维生素A制剂辅助布地奈德治疗支气管哮喘患儿临床疗效及对免疫功能的影响
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摘要
目的探讨维生素A制剂辅助布地奈德治疗支气管哮喘患儿临床疗效及对免疫功能的影响。方法选取2015年3月～2017年5月本院收治的122例支气管哮喘患儿为研究对象,按治疗方式不同分为对照组和观察组,每组各61例。两组患儿入院后均按照支气管哮喘常规治疗,对照组在常规治疗基础上给予布地奈德治疗,观察组在对照组的基础上加维生素A辅助治疗,两组均治疗4周。比较两组患儿治疗前后免疫功能、哮喘症状、血清IL-17、IL-10及TGF-β1水平变化以及对两组患儿临床疗效、不良反应的影响。结果治疗前两组体液免疫IgA、IgG、IgM水平比较差异无统计学意义(P>0.05),治疗后两组IgA、IgG、IgM明显升高,观察组明显高于对照组(P<0.05);治疗前两组T细胞亚群CD3~+、CD4~+、CD8~+、CD4~+/CD8~+水平比较差异无统计学意义(P>0.05),治疗后两组CD3~+、CD4~+、CD8~+明显升高,观察组明显高于对照组(P<0.05);治疗前两组IL-17、IL-10及TGF-β1水平无明显差异(P>0.05),治疗后两组IL-17均明显降低,观察组低于对照组(P<0.05),两组IL-10及TGF-β1均升高,观察组明显高于对照组(P<0.05);治疗后两组哮喘症状评分均明显下降,观察组低于对照组(P<0.05);观察组临床有效率明显高于对照组(P<0.05);对照组不良反应发生率组间比较差异无统计学意义(P>0.05)。结论采用维生素A辅助布地奈德治疗支气管哮喘患儿,可有效的缓解患儿症状,促进治疗效果,提高患者免疫水平,安全性可靠,可作为有效治疗支气管哮喘患儿的临床治疗方法之一。
Objective To investigate the effects of vitamin A preparation combined with budesonide on immune function of children with bronchial asthma. Methods 122 children with bronchial asthma treated in our hospital from March 2015 to May 2017 were selected and divided into control group and observation group, according to different treatment methods. All children received the routine treatment, based on this, the control group received the budesonide, while the observation group received the vitamin A preparation combined with budesonide, both tid. for 4 weeks. The immune function, asthma symptoms, serum IL-17, IL-10, and TGF-β1 levels, clinical efficacy and adverse reactions in the two groups were compared. Results The levels of humoral immunity IgA, IgG and IgM between the two groups had no difference before treatment(P>0.05), and were increased after treatment. The levels of humoral immunity IgA, IgG and IgM in the observation group were higher than those in the control group after treatment(P<0.05). The levels of CD3~+, CD4~+, CD8~+, and CD4~+/CD8~+ in T cell subsets had no difference before treatment(P>0.05), and above levels except CD4~+/CD8~+ were increased after treatment. The levels of CD3~+, CD4~+, CD8~+, and CD4~+/CD8~+ in T cell subsets in the observation group were higher than those in the control group(P<0.05). The levels of IL-17, IL-10 and TGF-β1 between the two groups had no difference before treatment(P>0.05), and the IL-17 level was decreased in both groups, the IL-10 and TGF-β1 levels were increased on both groups. Both of the decreasing and increasing degrees were more significant in the observation group than in the control group(P<0.05). The asthma symptoms scores of the two groups were decreased significantly. The asthma symptoms scores in the observation group were lower than those in the control group(P<0.05). The clinical efficiency of the observation group was significantly higher than that of the control group(P<0.05). The incidence of adverse reactions was 8.20% in the control group, which was not significantly different in observation group(P>0.05). Conclusion The vitamin A preparation combined with budesonide can safely and effectively relieve the symptoms, promote therapeutic effects and improve the immune level of children with bronchial asthma.
