维生素A、D治疗毛细支气管炎和儿童支气管哮喘的临床效果研究
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摘要
目的:探讨维生素A、D治疗毛细支气管炎和儿童支气管哮喘的临床效果。方法:选取2016年1月-2018年1月本院住院治疗的毛细支气管炎患儿120例、门诊就诊的支气管哮喘患儿120例、儿童保健门诊查体的健康患儿40例(近1年均无服用维生素AD史)作为研究对象。将毛细支气管炎组、哮喘组分别随机分为治疗组40例(常规治疗+口服维生素AD组)和对照组40例(常规治疗组)。治疗组补充口服维生素AD1粒qd,疗程共6个月。分别比较三组血清维生素A、D水平,随访6个月、1年内喘息的控制情况(喘息发作次数、持续时间、咳嗽程度、有无夜间症状或夜间憋醒、有无活动受限)及肺功能(第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC),哮喘组≥4岁患儿进行儿童哮喘控制测试(C-ACT)评分评价哮喘的控制情况。结果:观察组与对照组患儿血清维生素A、D水平无显著性差异(P>0.05);观察组、对照组患者维生素A、D水平显著低于健康组患儿(P<0.05);观察组患儿喘息发作次数、喘息发作时间、夜间症状、夜间憋醒、活动受限发生情况均显著低于对照组(P<0.05)。治疗后,两组各肺功能指标较治疗前均显著升高(P<0.05),观察组FEV1、FVC、FEV1/FVC水平及C-ACT评分均明显高于对照组(P<0.05),观察组进展支气管哮喘的发生率明显低于对照组(P<0.05)。结论:维生素A、D治疗毛细支气管炎和儿童支气管哮喘的临床效果显著。
Objective: To study Curative efficacy of Vitamins A and D in treatment of Bronchiolitis and childhood bronchial asthma.Methods: 120 cases of children with bronchiolitis admitted to our hospital from January 2016 to January 2018, 120 cases of children with bronchial asthma admitted to our outpatient department, and 40 cases of healthy children(no history of taking vitamin AD for nearly a year) examined in the outpatient department of children's health care were selected as subjects, the bronchiolitis group and asthma group were randomly divided into treatment group(40 cases) and control group(40 cases). The treatment group received oral vitamin AD1 qd supplement for 6 months. Respectively to compare three groups of serum vitamin A, D levels were followed up for 6 months, 1 year of control of breathing(breathing attack frequency, duration, and degree of cough, with or without symptoms or suppress wake up at night by night, and presence of restricted movement), and the evaluation of the lung function status(forced expiratory volume in 1 second(FEV1) and forced vital capacity(FVC), FEV1/FVC); In the asthma group, children aged 4 years old were assessed for asthma control by c-act score. Results: There was no significant difference in vitamin A and D levels between the observation group and the control group(P>0.05). The levels of vitamin A and D in the observation group and the control group were significantly lower than those in the healthy group(P<0.05). The number and duration of attack were significantly lower in the observation group than in the control group(P<0.05). The incidence of nocturnal symptoms, nocturnal anapnea and activity restriction in the observation group was significantly lower than that in the control group(P<0.05). Before treatment, there was no significant difference in pulmonary function between the two groups(P>0.05). After treatment, lung function indexes in both groups were significantly higher than before treatment(P<0.05), and FEV1, FVC and FEV1/FVC levels in the observation group were significantly higher than those in the control group(P<0.05). Before treatment, there was no significant difference in c-act score between the two groups(P>0.05). After treatment, the c-act score in the observation group was significantly higher than that in the control group(P<0.05). The progression of bronchial asthma in the observation group was lower than that in the control group(P<0.05). Conclusion: The use of vitamin A and D in patients with bronchiolitis and childhood bronchial asthma is effective and worthy of promotion and application.
