Abstract��OBJECTIVE To explore the curative effect of the daily and two different METHODS of intermittent atomization inhalation of budesonide(BUD) in the treatment of recurrrent wheezing children under 5 years old, providing the basis for early selection of appropriate intervention regimen for them.METHODS We studied 160 children between the aged 12 and 59 months who had positive values on the modified API(mAPI), recurrent wheezing episodes.Children were randomly divided into three groups according to admission time sequence:daily low dose atomization inhalation group (daily group) 54 cases, intermittent high dose early atomization inhalation group (early group) 53 cases and intermittent general dose preemptive atomization inhalation group (preemptive group) 53 cases.All children were observed for 1 year. Number of systemic corticosteroids courses,wheezing episodes,intravenous,the emergency number,symptomatic days,respiratory symptom scores and other curative effect indicators were compared between the three groups; and compare the number of systemic corticosteroids courses,intravenous,wheezing episodes,the emergency number,and hospitalization rates before and after treatment in each group.RESULTS In this study,10 children failed to complete the test because of various reasons,150 cases were effective, each group 50 cases.All three groups can reduce the number of systemic corticosteroids courses,intravenous,wheezing episodes,the emergency number and hospitalization rate,the difference were statistically significant(P<0.01).There were no statistical significant difference between the three group in the number of systemic corticosteroids courses,wheezing episodes,intravenous,the emergency number,symptomatic days(P>0.05);there was no significant difference between the respiratory symptom scores,the number of hospitalized patients,treatment failure rate, and use SABA days of the three group (P>0.05). The BUD use days and doses of intermittent inhalation regimens is less than daily inhalation regimen(P<0.01);among the three groups,the preemptive group used the least dose(P<0.01). CONCLUSION The efficacy of early and preemptive group is close to the daily group,and BUD days and doses of the early and preemptive group is less than that of daily group. The drug administration time of preemptive group was earlier and the overall drug delivery time is more flexible than early group, so the preemptive regimen can offer new options for 5-year-old children with recurrent wheezing and positive values on the mAPI.
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ZHENG Jiang-zhen, SUN Ping, LI Lu, CHEN Ting-ting, HUANG Tao, WU Ying. Efficacy Study of Three Different Schemes of Budesonide in Recurrent Wheezing Children under 5 Years Old. Chinese Pharmaceutical Journal, 2018, 53(12): 1024-1028.
REIS G G,MIRANDA V M,CARDOSO M R,et al. Prevalence and risk factors for wheezing in salvador, Brazil:a population-based study[J]. Qjm Mon J Associat Physic, 2014, 108(3):213-218.
[2]
CAMARGO C A J R. Human rhinovirus, wheezing illness, and the primary prevention of children asthma[J]. Am J Respir Crit Care Med, 2013, 188(11):1281-1282.
[3]
CASTRO-RODRIGUEZ J A. The asthma predictive index:a very useful tool for predicting asthma in young children[J]. J Allergy Clin Immunol, 2010, 126(2):212-216.
[4]
The respiratory group of the Chinese Medical Association for the moment/Editorial board of the Chinese Journal of Pediatrics.Guidelines for diagnosis and prevention of bronchial asthma in children(2016)[J]. Chin J Pediatr(�л�������־), 2016, 54(3):167-181.
[5]
LIN L, LI C C, ZHANG W X, et al. Effects of Glucocorticoids and Lentinan on the Expression of c-Jun NH2-Terminal Kinase in Lung Tissues of Rats with Asthmatic Airway remodeling[J]. Chin Pharm J(�й�ҩѧ��־), 2011, 46(14):1092-1096.
[6]
SHENG K L, DENG L, LI Y Z, et al. Expert consensus on Application of glucocorticoid aerosol inhalation in pediatrics(Revised edition of 2014)[J]. J Clin Pediatr(�ٴ�������־), 2014, 32(6):504-511.
[7]
ZEIGER R S, MAUGER D, BACHARIER L B, et al. Daily or intermittent budesonide in preschool children with recurrent wheezing[J]. N Engl J Med, 2011, 365(21):1990-2001.
[8]
DUCHARME F M, TSE S M, CHAUHAN B. Diagnosis, management, and prognosis of preschool wheeze[J]. Lancet, 2014, 383(9928):1593-1604.
[9]
ABU RAYA B, BAMBERGER E, KASSIS I, et al. Bordetella pertussis infection attenuates clinical course of acute bronchiolitis[J]. Pediatr Infect Dis J, 2013, 32(6):619-621.
[10]
SHANG Y X, HUANG Y, LIU E M, et al. A multicenter clinical study on the treatment for children��s acute bronchiolitis by nebulized recombinant human interferon ��1b[J]. Chin J Pract Pediatr, 2014, 29(11):840-844
[11]
Asthma group of the Chinese Medical Association. Guidelines for the diagnosis and treatment of coughing(2015)[J]. Chin J Tuberc Respir Dis(�л���Ϻͺ�����־), 2016, 39(5):323-354.
[12]
ROSENTHAL L A, AVILA P C, HEYMANN P W, et al. Viral respiratory tract infections and asthma:the course ahead[J]. J Allergy Clin Immunol, 2010, 125(6):1212-1217.
[13]
HAGAN J B, SAMANT S A, VOLCHECK G W, et al. The risk of asthma exacerbation after reducing inhaled corticosteroids:a systematic review and Meta-analysis of randomized controlled trials[J]. J Allergy Clin Immunol, 2013, 131(3):724-729.
[14]
CHUNG S. Febrile seizures[J]. Korean J Pediatr, 2014, 57(9):384-395.
[15]
SUN P. Clinical analysis of long-term or intermittent inhalation of budesonide in infants with wheezing episodes[J]. Acta Acad Med Mil Tert(������ҽ��ѧѧ��), 2009, 31(14):1336-1348.
[16]
BACHARIER L B, GUILBERT T W, ZEIGER R S, et al. Patient characteristics associated with improved outcomes with use of an inhaled corticosteroid in preschool children at risk for asthma[J]. J Allergy Clin Immunol, 2009, 123(5):1077-1082.
2018, Vol. 53 