Objective To investigate the effects of vitamin A preparation combined with budesonide on immune function of children with bronchial asthma. Methods 122 children with bronchial asthma treated in our hospital from March 2015 to May 2017 were selected and divided into control group and observation group, according to different treatment methods. All children received the routine treatment, based on this, the control group received the budesonide, while the observation group received the vitamin A preparation combined with budesonide, both tid. for 4 weeks. The immune function, asthma symptoms, serum IL-17, IL-10, and TGF-β1 levels, clinical efficacy and adverse reactions in the two groups were compared. Results The levels of humoral immunity IgA, IgG and IgM between the two groups had no difference before treatment(P>0.05), and were increased after treatment. The levels of humoral immunity IgA, IgG and IgM in the observation group were higher than those in the control group after treatment(P<0.05). The levels of CD3~+, CD4~+, CD8~+, and CD4~+/CD8~+ in T cell subsets had no difference before treatment(P>0.05), and above levels except CD4~+/CD8~+ were increased after treatment. The levels of CD3~+, CD4~+, CD8~+, and CD4~+/CD8~+ in T cell subsets in the observation group were higher than those in the control group(P<0.05). The levels of IL-17, IL-10 and TGF-β1 between the two groups had no difference before treatment(P>0.05), and the IL-17 level was decreased in both groups, the IL-10 and TGF-β1 levels were increased on both groups. Both of the decreasing and increasing degrees were more significant in the observation group than in the control group(P<0.05). The asthma symptoms scores of the two groups were decreased significantly. The asthma symptoms scores in the observation group were lower than those in the control group(P<0.05). The clinical efficiency of the observation group was significantly higher than that of the control group(P<0.05). The incidence of adverse reactions was 8.20% in the control group, which was not significantly different in observation group(P>0.05). Conclusion The vitamin A preparation combined with budesonide can safely and effectively relieve the symptoms, promote therapeutic effects and improve the immune level of children with bronchial asthma.
引文
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[18] 刘海燕,杨旭东.槐杞黄颗粒辅助治疗儿童支气管哮喘的临床疗效及对患儿免疫功能的影响[J].药物评价研究,2017,40(11):1618-1621.
[19] 王玮琳,杨春佳,杨湘峰,等.新生儿呼吸窘迫综合征患儿血清转化生长因子-β_1、骨形态发生蛋白-7、维生素A水平及其与病情程度的关系[J].广西医学,2017,39(10):1524-1526.
[20] 闫静静,林荣军,胡素娟,等.支气管哮喘患儿血清中白细胞介素25,33及嗜酸细胞趋化因子水平变化及临床意义[J].中国组织工程研究,2016,19(5):156-158.
[21] Gao X Y,Pediatrics D O.Analysis of Clinical Efficacy and Safety of Montelukast and Budesonide Treatment of Children with Bronchial Asthma[J].Medical Recapitulate,2016,22(6):685-686.
[22] 周月朋,李俊杰,李晓东,等.支气管哮喘患儿外周血 IL-27、IL-35及 EBI3的表达变化及意义[J].解放军医药杂志,2014,25(7):71-74.
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[24] 苏宝凤,郦银芳,张莉.白细胞介素-4、白细胞介素-8、白细胞介素-9在支气管哮喘患儿血清中的表达及临床意义[J].实用临床医药杂志,2014,18(19):91.
[25] 柏翠,于晓峰,王芳,等.维生素A制剂对支气管哮喘患儿外周血辅助性T淋巴细胞17和调节性T淋巴细胞功能的影响[J].中华实用儿科临床杂志,2016,31(9):675-678.
[26] 王平,高云,王利民,等.支气管哮喘患儿血清IL-17、ECP及IgE的水平测定及相关性研究[J].中国妇幼保健,2014,29(21):3443-3445.
[27] 米娜瓦·阿巴斯,祖木来提·吐尔逊,杨晓红.布地奈德对支气管哮喘患者血清炎性因子及免疫功能的影响[J].海南医学院学报,2015,21(8):1042-1044.
[28] 董玉红,史应进.支气管哮喘患儿血清白细胞介素变化及其与 IgE、中性粒细胞百分比相关性分析[J].中国临床医生杂志,2014,42(11):51-52.
[29] 李草旎,陈雪莉.自拟平喘汤配合GINA阶梯方案对支气管哮喘患儿血清IL-17、IL-33水平及生活质量的影响[J].现代中西医结合杂志,2016,25(29):3205-3207.
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[34] 柏翠,于晓峰,王芳,等.维生素A制剂对支气管哮喘患儿外周血辅助性T淋巴细胞17和调节性T淋巴细胞功能的影响[J].中华实用儿科临床杂志,2016,31(9):675-678.
[2] 陈静,张玉珍.信息及情感支持对支气管哮喘儿童父母疾病不确定感的影响[J].中国健康心理学杂志,2018,25(2):200-203.
[3] 郑碧武,周攀,范强.灵芝补肺汤对支气管哮喘患者肺功能及免疫功能影响分析[J].河北医药,2016,44(3):363-365.
[4] 陈阳,朱峰,李琪.泛福舒联合布地奈德对支气管哮喘患儿免疫功能的临床研究[J].中国临床药理学杂志,2015,31(6):409-411.
[5] Ling X,Pediatrics D O.Clinical Efficacy of Budesonide Inhalation Solution for the Treatment of Bronchial Asthma in Children[J].Journal of Rare & Uncommon Diseases,2016,6(4):425-426.
[6] 曹霞,肖斌,朱涛.炎琥宁雾化吸入对支气管哮喘急性发作期患者临床症状和炎症反应的影响[J].西部医学,2015,27(4):604-606.
