目的 观察实行中国儿童哮喘行动计划(CCAAP)对儿童支气管哮喘的临床管理效果和安全性。方法 选择2017年10月-2018年10月保定市第一中心医院儿科诊治的64例确诊为支气管哮喘的患儿,随机分为两组:治疗组(34例)采用CCAAP管理,对照组(30例)采用传统管理,对比两组治疗效果、急性哮喘发作次数、肺功能、免疫功能和并发症。结果 治疗组总控制效果优于对照组(97.06% vs.80.00%,χ2=4.761, P=0.029)。治疗组第1秒用力呼气容积(FEV1)、FEV1与用力肺活量(FVC)的比值(FEV1/FVC)、FEV1占预计值百分数(FEV1/pred)、用力呼气25%流速(MEF25)、MEF50、MEF75、CD3+、CD4+和CD4+/CD8+均较对照组显著增高(P＜0.05),免疫球蛋白E(IgE)和白细胞介素-4(IL-4)显著降低(P＜0.05),急性发作率(14.71% vs.50.00%,P＜0.05)和并发症发生较低(2.00% vs.10.00%,P＜0.05)。结论 CCAAP可提高儿童支气管哮喘治疗效果和安全性,并有助于改善患儿肺功能和免疫功能。
Abstract
Objective To observe the clinical management and safety of China Children Asthma Action Plan(CCAAP) in children with bronchial asthma. Methods A total of 64 children with bronchial asthma in the Pediatric Department of Baoding First Central Hospital from October 2017 to October 2018 were enrolled in this study,and were randomly divided into two groups by random number table method. The observation group(n=34) was managed by CCAAP,while the control group(n=30) received traditional management.The efficacy,pulmonary function,immune function and side effect of two groups were compared. Results Compared with the control group,the treatment effect of the observation group was better(97.06% vs.80.00%,χ2=4.761,P=0.029).The forced expiratory volume in 1 second(FEV1),FEV1/forced vital capacity(FEV1/FVC),FEV1/pred,25% of the maximal mid-expiratory flow(MEF25),MEF50,MEF75,CD3+,CD4+ and CD4+/CD8+ were significantly higher than those in control group,while the IgE and IL-4 levels decreased(P＜0.05).Moreover,the rates of acute attack(14.71% vs.50.00%) and complications(2.00% vs.10.00%) in the observation group were significantly lower(P＜0.05). Conclusion The CCAAP can improve the efficacy and safety of bronchial asthma in children and help improve pulmonary function and immune function.
关键词
中国儿童哮喘行动计划 /
支气管哮喘 /
临床管理
Key words
China Children Asthma Action Plan /
bronchial asthma /
clinical management
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参考文献
［1］马香萍,乔丽潘,多力坤,等.乌鲁木齐市0～14岁儿童支气管哮喘流行病学调查分析及危险因素分析[J].中华实用儿科临床杂志,2015,30(4):261-263.
[2]Pike KC,Levy ML,Moreiras J,et al.Managing problem atic severe asthma:beyond the guide lines[J].Arch Dis Child,2018,103(4):392-397.
[3]Bateman ED,Hurd SS,Barnes PJ,et al.Global strategy for asthma management and prevention:GINA executive summary[J].Eur Respir J,2018,51(2):pii:0751387.
[4]申昆玲,赵京.中国儿童哮喘行动计划的探索[J].中华实用儿科临床杂志,2017,32(4):241-244.
[5]中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南[J].中华儿科杂志,2016,54(3):167-181.
[6]Wang GW,Kwon N,Hang JG,et a1.Pediatric asthma control in Asia:phase 2 of the Asthma Insights and Reality in Asia-Pacific(AIRIAP 2) survey[J].Allergy,2013,68(4):524-530.
[7]罗新兵,朱晓萍,李波,等.贵阳地区400例支气管哮喘患儿病情控制情况及家长对疾病认知水平的调查分析[J].山东医药,2015，58(19):17-20.
[8]Weverhess J,Kouwenberg JM,Duiverman EJ,et al.Risk factors for exacerbations and hospital admissions in asthma of early childhood[J].Pediatr Pulmonol,2015,29(4):250-256.
[9]Kuhn L,Reeves K,Taylor Y,et al.Planning for action:the lmpact of an asthma action plan decision support tool integrated into an electronic health record(EHR) at a large health care system[J].J Am Board Fam Med,2015,28(3):382-393.
［10］于艳艳,张玉红,施庆喜,等.一体化管理模式对儿童哮喘控制水平的影响[J].重庆医学,2018，47(1):90-92.
[11]李吾菲,粟顺善,李爱琼,等.哮喘儿童自我管理模式的构建与应用研究[J].护理研究,2016,30(2):147-150.
[12]王利维,俞群,周立.知信行理论在学龄期哮喘儿童自我管理行为干预中的应用[J].解放军护理杂志,2017,34(7):32-35.
[13]张云彩.健康教育辅导联合居家自我护理对哮喘患儿临床症状及心理状况的影响[J].实用临床医药杂志,2017,21(20):203-205.
[14]王留义,忽新刚,顾建钦,等.基于手机端的慢病管理系统对社区支气管哮喘患儿自我管理能力及哮喘控制效果的影响[J].实用心脑肺血管病杂志,2018,26(4):86-88.
[15]喜雷,皇惠杰,倪鑫,等.基于移动互联网技术儿童哮喘自我管理工具的构建与应用研究[J].中国全科医学,2017,(28):3542-3547.
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