The Value Of Montelukast In The Treatment Of Mild-moderate Bronchial Asthma

Objective:Asthma is a chronic nonspecific airway inflammatory disease,with many inflammatory cells involved.The main clinic manifestation includes recurrent breathing,chest tightness,cough and breath of wheezing that mainly appears in expiratory phase.Because it is a common immunologic disease of respiratory system,and belongs to type I allergic reaction,so its pathologic mechanism is related to inflammatory reaction and allergic reaction.Recently,many researches about inflammatory mechanism of asthma have been well studied.Inlflammation causes various inflammatory cytokines producing in humanbody.Inhaled glucocorticoids can inhibit a variety of inflammatory factors,including inflammatory cytokines,cellular toxins,inflammatory enzymes,adhesion molecules and inflammatory mediator receptors.The long actingβ2 receptor agonist can obviously dilate bronchus and reduce airway resistence.Seretide(salmeterol and fluticasone propionate powder inhalation)has both effects of anti-inflammation and bronchial dilation.Two agents of Seretide are complementary on efficiacy,so it can be used to control asthma faster and more effectively.Montelukast,a non-steroidal anti-inflammatory agent,is a leukotriene receptor antagonist that can block the inflammatory action of cystyl-leukotriene and can also be used to treat asthma.The aim of this article is to try to evaluate the value of Montelukast by comparing the efficacy of Seretide and Montelukast.Methods:A total of 60 patient s with mild-moderate bronchial asthma were enrolled in this study.Among those there were 15 patients who also suffered from allergic rhinitis.The patients were randomly assigned in blocks of 3.GroupA-The Montelukast group(n=20)and group B-the Seretide group(n=20)were given Montelukast 10mg,every night before sleep and Seretide(50/250ug),inhaled twice daily respectively,Group C-The combination treatment group(n=20)received Seretide (50/250ug)once a day and Montelukast,10mg,every night before sleep.They were treated for 6 weeks.The lung function and clinical symptoms were evaluated before and after treatment,while adverse reaction of this drugs was observed.We observed several aspects as follows:(1)clinic efficacy.(2)changes of lung function(FEV1%and PEF%)before and after the treatment.(3)the safety of Montelukast and Seretide. Statistical methods were used to compare the differences within and among groups. Data analysis was performed using the SPSS 11.5 statistical package programme.P＜0.05 was considered as statistically significant.Results:1.Clinic efficacy:There were 8 cases of clinical control,7 cases of utility,4 cases of relieving,1 case of nullity in group A,the rate of effective was 75%;There were 9 cases of clinical control,8 cases of utility,2 cases of relieving,1 cases of nullity in group B,the rate of effective was 85%;There were 11 cases of clinical control,8 cases of utility,1 case of nullity in group C,the rate of effective was 95%.The rate of effect in group C was obviously better than group A and B.(Table 1)Table1 The comparison of the curative effect among 3 groups2.Changes of lung function before and after treatment.(Table 2)Table 2 Changes of lung function(FEV 1%and PEF%) There was obvious statistical difference in group A,B and C(p＜0.05).There was statistical differences between group A and B(p＜0.05)and no obvious statistical difference between group B and C.The lung function was better after treatment in every group than before.The improve of lung function in group C was the best of the 3 groups.3.Observation of adverse effects:Group A:hoarse voise in 2 cases,without any treatment the symptom disappeared;Group b:hoarse voise in 2 cases,palpitation happened in 2 cases and mild abdominal discomfort in 1 case,these symptoms disappeared after medication guide;Group C:throat discomfort occurred in 1 case and disappeared later.Conclusions:1.Seretide or Montelukast used individually can improve clinic symptoms and lung functions of mild-moderate asthma patients.The improvement of lung function is better after 6-week treatment of Seretide than Montelukast.2.With the same clinic effect,Seretide combined with Montelukast can reduce the dose of Seretide,so it can reduce the happens of adverse effect that may occur in Seretide treatment.The combination can get the same lung function improvement and more clinic curative effect.3.Besides the asthma symptoms,receiving Montelukast can also improve the allergic nasal symptoms,so Montelukast should be used in patients who suffer from allergic rhinitis.