【摘要】 目的:分析哮喘激发因素问卷调查对儿童支气管哮喘阶梯吸入治疗效果的影响。方法:调查于2003-06/2005-06在青岛大学医学院附属医院儿科哮喘中心完成,选择支气管哮喘患儿237例,监护人均知情同意。随机分为2组,对照组110例,问卷调查组127例。对照组在采用阶梯吸入治疗方案之前先行过敏原检测;问卷调查组在对照组治疗的基础上,进行激发因素调查并给予相应预防指导。过敏原检测采用皮肤点刺试验,依据华东地区常见过敏原特点,选取吸入性过敏原17种,食物过敏原9种。问卷调查内容包括常见的哮喘激发因素30个问题。6个月后进行临床疗效评价:①症状评价采用日间、夜间临床哮喘症状评分法(0～3分,0分无症状;3分影响活动,夜间经常憋醒)。②调查患儿治疗依从率、缓解期激素吸入量和哮喘发作次数。③肺功能检查采用MasterScope肺功能仪,检测指标为第1秒用力呼气容积和最大呼气峰流速。结果:患儿237例全部进入结果分析,无脱落。①治疗6个月后两组患儿治疗依从性、症状评分、缓解期激素吸入量和哮喘发作次数比较:问卷调查组患儿系统治疗的依从率显著高于对照组[76.8%,53.8%(P<0.01)];问卷调查组患儿的哮喘症状评分(0.8±0.10,1.2±0.15)、急性发作次数(2.7±1.43,4.0±1.67)、激素用量(340±160,400±200)均显著低于对照组(P<0.01)。②治疗6个月后两组患儿肺功能比较:治疗后问卷调查组患儿的肺功能指标最大呼气流速和第1秒最大呼气容积均显著高于治疗前及对照组(P<0.05～0.01)。结论:通过过敏原检测及激发因素问卷调查并给予预防指导,可以减少患儿药物用量,改善肺功能,减少复发,提高其治疗效果,在儿童支气管哮喘长期治疗中具有重要意义。更多还原

【Abstract】 AIM: To analyze the effect of questionnaire survey on exciting factors of asthma in children who received hierarchical inhalant regimen. METHODS: The investigation was conducted at the Asthma Center of Department of Pediatrics, Affiliated Hospital of Medical College, Qingdao University between June 2003 and June 2005. 237 children patients with bronchial asthma were enrolled with the agreement of their guardians, and they were assigned randomly into 2 groups: 110 cases in the control group and 127 cases in the questionnaire survey group. Allergen examination was performed before hierarchical inhalant regimen in the control group. Base on the test in the control group, investigation on exciting factor was conducted with relative preventive instruction in the questionnaire survey group. The skin prick test (SPT) was used in allergometry including 17 kinds of airborne allergen and 9 kinds of food allergen according to common allergen feature in east China. Content of questionnaire composed of 30 problems on exciting factor of asthma. Six months later, clinical curative evaluation was performed ①Evaluation on symptom was done with daytime and nighttime clinical asthma evaluation (0-3 points, 0 point as non-symptom; 3 points as influencing activity, always awake with the feeling of oppression during nighttime). ②Compliance, intape of hormone during remission period and time of attack of asthma in children patients were surveyed. ③Pulmonary function test was performed with MasterScope pulmonary function instrument to detect the indexes of forced expiratory volume in the first second (FEV1) and peak expiratory flow rate. RESULTS: A total of 237 children patients were involved in the result analysis, without drop out. ①Comparison of compliance, score of symptom, intape of hormone during remission period and time of attack of asthma in children patients of the two groups after being treated for 6 months: Compliance rate in children patients of the questionnaire survey group after systematical treatment was higher obviously than that in the control group 76.8%,53.8%(P < 0.01) . Scores on asthma symptom(0.8±0.10,1.2±0.15), time of acute attack (2.7±1.43,4.0±1.67) and dosage of hormone (340 ±160,400±200) were all lower markedly in children patients of the questionnaire survey group than that in the control group (P < 0.01). ②Comparison of pulmonary function in children patients of the two groups after being treated for 6 moths: Maximal expiratory flow rate and FEV1 of pulmonary function index in children patients in the questionnaire survey group after treatment were higher remarkably than before treatment and that in the control group (P < 0.05-0.01=. CONCLUSION: Allergometry and Questionnaire Survey with systematic clinical instruction can reduce the dosage of drug, ameliorate pulmonary function, decrease relapse and enhance therapeutic efficacy, which have important significance in the long-term treatment of bronchial asthma in children.更多还原