Small Airway Function Changes And Treatment Strategies In Patients With Bronchial Asthma

Object: Bronchial asthma is one of the common chronic respiratory diseases in pediatrics.Asthma control is often related to many factors.Poor small airway function is one of the important reasons that make it difficult to control asthma well.The small airway is an important part of the respiratory tract,and its dysfunction can lead to recurrent attacks and poor prognosis of asthma.Currently,medicines to improve small airway function mainly include glucocorticoids,β2 receptor agonists,leukotriene receptor antagonists and biological agents.Glucocorticoids have good anti-inflammatory effects and are currently the first-line drugs for improving small airway function.Oral,intravenous or inhalation use of glucocorticoids all have the risk of inhibiting the adrenal axis and affecting the growth of children.Biological agents have certain therapeutic value for refractory asthma,but are still in the exploratory stage.LTRA can control asthma and improve clinical symptoms by inhibiting the combination of inflammatory mediators and receptors.It is currently believed that it can also improve small airway function.Montelukast is a representative of this type of drug,has the advantages of good compliance and high safety.This study explored the effectiveness of montelukast as a kind of small airway medicine by evaluating the efficacy of combined use of montelukast,aiming to provide multiple choice of clinical medicine use for children with poorly controlled asthma and small airway dysfunction.Methods:Children with bronchial asthma diagnosed in Shaoxing People’s Hospital between January 2021 and February 2022 were collected,after screening,they were included into the study,and randomly divided into group A and B.Group A was given budesonide/formoterol powder inhalation twice a day;group B was given budesonide/formoterol powder inhalation once a day and montelukast sodium chewable tablet once a night,followed up for 1 year.Observation indexes include: lung function,height,weight,Asthma acute attack times,asthma control test scores,etc.Results: A total of 103 cases were finally completed(52 cases in group A and 51 cases in group B),and there was no statistical difference in the baseline period between the two groups.1.Intra-group comparison: At the 3rd,6th,and 12 th month after treatment,the main large and small airway function indexes and asthma symptom control scores of children in the two groups were improved,which was statistically significant compared with that before treatment(P<0.05).2.Inter-group comparison: In each follow-up period,the large and small airway function indexes and the control of asthma symptoms in the two groups were similar,and there was no statistical difference(P>0.05).During the 1-year follow-up,there was no significant difference in acute asthma attacks times between the two groups(P>0.05).3.After one year of follow-up,there was no significant difference in height and weight changes between the two groups(P>0.05).4.During the follow-up period,one case of mild adverse reactions occurred in group B during the study,mainly manifested as excitement,irritability,etc.,and no serious adverse reactions occurred in the two groups.Conclusion:As an asthma drug,montelukast can effectively improve the large and small airway functions of children with asthma,strengthen the control of asthma symptoms,and reduce the use of ICS.Montelukast has mild psychiatric adverse reactions in individual children,but it is generally an effective and safe drug for treating small airway dysfunction.