Significance Of Exhaled Nitric Oxide In Stepped Care For Children With Pre-School Asthma

Objective:To evaluate the clinical significance of fractional exhaled nitric oxide(FeNO)in guiding stepwise management of asthma in pre-school children asthma.Methods:According to the diagnostic criteria for childhood asthma in the 2016 edition of the guidelines for the diagnosis and Prevention of bronchial Asthma in Children,From June 2017 to June 2018,60 children with pre-school asthmatic children were randomly divided into two groups: observation group(n=30)and control group(n=30).They were randomly divided into observation group(n=30)and control group(n=30).All children with asthma were in non-acute attack stage.After the two groups were enrolled in the group,the asthma symptom control level was evaluated and FeNO was detected.All the children were treated with fluticasone propionate aerosol inhaler combined with montelukast sodium chewable tablets.Observation group adjusted therapeutic regimen according to children asthma symptom control level grading combined with FeNO test results;The control group adjusted the therapeutic regimen according to the control level of children's asthma symptoms.The patients in the two groups were followed up at 3,6,9 months after treatment.The follow-up included the number of acute attacks of asthma,the control level of asthma symptoms and the level of FeNO of the observation group.The frequency of acute attack and the control level of asthma symptoms were compared between the two groups at different time points(3,6,9 months)after treatment.Results:(1)There was no significant difference in sex,age,height and weight between the observation group and the control group(P>0.05).There was no significant difference in the level of FeNO between the two groups(P=0.454).There was no significant difference in the control level of asthma symptoms between the observation group and the control group(P=0.776).The data of the two groups were comparable.(2)There was no significant difference in the number of acute attacks between the two groups 1-3 months and 4-6 months after admission(P>0.05).The frequency of acute attack in the observation group was less than that in the control group from 7-9 months after admission,the difference was statistically significant(P=0.038).The total number of acute attacks in the observation group was less than that in the control group during the 9-month follow-up period,the difference was statistically significant(P=0.046).(3)There was no significant difference in asthma control level between the two groups 3rd month and 6th months after admission(P> 0.05).The control level of the observation group was better than the control group at the 9th month after admission,the difference was statistically significant(P=0.015).(4)There was no significant difference the number of items assessed in the control level of asthma symptoms between the two groups at the 3rd month and 6th to the group(P>0.05).At the 9th month,the number of items assessed in the control level of asthma symptoms in the observation group was less than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:The grading of asthma symptom control level combined with FeNO was superior to the stepwise management based on asthma symptom control level alone in the treatment of preschool asthma children.