Objective: To study Curative efficacy of Vitamins A and D in treatment of Bronchiolitis and childhood bronchial asthma.Methods: 120 cases of children with bronchiolitis admitted to our hospital from January 2016 to January 2018, 120 cases of children with bronchial asthma admitted to our outpatient department, and 40 cases of healthy children(no history of taking vitamin AD for nearly a year) examined in the outpatient department of children's health care were selected as subjects, the bronchiolitis group and asthma group were randomly divided into treatment group(40 cases) and control group(40 cases). The treatment group received oral vitamin AD1 qd supplement for 6 months. Respectively to compare three groups of serum vitamin A, D levels were followed up for 6 months, 1 year of control of breathing(breathing attack frequency, duration, and degree of cough, with or without symptoms or suppress wake up at night by night, and presence of restricted movement), and the evaluation of the lung function status(forced expiratory volume in 1 second(FEV1) and forced vital capacity(FVC), FEV1/FVC); In the asthma group, children aged 4 years old were assessed for asthma control by c-act score. Results: There was no significant difference in vitamin A and D levels between the observation group and the control group(P>0.05). The levels of vitamin A and D in the observation group and the control group were significantly lower than those in the healthy group(P<0.05). The number and duration of attack were significantly lower in the observation group than in the control group(P<0.05). The incidence of nocturnal symptoms, nocturnal anapnea and activity restriction in the observation group was significantly lower than that in the control group(P<0.05). Before treatment, there was no significant difference in pulmonary function between the two groups(P>0.05). After treatment, lung function indexes in both groups were significantly higher than before treatment(P<0.05), and FEV1, FVC and FEV1/FVC levels in the observation group were significantly higher than those in the control group(P<0.05). Before treatment, there was no significant difference in c-act score between the two groups(P>0.05). After treatment, the c-act score in the observation group was significantly higher than that in the control group(P<0.05). The progression of bronchial asthma in the observation group was lower than that in the control group(P<0.05). Conclusion: The use of vitamin A and D in patients with bronchiolitis and childhood bronchial asthma is effective and worthy of promotion and application.
引文
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[15] Alghobashy A A, Elsharawy S A, Alkholy U M, et al. B 2 adrenergic receptor gene polymorphism effect on childhood asthma severity and response to treatment[J]. Pediatric Research, 2017, 83(3):597-605
[16] Lukkarinen M, Haavisto L E, Lukkarinen H, et al. Exercise simultaneously increases nasal patency and bronchial obstruction in asthmatic children[J]. Respirology, 2016, 21(8):1493-1495
[17] Zhu K, Hou X L, Huang H J, et al.Distribution characteristics of serum specific Ig E for inhaled allergens in children with different airway allergic diseases[J]. Zhongguo Dang Dai Er Ke Za Zhi, 2017, 19(11):1185-1190
[18] Sherbini E, Mohamed, Ahmad, et al. Prevalence of asthma and other atopies among school children in Qalyubia Governorate, Egypt[J].Medical Research Journal, 2016, 15(1):27-33
[19] Bediwy A S, Hassan S M, El-Najjar M R. Receptor of advanced glycation end products in childhood asthma exacerbation[J]. Egyptian Journal of Chest Diseases&Tuberculosis, 2016, 65(1):15-18
[20] Inoue T, Akashi K, Watanabe M, et al. Periostin as a Biomarker for Diagnosis of Pediatric Asthma[J]. Pediatric Allergy&Immunology Official Publication of the European Society of Pediatric Allergy&Immunology, 2016, 27(5):521-526
