目的 探讨护理目标执行理念护理在哮喘患儿治疗中的价值。方法 前瞻性选取泉州市妇幼保健院于2021年8月—2023年8月收治的100例支气管哮喘患儿,应用随机数字表法将其分为两组,每组均为50例。对照组采取常规护理,观察组在常规护理基础上给予护理目标执行理念护理。3个月后,对比两组家属对患儿的疾病管理能力、哮喘控制状况、生活质量。结果 护理后两组患儿家属相关家庭管理测量量表（FaMM）评分均升高,且观察组高于对照组（P<0.05）;观察组患儿哮喘控制率高于对照组（P<0.05）;护理后两组患儿情感、活动、症状相关标准儿童哮喘生活质量评分表（PAQLQ）评分均升高,且观察组高于对照组（P<0.05）。结论 护理目标执行理念护理可改善哮喘患儿家属对患儿疾病的管理能力,改善哮喘控制效果,提升患儿生活质量。

Objective To explore the value of nursing goal execution concept intervention in the treatment of children with asthma．Methods From August 2021 to August 2023,100 children with bronchial asthma admitted to Quanzhou Maternal and Child Health Hospital were Prospective selected．They were randomly divided into observation group and control group,with 50 cases in each group．The control group of children received routine care,while the observation group of children received intervention based on the nursing goals execution concept in addition to routine care．After 3 months of intervention,The disease management ability,compliance,asthma control and quality of life of the two groups were compared．Results Family-related FaMM scores were increased in all two groups after the intervention,and the observation group was higher than the control group（P<0.05）．The asthma control rate of the children in the observation group was higher than that in the control group（P<0.05）;after nursing,the PAQLQ score increased,and the observation group was higher than the control group（P<0.05）．Conclusions Intervention based on the nursing goals execution concept can improve the management ability of family members of asthma patients towards their diseases,and enhance their quality of life,which is worthy of clinical application and promotion．

目的 探讨苏黄止咳胶囊联合多索茶碱对慢性持续期支气管哮喘的疗效及对肺功能、呼出气一氧化氮（FeNO）的影响。方法 选择2020年3月—2022年3月70例慢性持续期支气管哮喘患者,随机分为2组各35例,对照组仅予以多索茶碱治疗,研究组在对照组基础上加服苏黄止咳胶囊治疗。治疗3个月,采用哮喘控制测试（ACT）对患者进行评估,记录哮喘急性加重、急救药物使用情况及急诊入院情况,测定肺功能和呼出FeNO。结果 2组治疗1月的ACT评分比较无统计学意义（P>0.05）,治疗2、3个月时研究组的ACT评分高于对照组（P<0.05）。研究组哮喘急性加重次数、急救药物使用次数均少于对照组（P<0.05）,而2组急诊入院次数比较差异无统计学意义（P>0.05）。与基线值相比,2组治疗3个月时的肺功能指标无改变（P>0.05）且组间比较差异亦无统计学意义（P>0.05）;2组治疗3个月时的FeNO无改变（P>0.05）,而研究组的FeNO低于对照组（P<0.05）。结论 苏黄止咳胶囊联合多索茶碱治疗慢性持续期支气管哮喘可降低FeNO,提高哮喘控制水平。

Objective To investigate the effect of Suhuang Zhike capsule combined with doxofylline on chronic persistent bronchial asthma, pulmonary function and exhaled nitric oxide（FeNO）．Methods Seventy patients with chronic persistent bronchial asthma from March 2020 to March 2022 were randomly divided into two groups, 35 cases in each group．The control group was only treated with doxofylline, and the study group was treated with Suhuang Zhike capsule additionally．After 3 months of treatment, the patients were evaluated by asthma control test（ACT）, the acute exacerbation of asthma was recorded, and the pulmonary function and exhaled FeNO were measured．Results There was no statistical significance in the ACT score of the two groups after one month of treatment（P>0.05）．The ACT scores of the study group after two months and three months of treatment were significantly higher than those of the control group（P<0.05）．The times of acute exacerbation of asthma and the use of emergency drugs in the study group were less than those in the control group（P<0.05）, but there was no significant difference in the number of emergency hospitalizations between the two groups（P>0.05）．Compared with the baseline value, there was no significant change in lung function indexes in the two groups after 3 months of treatment（P>0.05）．Compared with the baseline value, there was no significant change in FeNO in the two groups after 3 months of treatment（P<0.05）, while FeNO in the study group was lower than that in the control group（P<0.05）．Conclusions Suhuang Zhike capsule combined with doxofylline in the treatment of chronic persistent bronchial asthma can reduce FeNO and improve the level of asthma control．

