周雯雯

[摘要] 目的 探究酮替芬联合氯雷他定治疗小儿咳嗽变异性哮喘的临床疗效及对转化生长因子β1（TGF-β1）的影响。 方法 选取我院2016年9月～2018年9月收治的90例咳嗽变异性哮喘患儿，将其按照随机数字法分为对照组和观察组，每组各45例。对照组患儿采用酮替芬進行治疗，观察组患儿采用酮替芬联合氯雷他定治疗。对比分析两组患儿临床治疗效果，以酶联免疫吸附法检测两组治疗前后血清TGF-β1的变化及不良反应。 结果 观察组临床治疗总有效率明显高于对照组，且不良反应低于对照组（P<0.05）。观察组治疗后FEV1水平和PEF水平均明显高于对照组，且两组治疗后FEV1水平和PEF水平均明显高于治疗前（P<0.05）。观察组治疗后血清TGF-β1明显高于对照组，且两组治疗后血清TGF-β1水平均高于治疗前（P<0.05）。 结论  对小儿咳嗽变异性哮喘患儿采用酮替芬联合氯雷他定治疗不仅临床应用效果显著，而且不良反应较少，其机制可能与提高TGF-β1水平有关。

[关键词] 酮替芬;氯雷他定;咳嗽变异性哮喘;转化生长因子-β1

[中图分类号] R725.6          [文献标识码] B          [文章编号] 1673-9701（2020）17-0057-03

The efficacy of ketotifen combined with loratadine in the treatment of cough variant asthma in children and the effect on serum TGF-β1

ZHOU Wenwen

Department of Pediatrics，the Central Hospital of Jiamusi City in Heilongjiang Province， Jiamusi   154002，China

[Abstract] Objective To explore the clinical effect of ketotifen combined with loratadine in the treatment of cough variant asthma （CVA） in children and the effect on the transforming growth factor-β1 （TGF-β1）. Methods Ninety children with CVA admitted to our hospital from September 2016 to September 2018 were selected and divided into the control group and the observation group through the random number method with forty-five patients in each group. The patients in the control group were treated with ketotifen， while the patients in the observation group were treated with ketotifen combined with loratadine. The clinical therapeutic effects of the two groups were compared and analyzed， the changes of serum TGF-β1 before and after treatment were detected by enzyme-linked immunosorbent assay （ELISA） and adverse reactions. Results The total effective rate of clinical treatment in the observation group was significantly higher than that in the control group， and the adverse reactions（ADRs） were fewer than those in the control group （P<0.05）. The levels of FEV1 and PEF in the observation group were significantly higher than those in the control group after treatment， and the levels of FEV1 and PEF in the two groups after treatment were significantly higher than those before treatment（P<0.05）. The serum TGF-β1 level in the observation group was significantly higher than that in the control group after treatment， and the serum TGF-β1 levels in the two groups after treatment were higher than those before treatment（P<0.05）. Conclusion Ketotifen combined with loratadine is not only much effective in clinical application， but also has fewer ADRs for children with CVA. Its mechanism may be related to the increase of TGF-β1 level.

[Key words] Ketotifen;Loratadine;Cough variant asthma （CVA）;Transforming growth factor-β1 （TGF-β1）

咳嗽变异性哮喘是一种较为常见的呼吸道疾病，在临床上主要表现为气道慢性炎症。咳嗽變异性哮喘往往难以根治并且容易反复，给患儿的生活质量造成了严重的影响，并且还极大地影响了患儿的心理状况。及时采取有效的治疗手段，缓解和消除疾病的影响并最终根治疾病是现在医学工作者重点关注的内容。小儿哮喘主要是因为呼吸道遭受到病毒和细菌的感染所引起，病毒和细菌是造成小儿哮喘的主要过敏源[1-3]。长期临床实践中发现对于咳嗽变异性哮喘患儿往往通过单一的药物治疗效果并不理想，较为常用的治疗药物酮替芬在临床使用过程中还容易产生各类不良反应[4]。本研究对小儿咳嗽变异性哮喘患儿采用酮替芬联合氯雷他定进行治疗，取得显著效果，现报道如下。……