[21] Zoratti E M, Krouse R Z, Babineau D C, et al. Asthma phenotypes in inner-city children[J]. Journal of Allergy&Clinical Immunology,2016, 138(4):1016-1029
[22] Dabbous O A, Soliman M M, Mohamed N H, et al. Evaluation of the improvement effect of laser acupuncture biostimulation in asthmatic children by exhaled inflammatory biomarker level of nitric oxide[J].Lasers Med Sci, 2016, 32(1):1-7
[23] Alsamghan A S, Awadalla N J, Mohamad Y A, et al. Influence of altitude on pediatric asthma severity and quality of life in southwestern Saudi Arabia[J]. Egyptian Journal of Chest Diseases&Tuberculosis,2016, 65(3):555-561
[24] Pardue J B, Fleming G M, Otillio J K, et al. Pediatric acute asthma exacerbations:evaluation and management from emergency department to intensive care unit[J]. Journal of Asthma Research, 2016, 53(6):607-617
[25] Okada Y, Kumagai H, Morikawa Y, et al. Epidemiology of pediatric allergic diseases in the Ogasawara Islands[J]. Allergol Int, 2016, 65(1):37-43
[26] Choi Y J, Suh D I, Sohn M H, et al. Dyspnea Perception During Induced Bronchoconstriction Is Complicated by the Inhaled Methacholine in Children With Clinical Asthma[J]. Allergy Asthma&Immunology Research, 2018, 10(2):131-136
[27] Kens O, Vishtak N, Acopyan H, et al. Allelic polymorphism C-590T of the IL4 gene as a probable genetic marker for the increased predisposition to the development of recurrent episodes of acute obstructive bronchitis in children[J]. Cytology&Genetics, 2016, 50(3):173-177
[28] Eladly T Z, Kamal S, Selim H, et al. Association of macrophage migration inhibitory factor promoter polymorphism-173G/C with susceptibility to childhood asthma[J]. Central-European Journal of Immunology, 2016, 41(3):268-272
[29] Mclellan K, Shields M, Power U, et al. Primary airway epithelial cell culture and asthma in children-lessons learnt and yet to come[J]. Pediatric Pulmonology, 2016, 50(12):1393-1405
[30] Krogulska A, Dynowski J, J誰drzejczyk M, et al. The impact of food allergens on airway responsiveness in schoolchildren with asthma:A DBPCFC study[J]. Pediatric Pulmonology, 2016, 51(8):787-795
[2] Elmaraghy M A, Hodieb M M, Khattab R A E R, et al. Association between TSLP gene polymorphism and bronchial asthma in children in Beni Suef Governorate in Egypt[J]. Comparative Clinical Pathology,2018, 27(3):565-570
[3] Hou C, Zhu X, Chang X. Correlation of vitamin D receptor with bronchial asthma in children[J]. Experimental&Therapeutic Medicine, 2018, 15(3):2773-2776
[4] Elrahman A A A, Handoka N M, Younes S E, et al. Detection of Vitamin(D)deficiency in children and adolescents suffering from bronchial asthma in Suez Canal University Hospital, Ismailia[J]. Photochemistry&Photobiology, 2016, 20(20):133-149
[5] Qureshi U A, Bilques S, Ul H I, et al. Epidemiology of bronchial asthma in school children(10-16 years)in Srinagar[J]. Lung India Official Organ of Indian Chest Society, 2016, 33(2):167-173
[6] Mohammed I A, Diab S M, Soliman D R, et al. Study of serum YKL-40 in children with bronchial asthma[J]. Egyptian Pediatric Association Gazette, 2016, 64(1):26-31
[7] Singh S, Jindal S, Goyal J P. Risk Factors for Bronchial Asthma in School Going Children[J]. Indian Journal of Pediatrics, 2017, 84(11):1-2
[8] Thomas B, Chay O M, Jr A J, et al. Concordance between bronchial hyperresponsiveness, fractional exhaled nitric oxide, and asthma control in children[J]. Pediatric Pulmonology, 2016, 51(10):1004-1009
[9] Lee E, Kim Y H, Han S, et al. Different cutoff values of methacholine bronchial provocation test depending on age in children with asthma[J]. World Journal of Pediatrics Wjp, 2017, 13(5):1-7
[10] Takahiro Nakamura(&xed, xbd, Masahiro Hashizume(&xab, et al.Asian Dust and Pediatric Emergency Department Visits Due to Bronchial Asthma and Respiratory Diseases in Nagasaki, Japan[J].Journal of Epidemiology, 2016, 26(11):593-601
[11] Chen B, Feng S, Yin X W. Clinical characteristics of different ages of children with acute exacerbation of bronchial asthma[J]. Zhongguo Dang Dai Er Ke Za Zhi, 2016, 18(4):320-323
