目的 探討丙酸氟替卡松吸入氣霧劑聯(lián)合吸入用布地奈德混懸液治療小兒支氣管哮喘的臨床療效。方法 選取2015年1月-2016年1月在第四軍醫(yī)大學(xué)第一附屬醫(yī)院治療的支氣管哮喘患兒96例作為研究對(duì)象，利用隨機(jī)數(shù)字表法將患兒分為對(duì)照組和治療組，每組各48例。對(duì)照組霧化吸入吸入用布地奈德混懸液，0.5 mg/次，2次/d。治療組在對(duì)照組基礎(chǔ)上吸入丙酸氟替卡松吸入氣霧劑，2撳/次，2次/d。兩組患兒均連續(xù)治療12周。觀察兩組的臨床療效，比較兩組肺功能、血?dú)庵笜?biāo)和炎性因子情況。結(jié)果 治療后，對(duì)照組和治療組總有效率分別為83.3%、95.8%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組呼氣峰流速值（PEF）、1 s用力呼氣容積（FEV1）、呼氣高峰流量（PEFR）和FEV₁/用力肺活量（FVC）均明顯上升，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)明顯高于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組血氧分壓（PaO₂）和酸堿度（pH）值均顯著上升，二氧化碳分壓（PaCO₂）均顯著下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組腫瘤壞死因子α（TNF-α）、超敏C反應(yīng)蛋白（hs-CRP）、白細(xì)胞介素4（IL-4）、白細(xì)胞介素8（IL-8）和白細(xì)胞介素13（IL-13）水平均明顯下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)明顯低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 丙酸氟替卡松吸入氣霧劑聯(lián)合吸入用布地奈德混懸液治療小兒支氣管哮喘具有較好的療效，可改善肺功能，緩解炎癥反應(yīng)，具有一定臨床推廣應(yīng)用價(jià)值。

Objective To explore the clinical effect of Fluticasone Propionate Inhaled Aerosol combined with Budesonide Suspension for inhalation in treatment of bronchial asthma in children. Methods Children (96 cases) with bronchial asthma in the First Affiliated Hospital of the Fourth Military Medical University from January 2015 to January 2016 were randomly divided into control and treatment groups, and each group had 48 cases. Children in the control group were nebulization inhalation administered with Budesonide Suspension for inhalation, 0.5 mg/time, twice daily. Children in the treatment group were inhalation administered with Fluticasone Propionate Inhaled Aerosol on the basis of the control group, 2 presses/time, twice daily. Children in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and lung function, blood gas indexes, and inflammatory factors in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 83.3% and 95.8%, respectively, and there was difference between two groups (P<0.05). After treatment, PEF, FEV₁, PEFR, and FEV₁/FVC in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, PaO₂ and pH value in two groups were significantly increased, but the PaCO₂ in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of TNF-α, hs-CRP, IL-4, IL-8, and IL-13 in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Fluticasone Propionate Inhaled Aerosol combined with Budesonide Suspension for inhalation has clinical curative effect in treatmeat of bronchial asthma in children, can improve lung function, and relieve inflammation reaction, which has a certain clinical application value.