To investigate the therapeutic value and safety profile of combined nebulized budesonide and salbutamol for pediatric acute severe asthma exacerbations.

This prospective, randomized and controlled trial enrolled 94 children with acute severe asthma exacerbations treated between January 2020 and December 2024. Patients were randomly assigned to a combination therapy group (n=48, budesonide + salbutamol nebulization)and a monotherapy group (n=46, salbutamol nebulization alone). Comparative assessments included clinical efficacy evaluation, pulmonary function parameters, inflammatory biomarker modulation, symptom resolution rates, medication safety, and subsequent recurrence frequency.

The combination therapy group demonstrated significant advantages, including higher total effective rate (P<0.05), superior pulmonary function recovery, with greater improvements in FEV1, PEF, and FEV1/FVC compared to the monotherapy group (P<0.05), more pronounced reduction in inflammatory markers (IL-6, TNF-α, hs-CRP) (P<0.05), accelerated symptom resolution (wheezing, dyspnea, coughing) and shortened hospitalization duration (P<0.05), comparable adverse reaction rates (P>0.05) and significantly reduced three-month recurrence risk (P<0.05).

For children with acute severe asthma, combined budesonide-salbutamol nebulization speeds symptom relief, aids lung function recovery, reduces airway inflammation, lowers recurrence risk, and it is safe, warranting clinical promotion. This regimen offers integrated benefits and is a valuable clinical option.