[12] Kubysheva N I, Ignatov S K, Bulgakova V A, et al. Body Height of Children with Bronchial Asthma of Various Severities[J].Canadian Respiratory Journal, 2017, 2017(6):1-6
[13] Alharbi S, Alharbi A S, Alkhorayyef A, et al. Awareness regarding childhood asthma in Saudi Arabia[J]. Annals of Thoracic Medicine,2016, 11(1):60-65
[14] Shan L, Kang X, Liu F, et al. Expression of vitamin D receptor in bronchial asthma and its bioinformatics prediction.[J]. Molecular Medicine Reports, 2018, 18(2):2052-2060
[15] Alghobashy A A, Elsharawy S A, Alkholy U M, et al. B 2 adrenergic receptor gene polymorphism effect on childhood asthma severity and response to treatment[J]. Pediatric Research, 2017, 83(3):597-605
[16] Lukkarinen M, Haavisto L E, Lukkarinen H, et al. Exercise simultaneously increases nasal patency and bronchial obstruction in asthmatic children[J]. Respirology, 2016, 21(8):1493-1495
[17] Zhu K, Hou X L, Huang H J, et al.Distribution characteristics of serum specific Ig E for inhaled allergens in children with different airway allergic diseases[J]. Zhongguo Dang Dai Er Ke Za Zhi, 2017, 19(11):1185-1190
[18] Sherbini E, Mohamed, Ahmad, et al. Prevalence of asthma and other atopies among school children in Qalyubia Governorate, Egypt[J].Medical Research Journal, 2016, 15(1):27-33
[19] Bediwy A S, Hassan S M, El-Najjar M R. Receptor of advanced glycation end products in childhood asthma exacerbation[J]. Egyptian Journal of Chest Diseases&Tuberculosis, 2016, 65(1):15-18
[20] Inoue T, Akashi K, Watanabe M, et al. Periostin as a Biomarker for Diagnosis of Pediatric Asthma[J]. Pediatric Allergy&Immunology Official Publication of the European Society of Pediatric Allergy&Immunology, 2016, 27(5):521-526
[21] Zoratti E M, Krouse R Z, Babineau D C, et al. Asthma phenotypes in inner-city children[J]. Journal of Allergy&Clinical Immunology,2016, 138(4):1016-1029
[22] Dabbous O A, Soliman M M, Mohamed N H, et al. Evaluation of the improvement effect of laser acupuncture biostimulation in asthmatic children by exhaled inflammatory biomarker level of nitric oxide[J].Lasers Med Sci, 2016, 32(1):1-7
[23] Alsamghan A S, Awadalla N J, Mohamad Y A, et al. Influence of altitude on pediatric asthma severity and quality of life in southwestern Saudi Arabia[J]. Egyptian Journal of Chest Diseases&Tuberculosis,2016, 65(3):555-561
[24] Pardue J B, Fleming G M, Otillio J K, et al. Pediatric acute asthma exacerbations:evaluation and management from emergency department to intensive care unit[J]. Journal of Asthma Research, 2016, 53(6):607-617
[25] Okada Y, Kumagai H, Morikawa Y, et al. Epidemiology of pediatric allergic diseases in the Ogasawara Islands[J]. Allergol Int, 2016, 65(1):37-43
[26] Choi Y J, Suh D I, Sohn M H, et al. Dyspnea Perception During Induced Bronchoconstriction Is Complicated by the Inhaled Methacholine in Children With Clinical Asthma[J]. Allergy Asthma&Immunology Research, 2018, 10(2):131-136
[27] Kens O, Vishtak N, Acopyan H, et al. Allelic polymorphism C-590T of the IL4 gene as a probable genetic marker for the increased predisposition to the development of recurrent episodes of acute obstructive bronchitis in children[J]. Cytology&Genetics, 2016, 50(3):173-177
[28] Eladly T Z, Kamal S, Selim H, et al. Association of macrophage migration inhibitory factor promoter polymorphism-173G/C with susceptibility to childhood asthma[J]. Central-European Journal of Immunology, 2016, 41(3):268-272
[29] Mclellan K, Shields M, Power U, et al. Primary airway epithelial cell culture and asthma in children-lessons learnt and yet to come[J]. Pediatric Pulmonology, 2016, 50(12):1393-1405
[30] Krogulska A, Dynowski J, J誰drzejczyk M, et al. The impact of food allergens on airway responsiveness in schoolchildren with asthma:A DBPCFC study[J]. Pediatric Pulmonology, 2016, 51(8):787-795