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目的:观察哮喘患儿吸入丙酸氟替卡松(FP)治疗的疗效及评估哮喘控制水平。方法:(1)采用回顾性研究和临床随访的方法,选取在我院哮喘门诊就诊的哮喘患儿200例,按照哮喘控制简易方案(easyasthma management)进行病情严重程度分级,采取半随机自愿的形式(愿意接受激素治疗与拒绝激素治疗)分为两组,治疗组100例,根据病情程度给予FP治疗,非治疗组100例给予相关的对症治疗,疗程4周。治疗组在治疗2、4周后进行重新评估,比较治疗组在治疗前后日间及夜间症状评分改善情况,且以非治疗组同期观察哮喘控制情况作对比。(2)对200例哮喘患儿中≥4岁的98例检测峰流速(PEFR)值,对比治疗组在治疗前后此值变化情况及两组间该值对比情况。结果:(1)治疗组与非治疗组在年龄、性别、治疗前病情严重程度、日间及夜间症状评分均差异无统计学意义(P>0.05);治疗组在吸入FP治疗2、4周后各项症状评分均明显改善(P<0.001);治疗组与非治疗组2、4周后日间、夜间症状评分比较差异有统计学意义(P<0.001)。(2)治疗组在吸入FP 4周后PEFR值比治疗前明显改善(P<0.001),与非治疗组比较差异亦有统计学意义(P<0.001)。结论:吸入FP疗效明显,是目前较佳的支气管哮喘的治疗方法。
Objective: To observe the efficacy of inhaled fluticasone propionate (FP) in children with asthma and evaluate the control of asthma. Methods: (1) A retrospective study and clinical follow-up method were used to select 200 asthmatic children who were treated in asthma clinics in our hospital. The patients were classified according to the severity of asthma control by easy asthma management, (Willing to accept hormone therapy and reject hormone therapy) were divided into two groups, the treatment group of 100 cases, according to the severity of the disease given FP treatment, non-treatment group of 100 patients given symptomatic treatment, treatment for 4 weeks. The patients in the treatment group were reevaluated after 2 and 4 weeks of treatment. The improvement of symptom scores in the treatment group during daytime and nighttime before and after treatment were compared. The comparison of asthma control over the same period in the non-treatment group was also compared. (2) The peak flow velocity (PEFR) was measured in 98 cases of ≥4 years old in 200 children with asthma. The changes of this value in the treatment group before and after treatment were compared with those in the two groups. Results: (1) There was no significant difference between the treatment group and the non-treatment group in age, sex, severity of illness before treatment, daytime and nighttime symptom scores (P> 0.05) The score of each symptom was significantly improved after treatment (P <0.001). There was significant difference between the treatment group and the non-treatment group in daytime and nighttime symptom scores after 2,4 weeks (P <0.001). (2) PEFR in treatment group after 4 weeks of inhalation FP was significantly improved (P <0.001) compared with that before treatment, and there was also significant difference between the treatment group and non-treatment group (P <0.001). Conclusion: The obvious effect of inhaled FP is the better treatment of bronchial asthma.