【摘要】 目的 观察在吸入糖皮质激素的基础上联合应用白三烯受体拮抗剂对儿童哮喘伴变应性鼻炎的防治作用。方法 将74例轻、中度支气管哮喘伴变应性鼻炎患儿随机分为治疗组和对照组，每组各37例，进行3个月的治疗，治疗组吸入布地奈德，每天400μg，1个月后减至每天200μg，治疗组在此基础上加用孟鲁司特，每天5mg。记录患儿的哮喘症状评分、变应性鼻炎症状评分、按需吸入β2受体激动剂的次数及测定气道反应性。结果 治疗后两组患儿的哮喘症状评分、变应性鼻炎症状评分及气道高反应性均明显改善。治疗组治疗后夜间哮喘症状评分及变应性鼻炎症状评分为0分及0.30±0.36分,对照组评分为0.41±0.36分及1.29±0.54分,两组比较差异有非常显著性(P<0.01);按需吸入β2受体激动剂的次数治疗组为1.84±0.04喷,对照组为2.97±0.03喷,两组比较差异有显著性(P<0.05)。结论 在吸入糖皮质激素的基础上联合应用白三烯受体拮抗剂可显著提高对儿童哮喘伴变应性鼻炎的疗效。

    【关键词】 孟鲁司特；布地奈德；儿童；哮喘；变应性鼻炎

    Effects of leukotriene receptor antagonist and inhaled corticosteroid on asthmatic children with allergic rhinitis

    CHEN Hong-jun, TAN Xian-ling,ZOU Shang-qun.Zhuhai Maternal and Child Health Hospital,Zhuhai,Guangdong 519000,China

    【Abstract】 Objective To evaluate the therapeutic effects of leukotriene receptor antagonist,the montelukast, in combination with inhaled corticosteroid on asthmatic children with allergic rhinitis.Methods Seventy-four mild to moderate asthmatic children with allergic rhinitis were randomly divided into treating group and control group. Thirty-seven children in control group were treated only with budesonide inhalation(400μg/d for one month, then reduced to 200μg/d) for 3 months. On the basis of inhalation, the other thirty-seven children in treating group were added montelukast 5mg/d orally. Daytime and night asthma symptom scores, allergic rhinitis symptom score and doses of inhaled terbutaline as rescue drug were recorded. Bronchial responsiveness were measured before and after the treatment. Results After treatment, there was much better improvement in scores of asthma symptoms and allergic rhinitis symptoms and bronchial responsiveness in both groups. Night asthma symptom score, allergic rhinitis symptom score after treatment and average doses of inhaled β2 agonist per week in treating group were significantly lower than those in control group. There was no significant difference in bronchial responsiveness between the two groups.Conclusion On the basis of low dose inhaled corticosteroid, orally leukotriene receptor antagonist significantly improves the therapeutic efficacy of asthmatic children with allergic rhinitis. ......