Bao Wuping, Liu Ping, Qiu Zhongmin, Yu Li, Hang Jingqing, Gao Xiaohua, Zhou Xin
Department of Respiratory Medicine, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai 200080, China.
Chin Med J (Engl). 2015 Jan 5;128(1):39-45. doi: 10.4103/0366-6999.147805.
The efficacy of montelukast (MONT), a cysteinyl leukotriene receptor antagonist, in nonasthmatic eosinophilic bronchitis (NAEB), especially its influence on cough associated life quality is still indefinite. We evaluated the efficacy of MONT combined with budesonide (BUD) as compared to BUD monotherapy in improving life quality, suppressing airway eosinophilia and cough remission in NAEB.
A prospective, open-labeled, multicenter, randomized controlled trial was conducted. Patients with NAEB (aged 18-75 years) were randomized to inhaled BUD (200 μg, bid) or BUD plus oral MONT (10 μg, qn) for 4 weeks. Leicester cough questionnaire (LCQ) life quality scores, cough visual analog scale (CVAS) scores, eosinophil differential ratio (Eos), and eosinophil cationic protein (ECP) in induced sputum were monitored and compared.
The control and MONT groups contained 33 and 32 patients, respectively, with similar baseline characteristics. Significant with-in group improvement in CVAS, LCQ scores, Eos, and ECP was observed in both groups during treatment. After 2-week treatment, add-on treatment of MONT was significantly more effective than BUD monotherapy for CVAS decrease and LCQ scores improvement (both P < 0.05). Similar results were seen at 4-week assessment (both P < 0.05). 4-week add-on therapy of MONT also resulted in a higher percentage of patients with normal sputum Eos (<2.5%) and greater decrease of ECP (both P < 0.05).
MONT combined with BUD was demonstrated cooperative effects in improvement of life quality, suppression of eosinophilic inflammation, and cough remission in patients with NAEB.
半胱氨酰白三烯受体拮抗剂孟鲁司特（MONT）在非哮喘性嗜酸性粒细胞性支气管炎（NAEB）中的疗效，尤其是其对咳嗽相关生活质量的影响尚不确定。我们评估了MONT联合布地奈德（BUD）与BUD单药治疗相比，在改善NAEB患者生活质量、抑制气道嗜酸性粒细胞增多和咳嗽缓解方面的疗效。
进行了一项前瞻性、开放标签、多中心、随机对照试验。将NAEB患者（年龄18 - 75岁）随机分为吸入BUD（200μg，每日两次）组或BUD加口服MONT（10μg，每晚一次）组，治疗4周。监测并比较莱斯特咳嗽问卷（LCQ）生活质量评分、咳嗽视觉模拟量表（CVAS）评分、诱导痰中的嗜酸性粒细胞分类比例（Eos）和嗜酸性粒细胞阳离子蛋白（ECP）。
对照组和MONT组分别有33例和32例患者，基线特征相似。两组在治疗期间CVAS、LCQ评分、Eos和ECP均有显著的组内改善。治疗2周后，MONT附加治疗在降低CVAS和改善LCQ评分方面显著优于BUD单药治疗（均P < 0.05）。4周评估时也观察到类似结果（均P < 0.05）。MONT的4周附加治疗还使痰Eos正常（<2.5%）的患者比例更高，ECP下降幅度更大（均P < 0.05）。
MONT联合BUD在改善NAEB患者生活质量、抑制嗜酸性粒细胞炎症和咳嗽缓解方面显示出协同作用。
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