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目的探讨孟鲁司特联合布地奈德治疗老年哮喘的临床疗效及对肺功能的影响。方法选取2014年6月—2015年2月洛阳市第七人民医院收治的老年哮喘患者83例。按照随机数字表法将患者分为B+M组42例与B组41例。两组患者均给予常规药物治疗,B组给予布地奈德进行治疗,B+M组在对照组治疗基础上给予孟鲁司特治疗。比较两组患者临床疗效及治疗前后患者白天、夜间哮喘发作次数、用力肺活量(FVC)、第1秒用力呼气容积(FEV_1)、FEV_1/FVC和呼气峰流速(PEF)、不良反应发生率、1年再住院率、临床咳嗽、胸闷、喘息和肺部症状持续时间。结果 B+M组患者总有效率高于B组,差异有统计学意义(P<0.05)。治疗前两组患者白天、夜间哮喘发作次数比较,差异无统计学意义(P<0.05);治疗后B+M组患者白天、夜间哮喘发作次数少于B组,差异有统计学意义(P<0.05)。治疗前两组患者FEV、FEV_1、FEV_1/FEV和PEF比较,差异无统计学意义(P>0.05);治疗后B+M组患者FEV、FEV_1、FEV_1/FEV和PEF高于B组,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05);B+M组1年再住院率低于B组,差异有统计学意义(P<0.05)。B+M组患者咳嗽、胸闷、喘息和肺部症状持续时间短于B组,差异有统计学意义(P<0.05)。结论老年哮喘患者应用孟鲁司特联合布地奈德治疗的可行性高,治疗效果确切,可有效缓解患者临床症状,改善患者肺功能,且不良反应少。
Objective To investigate the clinical efficacy of montelukast combined with budesonide in the treatment of senile asthma and its effect on lung function. Methods A total of 83 elderly patients with asthma admitted to the Seventh People’s Hospital of Luoyang from June 2014 to February 2015 were selected. Patients were divided into 42 cases of B + M group and 41 cases of B group according to random number table method. Both groups were given conventional drug treatment, B group treated with budesonide, B + M group on the basis of the treatment of montelukast treatment. The clinical efficacy and the number of asthma attacks, FVC, FEV_1, FEV_1 / FVC, and peak expiratory flow (PEF) were compared between the two groups before and after treatment. The incidence of adverse reactions , 1 year rehospitalization rate, clinical cough, chest tightness, wheezing and duration of lung symptoms. Results The total effective rate of B + M group was higher than that of B group, the difference was statistically significant (P <0.05). There was no significant difference in the number of asthma attacks between the two groups before treatment (P <0.05). The number of asthma attacks in B + M group was less than that in group B at daytime and nighttime, the difference was statistically significant (P < 0.05). There was no significant difference in FEV, FEV 1, FEV 1 / FEV and PEF between the two groups before treatment (P> 0.05). After treatment, the FEV, FEV 1, FEV 1 / FEV and PEF in B + M group were higher than those in B group Statistical significance (P <0.05). There was no significant difference in incidence of adverse reactions between the two groups (P> 0.05). One-year rehospitalization rate in B + M group was lower than that in B group (P <0.05). The duration of cough, chest tightness, wheezing and pulmonary symptoms in B + M group was shorter than that in B group, with significant difference (P <0.05). Conclusion The application of montelukast combined with budesonide in elderly patients with asthma is highly feasible and effective. It can effectively relieve the clinical symptoms and improve the lung function of patients with less adverse reactions.