【摘要】 目的　探讨小儿咳嗽变异型哮喘 (CVA)的疗法与预后。方法　 84例CVA患儿随机分成对照组、吸入糖皮质激素组 (I C组 )、口服沙丁胺醇和酮替酚组 (S K组 )、口服氨茶碱和扑尔敏组 (A C组 )。对照组仅予止咳、祛痰、抗感染等治疗。I C组予丙酸倍氯米松气雾剂吸入 ,每次 10 0 μg ,每日 2次。S K组予口服沙丁胺醇 <5岁每次0 5～ 1mg ,≥ 5岁每次 2mg ,均为每日 3次 ;酮替酚 <3岁每次 0 5mg ,每日 2次 ,≥ 3岁每次 1mg ,每日 1～ 2次 ;沙丁胺醇在咳嗽消失后继续服用 2周停药。A C组口服氨茶碱每次 4～ 5mg/kg ,扑尔敏每次 0 1mg/kg ,均为每日 3次。各组疗程均为 6个月。随访半年至 4年 6个月。结果　用药 2周治疗有效率、平均止咳天数I C组、S K组、A C组间无显著性差异 ,但均明显优于对照组 (P <0 0 1)。一个疗程结束后CVA复发率I C组低于S K组和A C组 (均为P <0 0 5 )。S K组与A C组无显著性差异 (P >0 0 5 )。CVA转化为哮喘发生率I C组低于S K组和A C组 (均为P <0 0 5 ) ,明显低于对照组 (P <0 0 1) ;S K组与A C组无显著性差异 (P >0 0 5 ) ,但均低于对照组(P <0 0 5 )。药物副作用发生率I C、S K、A C组间无显著性差异 (P >0 0 5 )。结论　吸入糖皮质激素、口服沙丁胺醇和酮替酚、氨茶碱和扑?更多还原

【Abstract】 Objective To explore the therapy and prognosis of c hildren with cough variant asthma(CVA).Methods The eighty-four cases with CVA were randomly divided into control group,inhalant corticosteroid group(I-C group),oral salbutamol and kote tifen group(S-K group),oral aminophylline and chlorpheniramine group(A-C group ).The control group was treated only by antitussives,expectorants and antibiotic s.I-C group was adminstered by inhalation of beclomathasone dipropionate with 1 00μg twice daily.S-K group was administered by oral salbutamol and kotetifen.T he doses of salbutamol was 0 5～1mg thrice daily in patients under 5 years old, 2 mg thrice daily in patients over 5.The doses of kotetifen was 0 5mg twice daily in patients undey 3,1mg 1～2 times daily in patients over 3.Salbutamol was disu s ed after 2 weeks of cough-free.A-C group was adminstered by oral aminophylline with 4～5mg/kg thrice daily and chlorpheniramine with 0 1mg/kg 3 times daily.E v ery course of treatment was 6 months in all groups.The patients were followed up from 6 months to 4 years and 6 months.Results After 2 weeks of administration,the effective rates in I-C group,S-K group and A-C group were 100%,95 45% and 90 48%,respectively(P >0 05),while control group was 30%,which was significantly lower than other g roups(P<0 01).Mean days of cough being controlled hadn’t significant differ ence in I-C group,S-K group and A-C group(P>0 05),while control group wa s significantly longer than other groups(P<0 01).After one coure of treatme nt,the recurrent rates of CVA in S-K group and A-C group were 50% and 47 62%, respectively(P>0 05),while I-C group was 19 05%,lower than S-K and A-C groups(P<0 05,respectively).The ocurrence of asthma in I-C,S-K,A-C and c ontrol groups were 9 52%,40 91%,38 10% and 75%,respectively(I-C group vs S- K and A-C groups,P<0 05;I-C group vs control groups,P<0 01;S -K group vs A-C group,P>0 05,S-K and A-C groups vs control group,P< 0 05).The ocurrence of side effects were 19 05%,40 91% and 33 33% in I-C,S -K and A-C groups,respectively(P>0 05).Conclusion Inhalant corticosteroid,oral salbutamol and kotetifen,or al aminophylline and chlorpheniramine are all effective to control cough of CVA. Inhalant corticosteroid are more effective than oral salbutamol and kotetifen,am inphylline and chlorpheniramine to prevent recurrence of CVA and CVA conversion asthma.更多还原