目的 探讨沙丁胺醇与M胆碱受体阻断剂应用于支气管哮喘患儿对其症状改善及肺功能的影响。方法 选择我院2018年9月—2019年9月收治的88例支气管哮喘患儿,采用随机数表法分为观察组(n=44)和对照组(n=44)。在对症治疗基础上,对照组给予沙丁胺醇治疗,在对照组基础上,观察组加入M胆碱受体阻断剂(异丙托溴铵气雾剂)治疗。比较两组患儿治疗效果、症状表现、肺功能指标、生活质量及不良反应发生率。结果 与对照组总有效率77.27%(34/44)相比,观察组93.18%(41/44)较高,差异有统计学意义(P＜0.05);治疗7 d后,观察组咳嗽消失时间(5.12±1.88)d、憋喘消失时间(1.88±0.95)d、肺啰音消失时间(5.45±1.21)d均较对照组[(8.03±1.22)d、(3.65±1.04)d、(7.02±1.62)d]短,差异有统计学意义(P＜0.05);治疗7 d后,观察组FVC、FEV₁、PEF水平[(3.38±0.42)、(2.13±0.48)、(435.79±40.75)L/min]均高于对照组[(2.67±0.46)、(1.75±0.43)、(388.94±35.93)L/min],差异有统计学意义(P＜0.05)。治疗7 d后,观察组SGRQ评分(34.11±4.25)分低于对照组(42.52±4.48)分,差异有统计学意义(P＜0.05)。两组不良反应发生率比较[13.64%(6/44),9.09%(4/44)],差异无统计学意义(P＞0.05)。结论 沙丁胺醇与M胆碱受体阻断剂应用于支气管哮喘患儿,可提高其治疗效果,可缩短咳嗽消失、憋喘消失及肺啰音消失时间,改善其肺功能,提高生活质量,降低不良反应发生率,值得临床推广应用。

目的 探讨阿莫西林克拉维酸钾干混悬剂(7:1)联合胸腺肽治疗支气管哮喘合并肺部感染患儿的临床疗效。方法 选取我院支气管哮喘合并肺部感染患儿102例,依照治疗方案不同分为研究组(n=51)、常规组(n=51)。常规组采用M胆碱受体阻断剂联合阿莫西林克拉维酸钾干混悬剂(7:1)治疗,研究组于常规组基础上采用胸腺肽治疗,统计比较两组临床疗效、随访3个月复发率及治疗前后血清炎性因子[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平、肺功能指标[第1 s用力呼气容积(FEV₁)、第1 s用力呼气容积/用力肺活量(FEV₁/FVC)]。结果 研究组治疗总有效率94.12%高于常规组80.39%(P＜0.05);治疗2周后研究组FEV₁、FEV₁/FVC水平高于常规组,血清IL-6、TNF-α水平低于常规组(P＜0.05);研究组复发率3.70%(1/27)与常规组11.11%(2/18)比较,差异无统计学意义(P＞0.05)。结论 阿莫西林克拉维酸钾干混悬剂(7:1)联合胸腺肽治疗支气管哮喘合并肺部感染患儿疗效显著,可降低患儿炎症反应、改善肺功能。

支气管哮喘是由多种细胞和和细胞因子参与的气道慢性炎症性疾病,白细胞介素、干扰素、集落刺激因子、肿瘤坏死因子、趋化因子等细胞因子在哮喘发生发展过程中发挥着重要作用。

目的 本研究通过检测吸入布地奈德治疗支气管哮喘患儿前、后气道重塑、肺功能及外周血TGF-β浓度的变化,探讨布地奈德在哮喘患儿气道重塑早期干预的作用。方法 将2013年1月—2014年10月在我院确诊为支气管哮喘患儿18例,给予规律吸入布地奈德治疗6个月,分别于治疗前、后检测肺功能、外周血TGF-β浓度以及通过高分辨CT(HRCT)测量支气管管壁厚度(T)并计算管壁面积(WA)、支气管管壁厚度与气管外径之比(WT%)、气道壁横截面面积占气道总截面积的的百分比(WA%)。结果 吸入布地奈德治疗治疗6个月后,哮喘患儿WT%、WA%、肺功能以及TGF-β浓度均明显改善,与治疗前比较差异有统计学意义(P<0.05)。结论 规律吸入布地奈德治疗能减轻支气管哮喘患儿早期气道重塑,改善肺功能,可能通过下调细胞因子TGF-β的表达有关。

Objective We detected the changes of Airway remodeling,lung function and peripheral blood concentrations of TGF-β in asthmatic children before and after inhaled budesonide, and explored the role of budesonide in airway remodeling before early intervention in asthmatic children. Methods 32 cases of children were diagnosed asthma in our hospital,and given treatment of inhaled budesonide for 6 months, and to detect lung function,pheral blood TGF-β concentration as well as measuring the bronchial wall thickness (T) and calculate the wall area (WA), the outer diameter of the trachea and bronchial wall thickness ratio (WT%), the cross-sectional area of the airway wall accounted for airway percentage (WA%) of the total cross-sectional area by high-resolution CT (HRCT) before and after treatment. Results After treatment with inhaled budesonide in six months, the asthma WT%, WA%, lung function, and TGF-β concentrations were significantly improved, the differences compared with that before treatment were statistically significant(P<0.05). Conclusion The treatment of inhaled budesonide can alleviate asthmatic airway remodeling in early, improve lung function,possibly related to down the expression TGF-β.