| Objective:To explore the value of Inhaled corticosteroids(ICS)dose adjustment in children with bronchial asthma in combination with Fractional exhaled nitric oxide(FeNO)and lung function detection,and the outcome characteristics of FeNO and lung function in the course of asthma treatment.Methods: A total of 133 newly treated children with bronchial asthma aged 6 to 12 who were admitted to our hospital from October 2018 to October 2020 were selected as the research subjects,including 105 moderate cases and 28 severe cases.After admission,they were randomly divided into the test group(n= 68)and the control group(n=65),and then the two groups were treated accordance to the guidelines for the diagnosis and prevention of bronchial asthma in children revised by the respiratory group of the pediatrics branch of the chinese medical association in 2016.The test group adjusted the dose of ICS based on the controlling level of asthma and the testing results of pulmonary function and FeNO,while the control group adjusted the dose of ICS based on the control level of asthma and the testing results of pulmonary function after 3 months of treatment.The frequency of asthma exacerbation,pulmonary function and FeNO results were compared between the two groups after 3 months of treatment.Childhood asthma control test(C-ACT)was used to evaluate the scores of the two groups.Results:(1)Pulmonary function of test group and control group was improved after treatment for 3 months,and the FeNO of test group and control group was reduced after treatment for 3 months.Pulmonary function normal rate in the test group and the control group were 55.9% and 55.4% respectively,and the FeNO normal rate in the test group and the control group were 19.1% and18.5% respectively.After 3 months of treatment,there was no significant difference in pulmonary function and FeNO between the experimental group and the control group(P > 0.05).There was no significant difference in asthma control rate and C-ACT score between the two groups after treatment(P > 0.05).(2)After 6 months of treatment,pulmonary function in the test group and control group was improved compared with that in the 3 months of treatment,while FeNO was decreased compared with that in the 3months of treatment,and the difference was statistically significant(P < 0.05).The normal rates of pulmonary function in the test group and the control group were 85.3% and 67.7%respectively.The normal rate of FeNO in thetest group and the control group was 91.2% and75.4% respectively,and the difference between the two groups was statistically significant(P< 0.05).(3)After 6 months of treatment,the rate of acute exacerbation of asthma in the test group was lower than that in the control group,17.7% of children with asthma in the test group had acute exacerbation of asthma,and 35.4% of children in the control group had acute exacerbation of asthma,and the comparison between the two groups had statistical significance(P < 0.05).The total control(control + partial control)rate in the test group was higher than that in the control group(91.2% in the experimental group and 76.9% in the control group),and the comparison between the two groups was statistically significant(P <0.05).C-ACT score of the tes group was higher than that of the control group,and the difference was statistically significant(P < 0.05).Conclusion: The recovery time of atmospheric tract functions such as PEF and FEV1 to normal is shorter than that of FeNO,while the recovery time of small airway function(MMEF)is slower,suggesting that the change of FeNO should be considered in the adjustment of ICS dose,and the recovery of small airway function in children with asthma should be followed up for a long time.The combination of exhaled nitric oxide and Pulmonary function measurement as an indicator of asthma ICS treatment can promote the recovery of pulmonary function,reduce airway inflammation,and improve the rate of asthma control and reduce the rate of asthma exacerbation,which has certain clinical guiding significance. |
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