The Effect Of Mometasone Furoate Nasal Spray And Montelukast Sodium Chewable Tablets In The Treatment Of Children With Obstructive Sleep Apnea Hypopnea Syndrome

Objective:To evaluate the clinical efficacy of Mometasone furoate nasal spray and Montelukast sodium chewable tablets?in the treatment of children with obstructive sleep apnea hypopnea syndrome?OSAHS?,In order to find a safe and effective method of conservative treatment of children with OSAHS.Methods:Children with symptoms of snoring and choking during sleep who were treated in the Department of Otolaryngology from December 2018 to December 2019 were selected.And the family members of the children asked for conservative treatment,Children were randomly divided into three groups: Nasal Hormone Group?M1 group?30 cases,Montelukast Sodium Group?M2 group?30 cases and combined medication group?M3 group?30 cases.The general data of children were collected: sex,age,course of disease and weight.the score of the adenoidal nasopharyngeal ratio?A/N ratio?,disease-specific quality of life forchildren with obstructive sleep apnea18 items survey?OSA-18?and PSG were recorded before treatment,its completion and at 8 weeks after end of treatment.Results:A total of 83 children were followed up after 4 weeks of medication treatment,and 47 children were followed up 8 weeks after treatment.At the end of 4 weeks:1.the A/N ratio of adenoids in M1 group decreased from 0.71±0.06 to 0.65±0.05?P < 0.05?.and M2 group decreased from 0.76±0.06 to 0.70±0.08?P < 0.05?.and the M3 group decreased from 0.72±0.05 to 0.60±0.09?P < 0.05?.At the end of 4 weeks,the A / N ratio of in M3 groups was significantly lower than the M1 and M2 groups?P < 0.05?.2.In M1 group,AHI decreased from 11.80±4.23 to 9.18±4.91,LSaO₂ increased from 86.15±5.10 to 87.19±6.03?P < 0.05?.In M2 group,AHI decreased from 12.43±4.61 to 8.99±4.12,LSaO₂ increased from 84.39±5.22 to 86.96±6.40?P < 0.05?.In M3 group,AHI decreased from 11.34±4.81 to 6.51±3.82,LSaO₂ increased from 84.79±6.56 to 90.25±5.72?P < 0.05?.At the end of 4 weeks,there were significant differences in AHI and LSaO₂ among the three groups.AHI in M3 group was lower than that in M1 and M2 group,and LSaO₂ in M3 group was higher?P < 0.05?.3.M1 Group: the total score of OSA-18 was 45.44 ±16.81 after 4 weeks of treatment,which was significantly lower than that of 58.56 ±13.54 before treatment?P < 0.05?.In M2 group,the total score of OSA-18 was 48.79 ± 18.99 after 4 weeks of treatment,which was significantly lower than that of 61.11± 15.98 before treatment?P < 0.05?.In M3 group,the total score of OSA-18 was 35.25 ±15.57 after 4 weeks of treatment,which was significantly lower than that of 61.93 ±15.29 before treatment?P < 0.05?.The scores of sleep disorder,physical symptoms and the influence on the guardian were significantly decreased in the three groups,while the scores of mood and daytime function were not significantly decreased,but the changes of the scores of the five dimensions were statistically significant?P < 0.05?.At the end of 4 weeks,the total score of OSA-18 in M3 group was significantly lower than that in M1 group and M2 group?P < 0.05?.4.The total effective rate was 66.7% in M1 group,57.1% in M2 group and 82.1% in M3 group.The total effective rate of M3 group was higher than that of M1 group and M2 group?P < 0.05?.5.The total improvement rate was 74.1% in M1 group,60.7% in M2 group and 92.9% in M3 group.The total improvement rate of M3 group was higher than that of M1 group and M2 group?P < 0.05?.At the end of 8 weeks,the A / N ratio,AHI,LSaO₂ and the total score of OSA-18 in the three groups were slightly changed compared with the end of treatment,but there was no significant difference?P < 0.05?.Conclusion:1.Both mometasone furoate nasal spray and montelukast sodium chewable tablets can reduce the volume of adenoids,relieve upper airway obstruction,reduce the severity of illness and improve the quality of life of children with OSAHS.2.The clinical efficacy of combined treatment is better than that of single-drug treatment.3.The effect of treatment can last at least 8 weeks after the end of treatment.