[7] 蔡晓华.匹多莫德对支气管哮喘患儿免疫功能的影响及疗效分析[J].重庆医学,2014,42(12):1508-1511.
[8] 彭波,刘青,梁红英,等.糖皮质激素吸入治疗小儿支气管哮喘对患儿外周血sICAM-1、EOS和NT-3的影响[J].解放军医药杂志,2017,28(12):1225-1226.
[9] 周玲,张伟,刘世青,等.匹多莫德对支气管哮喘患儿免疫因子水平影响及临床疗效研究[J].陕西医学杂志,2016,45(7):875-876.
[10] 姜增凯,贾萍,叶晓歌.孟鲁司特钠联合沙美特罗替卡松粉吸入剂治疗支气管哮喘的临床疗效及其对炎性因子、肺功能、免疫功能的影响研究[J].实用心脑肺血管病杂志,2016,24(4):49-52.
[11] 中华医学会儿科学分会呼吸学组.儿童支气管哮喘诊断与防治指南(2016年版)[J].中华儿科杂志,2016,54(3):167-181.
[12] 郭惠娟,钟明,叶旭辉,等.儿童支气管哮喘的药学服务及临床效果分析[J].儿科药学杂志,2016,21(1):37-41.
[13] 蔡梅香,郑小兰,翁静.参麦注射液对支气管哮喘患儿免疫状态及Th1/Th2型细胞因子的影响[J].现代中西医结合杂志,2015,23(32):3578-3580.
[14] 陶青,蔡榕,诸白美,等.学龄期哮喘患儿系统性家庭干预的临床意义[J].西部医学,2017,14(10):1481-1484.
[15] 许立,保丽丽,王红飞.支气管哮喘患儿缓解期健康指导及定期随访意义[J].临床误诊误治,2016,31(10):111-112.
[16] 万裕辉,温泳涛,张翀.急性上消化道出血患者外周血CD_4～+CD_(25)～+、TGF-β_1、IL-10水平变化及意义[J].山东医药,2015,58(14):45-47.
[17] 张佳佳,胡赤军,周小勤,等.布地奈德联合孟鲁司特钠对支气管哮喘患儿细胞因子、免疫功能影响[J].现代生物医学进展,2017,17(3):550-553.
[18] 刘海燕,杨旭东.槐杞黄颗粒辅助治疗儿童支气管哮喘的临床疗效及对患儿免疫功能的影响[J].药物评价研究,2017,40(11):1618-1621.
[19] 王玮琳,杨春佳,杨湘峰,等.新生儿呼吸窘迫综合征患儿血清转化生长因子-β_1、骨形态发生蛋白-7、维生素A水平及其与病情程度的关系[J].广西医学,2017,39(10):1524-1526.
[20] 闫静静,林荣军,胡素娟,等.支气管哮喘患儿血清中白细胞介素25,33及嗜酸细胞趋化因子水平变化及临床意义[J].中国组织工程研究,2016,19(5):156-158.
[21] Gao X Y,Pediatrics D O.Analysis of Clinical Efficacy and Safety of Montelukast and Budesonide Treatment of Children with Bronchial Asthma[J].Medical Recapitulate,2016,22(6):685-686.
[22] 周月朋,李俊杰,李晓东,等.支气管哮喘患儿外周血 IL-27、IL-35及 EBI3的表达变化及意义[J].解放军医药杂志,2014,25(7):71-74.
[23] 李永梅,宋梅,杜昊.布地奈德联合孟鲁司特治疗小儿支气管哮喘疗效观察[J].现代中西医结合杂志,2013,22(32):3567-3568.
[24] 苏宝凤,郦银芳,张莉.白细胞介素-4、白细胞介素-8、白细胞介素-9在支气管哮喘患儿血清中的表达及临床意义[J].实用临床医药杂志,2014,18(19):91.
[25] 柏翠,于晓峰,王芳,等.维生素A制剂对支气管哮喘患儿外周血辅助性T淋巴细胞17和调节性T淋巴细胞功能的影响[J].中华实用儿科临床杂志,2016,31(9):675-678.
[26] 王平,高云,王利民,等.支气管哮喘患儿血清IL-17、ECP及IgE的水平测定及相关性研究[J].中国妇幼保健,2014,29(21):3443-3445.
[27] 米娜瓦·阿巴斯,祖木来提·吐尔逊,杨晓红.布地奈德对支气管哮喘患者血清炎性因子及免疫功能的影响[J].海南医学院学报,2015,21(8):1042-1044.
[28] 董玉红,史应进.支气管哮喘患儿血清白细胞介素变化及其与 IgE、中性粒细胞百分比相关性分析[J].中国临床医生杂志,2014,42(11):51-52.
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