目的 探討分析孟魯司特聯(lián)合布地奈德治療咳嗽變異性哮喘（CVA）的臨床療效，及其對患兒肺功能和血清轉(zhuǎn)化生長因子β1水平的影響。方法 選取2013年8月-2016年6月在西安市中心醫(yī)院接受治療的117例CVA患兒為研究對象，隨機分為對照組59例和觀察組58例。對照組患者給予霧化吸入布地奈德治療，觀察組在對照組的基礎(chǔ)上給予孟魯司特鈉咀嚼片治療，均治療2個月。觀察治療前后兩組患兒肺功能指標(biāo)包括肺活量（VC）、1 s用力呼吸容積（FEV1）、FEV1/用力肺活量（FVC）、最大呼氣峰流速（PEF）/預(yù)計值的百分比（PEF pred%），以及血清轉(zhuǎn)化生長因子β1（TGF-β1）和炎癥因子包括血清免疫球蛋白E（IgE）、血漿白細胞介素8（IL-8）、人腫瘤壞死因子-α（TNF-α），以及臨床癥狀積分的變化。結(jié)果 治療2個月后，兩組的癥狀積分均有顯著降低，治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且觀察組患兒癥狀評分顯著低于對照組，差異具有統(tǒng)計學(xué)意義（P<0.05）。兩組患兒的VC無明顯變化，而FEV1、FEV1/FVC以及PEF pred%較治療前均有顯著升高，治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且觀察組的該3種指標(biāo)顯著高于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。兩組的TGF-β1較治療前有顯著升高，IgE、IL-8、TNF-α明顯降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05），且觀察組的TGF-β1顯著低于對照組，IgE、IL-8、TNF-α明顯高于對照組，比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 孟魯司特聯(lián)合布地奈德吸入治療咳嗽變異性哮喘的臨床療效顯著，可有效改善患兒的肺功能以及TGF-β1水平，抑制炎癥因子水平。

Objective To investigate the clinical efficacy of budesonide combined with montelukast on treatment of children with cough variant asthma, and its influence on lung function and transforming growth factor-β1. Methods One hundred and seventeen children with cough variant asthma inXi’an Central Hospital from August 2013 to June 2016 were divided into control group and observation group. Fifty-nine children in control group were treated with aerosol budesonide, while 58 children in observation group were treated with montelukast based on control group. The lung function index including VC, FEV1, FEV1/FVC, and PEF pred%, TGF-β1, inflammatory factors including IgE, IL-8, TNF-α, and clinical symptom score in both groups were detected and analyzed before and after treatment. Results After two months of treatment, clinical symptom score in each group obviously decreased, and that in observation group was significantly lower than that of control group (P<0.05). The FEV1, FEV1/FVC, and PEF pred% of two groups showed remarkable increase, and those in observation group were much higher than those of control group (P<0.05), while no conspicuous changes were detected in VC. Additionally, TGF-β1 of each group increased markedly, and that in observation group was much higher, while IgE, IL-8, and TNF-α in two groups showed obvious decrease, andthose in observation group were significantly lower than those of control group (P<0.05). Conclusion Budesonide combined with montelukast had a great ability on treatment of children with cough variant asthma, and could significantly improve the lung function and levels of TGF-β1, and inhibit the levels of inflammatory factors.