation group(preemptive group)53 cases.The initial atomized inhaled dose of BUD in daily group was initially 1mg,1 times a day,every 1-3 months to assess the condition,the dose of BUD was reduced the original dose of 25%-50% if the wheezing was controled,until the last atomized inhaled dose of BUD was 0.25 mg,1 times a day was maint-ained for 1 years,otherwise,continue the original dose.When children in the early group have cough,runny nose and other respiratory symptoms before the start of wheezing,they were given 1mg BUD,2 times a day,7 days.Children in preem-ptive group were given 0.5mgBUD,2 times a day immediately when they have nasal congestion,runny nose,cough and any other suspicious respiratory symptoms or before they contact allergens,when the symptoms are reduced or risk factors are removed for 2-3 days,stop the drug.All children were observed for 1 year.Number of systemic corticosteroids courses,wheezing episodes,intravenous,the emergency number,symptomatic days,respiratory symptom scores and other curative effect indicators were compared between the three groups;and compare the number ofsystemic corticosteroids courses,intravenous,wheezing episodes,the emergency num-ber,and hospitalization rates before and after treatment in each group.Results:(1)During the 1 year follow-up period,54 cases were enrolled in the daily group,1 case was lost,2 cases changed to intermittent treatment because of compliance problems,and 1 case withdrawn for other reasons.In the early group,there were 53 cases,2 cases were converted into daily group due to treatment failure,and 1 case was withdrawn for other reasons.In the first group,there were 53 cases,1 case was lost,1 case was changed to the daily group due to treatment failure,and 1 case dropped out due to other reasons.and finally 150 cases completed the experiment,50 cases in each group.(2)All three groups can reduce the number of systemic corticosteroids courses,intravenous,wheezing episodes,the emergency number and hospitalization rate,the difference were statistically significant(p<0.01).(3)There were no statistical significant difference between the three group in the number of systemic corticosteroids courses,wheezing episodes,intravenous,the emerg-ency number,symptomatic days(p>0.05);there was no significant difference between the respiratory symptom scores,the number of hospitalized patients,treatment failure rate,and use SABA days of the three group(p>0.05).(4)The BUD use days and doses of the two intermittent inhalation regimens is less than daily low dose atomization inhalation regimen(p<0.01);among the three groups,the preemptive atomization inhalation used the least dose(p<0.01).Conclusion:(1)The intermittent high dose early atomization inhalation regimen,the intermi-ttent general dose preemptive atomization inhalation regimen and the daily low dose atomization inhalation regimen can significantly reduce recurrent wheezing severity in children under 5 years of age,and the clinical efficacy of the three regimen is close.(2)The use of BUD days and doses of the intermittent high dose early atomization inhalation regimen and the intermittent general dose preemptive atomiza-tion inhalation regimen is less than that of the daily low dose atomization inhalationregimen.and the use of BUD doses of the intermittent general dose preemptive atomization inhalation regimen is the least.(3)The drug administration time of preemptive atomization inhalation regimen was the earliest and the overall drug delivery time is more flexible than early atomization inhalation regimen,so the preemptive atomization inhalation regimen can offer new options for 5-year-old children with recurrent wheezing and positive values on the mAPI.