Clinical Effect Observation Of Fluticasone Propionate,Montelukast Sodium And Ketotifen In Treatment Of Cough Variant Asthma For Children

Objective: To evaluate the clinical therapeutic efficacy and security of fluticasone propionate(Flu),montelukast sodium(Mon)and Ketotifen(Ket)in different combinatinons of therapeutic regimen on treating cough variant asthma(CVA)in children.Methods: Random allocation and repeated measure were taken in the study.We selected 280 outpatients who were diagnosed with CVA in the respiratory department of children's hospital of Chongqing Medical University from June 2015 to January 2018.All patients were randomly divided into 7 groups according to therapy plans,with 40 cases in each group.The patients of group Flu+Mon+Ket were treated with inhaled Flu combined with Mon and Ket,the group Flu+Mon were treated with inhaled Flu and Mon,the group Flu+Ket were treated with inhaled Flu and Ket,the group Mon+Ket were treated with Mon and Ket,the group Flu were treated with inhaled Flu alone,the group Mon were treated with Mon alone,thegroup Ket were treated with Ket alone.All the patients were treated for three months.We observed cough and symptom score,pulmonary function,adverse drug reactions after regularly treating 2 months and 3 months,including the recurrence of cough during 3 months after drug withdrawal.Results:(1)During 3 months the cough symptom score tended to decrease in all groups,with increases in the percentage of predicted in FEV1,PEF(FEV1%,PEF%)in all groups.(2)After 2 months of treatment,the cough symptom score of group Flu+Mon+Ket was markedly lower than other groups(P<0.05),and group Ket was markedly higher than other groups(P<0.05),nevertheless group Flu+Ket and Mon+Ket,group Flu and Mon didn't have evident difference(P>0.05);meanwhile FEV1% and PEF% of group Flu+Mon+Ket was markedly higher than other groups(P<0.05),group Ket was markedly lower than other groups(P<0.05),group Flu+Ket and Mon+Ket,group Flu and Mon didn't have marked difference(P>0.05).(3)After 3 months of treatment,the cough symptom score in group Ket was markedly higher than other groups(P<0.05),however,there was no obvious difference in other six groups(P>0.05);FEV1%,PEF% of group Ket was markedly lower than other groups(P<0.05),and there was no obvious difference in other six groups(P>0.05).(4)The occurrence rate of adverse drug reactions was low,and the mutual differences weren't marked in 7 groups(P>0.05).(5)The recurrence rate of cough in group Ket was markedly higher than other groups(P<0.05),but other six groups hadno difference(P>0.05).Conclusions: For children with CVA,a combination of Flu,Mon,and Ket has a better clinical effect than a combination of two kinds of drugs and a single drug at 2 months of treatment and has good safety.After 3 months of treatment,Flu or Mon alone has a similar effect to drug combination;Ket alone has a poor clinical effect,with a high recurrence rate after drug withdrawal.