Observation of the curative effect of montelukast in the treatment of bronchial asthma: There were 16 female cases, aged between 18 and 51 years old, with an average age of 38 years. The 36 patients were randomly divided into a treatment group and a control group, each consisting of 18 cases. There were no statistically significant differences between the two groups regarding sex, age, course of disease, and severity of the disease. The selected cases met the diagnostic criteria for bronchial asthma... and fulfilled the following conditions: 1) Inhaled glucocorticoid was less than or equal to 1200D; 2) No systemic corticosteroids were used within the last month; 3) No leukotriene receptor antagonists were used within the last two weeks; 4) Adrenergic receptor agonist was used within the last week; 5) Currently without respiratory infection, and no hospitalization due to respiratory disease within the last month; 6) No careless, liver, renal insufficiency, and mental disorders.
Treatment method: The 36 patients were given Seretide (salmeterol / fluticasone propionate 50 ~ / 25og dry powder inhalation agents) produced by GlaxoSmithKline pharmaceutical companies, 2/D, 1 suction/time. The treatment group was additionally given Singulair (Meng Lu Division special sodium) produced by MSD pharmaceutical companies, 10mg orally every night before bed, for a total of 4 weeks. Before and after treatment, blood and urine routine tests, liver and renal function, blood pressure, heart rate, and ECG changes were observed.
Clinical observation on treatment indicators: Forced expiratory volume in one second (FEV1) was measured before and after treatment, along with asthma symptom scores. Scoring standards: Inquiry about symptoms: 0: No cough, chest tightness, wheezing, dyspnea; 1: Mild or intermittent symptoms, mild discomfort that may be ignored; 2: Moderate or frequent symptoms, manifested as discomfort or affecting normal activity at least once; 3: Persistent symptoms affecting activity. Nighttime symptoms: 0: No symptoms at night; 1: Nighttime awakening once; 2: Frequent nighttime awakenings interrupting sleep; 3: Insomnia orthopnea, inability to lie down.
Statistics: Data from the two groups were compared using the (2) test. Asthma symptom scores, FEV1% predicted values were expressed as mean ± standard deviation (± s), and analyzed using the t-test.
Results: After treatment, the comparison of curative effects between the two groups showed statistically significant differences in asthma symptom scores and FEV1% estimates (P<0.05), see Table 1.
Table 1: Asthma symptom scores and FEV1% expected values (± s) before and after treatment in the two groups.
Adverse reactions: Individual patients experienced headaches, abdominal discomfort, mild adverse reactions, without special treatment, naturally relieved after stopping the medication. After the end of treatment, review of blood and urine routine, liver and renal function, blood pressure, heart rate, and ECG showed no changes.
Discussion: Bronchial asthma is related to a range of inflammatory cells and inflammatory mediators in the complex reaction process. Leukotrienes are important inflammatory mediators, with cysteinyl leukotrienes being their main pathogenic components, playing a key role in the onset and development of asthma. Both during seizures and stable periods, the levels of leukotrienes in asthma patients are higher than those in normal people. Leukotrienes cause bronchial smooth muscle spasm contraction, increased microvascular permeability, bronchial mucosa edema, increased mucus secretion, and have eosinophil chemotactic activity, which can induce bronchial smooth muscle hyperplasia and reconstruction. In particular, the contracting function of leukotrienes on bronchial smooth muscle is much stronger than histamine and acetylcholine, with a longer duration, increasing mucus glycoprotein secretion, promoting the formation of mucus plugs, further aggravating airway obstruction. Montelukast is so far the most powerful specific leukotriene receptor antagonist, competing with leukotriene receptors, blocking leukotriene receptor binding, inhibiting the inflammatory response, not only alleviating acute attacks but also reducing the infiltration of inflammatory cells, alleviating airway inflammation, and reducing airway reactivity.