[摘要]目的 觀察聯(lián)合用藥降階梯療法治療嬰幼兒喘息急性發(fā)作的臨床效果。方法 選取2015年2月～2017年2月就診于我中心兒科門(mén)診的103例急性喘息發(fā)作的嬰幼兒作為研究對(duì)象，隨機(jī)分為兩組，均采取綜合治療。觀察組52例，采用降價(jià)梯療法，口服潑尼松0.5 mg/（kg·d），3 d；按需霧化吸入硫酸沙丁胺醇溶液（2.5 mg/次）、異丙托溴胺溶液（125 μg/次）7 d；口服孟魯斯特4 mg/d，14 d。對(duì)照組51例，采取日常門(mén)診常見(jiàn)的治療方法，霧化吸入布地奈德混懸液聯(lián)合或按需霧化吸入沙丁胺醇溶液及異丙托溴胺溶液治療至穩(wěn)定期（2周）。評(píng)估兩組患兒不同時(shí)間點(diǎn)癥狀體征的評(píng)分，觀察兩組患兒用藥后2 h、3 d、5 d、7 d各癥狀體征改善情況及其消失天數(shù)、隨訪1個(gè)月內(nèi)喘息復(fù)發(fā)的次數(shù)。結(jié)果 觀察組喘息、咳嗽、哮鳴音改善分值明顯高于對(duì)照組（P<0.05），其消失時(shí)間明顯短于對(duì)照組（P<0.05），觀察組1個(gè)月內(nèi)喘息復(fù)發(fā)次數(shù)顯著低于對(duì)照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組患兒均無(wú)藥物不良反應(yīng)。結(jié)論 聯(lián)合用藥降階梯療法治療嬰幼兒喘息急性發(fā)作的患兒療效顯著、安全可靠。
　　[關(guān)鍵詞]喘息；嬰幼兒；聯(lián)合用藥降價(jià)梯；臨床效果
　　[中圖分類號(hào)] R72 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-4721（2018）2（b）-0065-03
　　Effect observation of drug combination de-escalation in the treatment of acute attack of wheezing in infants
　　CHEN Ai-qing ZHANG Jun-ling
　　Department of Pediatrics，the Second Community Health Service Center，Guanzhuang，Chaoyang District，Beijing 100070，China
　　[Abstract]Objective To observe the clinical effect of drug combination de-escalation in the treatment of acute attack of wheezing in infants.Methods From February 2015 to February 2017，103 infants with acute attack of wheezing in outpatient department of pediatrics in our center were selected as research objects.They were randomly divided into two groups.The comprehensive treatment was applied in both groups.In the observation group（n=52），de-escalation therapy was used，0.5mg/（kg·d） Prednisone for oral administration for 3 d，Salbutamol Sulfate solution for aerosol inhalation as required （2.5 mg each time），Ipratropium Bromide solution （125 μg each time for 7 d），and oral administration of 4 mg/d Montelukast for 14 d.In the control group （n=51），common treatments in clinic were used，like aerosol inhalation of Budesonide Suspension combined with or Inhalation of Salbutamol solution and Ipratropium Bromide solution as required to the stable period （2 weeks）.The scores of symptoms and signs at different time points in the two groups were evaluated.The improvement of symptoms and signs 2 h，3 d，5 d，7 d after medication，disappearing time，and recurrent frequency of wheezing within one month follow up were observed.Results In the observation group，the scores of improving wheezing，cough，and wheezing rale were higher than those in the control group （P<0.05）.The disappearing time of these symptoms and signs was shorter compared with that in the control group （P<0.05）.The recurrent frequency in the observation group within one month follow up was significantly lower than that in the control group，the difference was statistically significant （P<0.05）.There was no drug adverse reaction in the two groups.Conclusion Drug combination de-escalation in the treatment of acute attack of wheezing in infants is remarkable on effect，safe and reliable.

相關(guān)熱詞搜索：嬰幼兒 喘息 階梯 用藥 發(fā)作