重组人干扰素α1b联合宣肺止嗽合剂治疗小儿支气管炎效果观察及对血清细胞因子的影响
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摘要
目的:探讨重组人干扰素α1b联合宣肺止嗽合剂治疗小儿支气管炎的效果观察及对血清细胞因子的影响。方法146例小儿支气管炎患儿,根据随机区组设计法将患儿分为观察组和对照组各73例。对照组采用重组人干扰素α1b治疗,观察组采用重组人干扰素α1b联合宣肺止嗽合剂治疗。比较两组患儿临床疗效、临床症状改善时间、血气指标、肺功能、免疫球蛋白水平、血清细胞因子及不良反应发生情况。结果:观察组的总有效率(93.2%)显著高于对照组(80.8%)(P<0.05)。观察组喘息缓解时间、罗音消失时间、咳嗽消失时间均显著短于对照组(P<0.05)。观察组PaO_2显著高于对照组,PaCO_2显著低于对照组(P<0.05)。观察组VT、TPTEF/TE、VPTEF/VE均显著高于对照组,RR显著低于对照组(P<0.05)。观察组IgG、IgA及IgM均显著高于对照组(P<0.05)。观察组血清PCT、MCP-1显著低于对照组,INF-γ显著高于对照组(P<0.05)。两组在治疗期间均未发生明显不良反应。结论:重组人干扰素α1b联合宣肺止嗽合剂可有效改善支气管炎患儿的临床症状和肺功能,提高免疫指标,降低炎性因子,促进患儿快速恢复。
Objective:To investigate the effect of recombinant human interferon α1 b combined with Xuanfei Zhisou Mixture on children with bronchitis and its effect on serum cytokines. Methods:According to the randomized block design, a total of 146 children with bronchitis were divided into observation group and control group. The control group was treated with recombinant human interferon α1 b. The clinical efficacy, clinical symptom improvement time, blood gas index, lung function, immunoglobulin level, serum cytokines and adverse reactions were compared between the two groups. Results:The total effective rate of observation group(93.2%) was significantly higher than that of control group(80.8%)(P<0.05). The time of relief, rale and cough in the observation group were significantly shorter than those in the control group(P<0.05). Compared with the control group, PaO_2 of the observation group was significantly higher and PaCO_2 was significantly lower(P<0.05). Compared with the control group, VT, TPTEF/TE and VPTEF/VE of the observation group were significantly higher and RR was significantly lower(P<0.05). IgG, IgA and IgM in the observation group were significantly higher than those in the control group(P<0.05). Compared with the control group, serum PCT and MCP-1 in the observation group were significantly lower and INF-γ was significantly higher(P<0.05). There was no obvious adverse reaction during the treatment in both groups. Conclusion: The combination of recombinant human interferon α1 b combined with Xuanfei Zhisou Mixture can effectively improve the clinical symptoms and lung function of children with bronchitis, improve the immune index, reduce inflammatory factors and promote the rapid recovery of children with bronchitis.
Objective:To investigate the effect of recombinant human interferon α1 b combined with Xuanfei Zhisou Mixture on children with bronchitis and its effect on serum cytokines. Methods:According to the randomized block design, a total of 146 children with bronchitis were divided into observation group and control group. The control group was treated with recombinant human interferon α1 b. The clinical efficacy, clinical symptom improvement time, blood gas index, lung function, immunoglobulin level, serum cytokines and adverse reactions were compared between the two groups. Results:The total effective rate of observation group(93.2%) was significantly higher than that of control group(80.8%)(P<0.05). The time of relief, rale and cough in the observation group were significantly shorter than those in the control group(P<0.05). Compared with the control group, PaO_2 of the observation group was significantly higher and PaCO_2 was significantly lower(P<0.05). Compared with the control group, VT, TPTEF/TE and VPTEF/VE of the observation group were significantly higher and RR was significantly lower(P<0.05). IgG, IgA and IgM in the observation group were significantly higher than those in the control group(P<0.05). Compared with the control group, serum PCT and MCP-1 in the observation group were significantly lower and INF-γ was significantly higher(P<0.05). There was no obvious adverse reaction during the treatment in both groups. Conclusion: The combination of recombinant human interferon α1 b combined with Xuanfei Zhisou Mixture can effectively improve the clinical symptoms and lung function of children with bronchitis, improve the immune index, reduce inflammatory factors and promote the rapid recovery of children with bronchitis.
引文
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[26] 熊雪芹,罗健.616例毛细支气管炎患儿临床特征分析[J].重庆医学,2016,45(14):1961-1964.
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[30] 张雅凤,林忠嗣,陈爱丰,等.中医综合疗法治疗小儿肺炎临床疗效评价[J].中医儿科杂志, 2010,6(4):13-16.
[2] 黄敏.小儿支气管炎患者免疫状态研究[J].河北医药,2013,35(15):2291-2292.
[3] 高艳,魏悦,林宏,等.天津市儿童医院2014年9月小儿肺热咳喘口服液的应用处方分析[J].现代药物与临床,2015,30(3):94-97.
[4] 李菲,马建梅,张苏梅,等.小儿肺热咳喘口服液联合热毒宁注射液治疗儿童毛细支气管炎的疗效观察[J].现代药物与临床,2018,33(1):88-92.
[5] 万江,杨树杰,程黎,等.小儿呼吸道感染病毒检测新进展[J].临床肺科杂志,2012,17(2):321-332.
[6] 胡亚美,江载芳.诸福堂实用儿科学[M].7版.北京:人民卫生出版社,2008:1171-1172.
[7] 国家中医药管理局.中医病症诊断疗效标准[M].南京:南京大学出版社,1994:76-78.
[8] Li JN, Liu KC, Liu Y, et al. Exosomes mediate the cell- to-cell transmission of IFN-α-induced antiviral activity[J]. Nat Immunol,2013,14(3):793-803.
[9] Muller MP, Dresser L, Raboud J, et al. Adverse events associated with high-dose ribavirin: evidence from the Toronto outbreak of severe acute respiratory syndrome[J]. Pharmacotherapy, 2007,27(4):494-503.
[10] Graham BS. Biological challenges and technological opportunities for respiratory syncytial virus vaccine development[J]. Immunol Rev,2011,239(1):149-166.
[11] Bondue B,Vosters O, de NadaiP, et al. ChemR23 dampens lung inflammation and enhances an ti-viral immnuity in a mouse model of acute viral pneumonia[J].PLoS Pathog,2011,7(11): el002358.
[12] 苏聃.抗生素在儿科支气管炎患者中的使用效果观察[J].检验医学与临床,2016,13(A2): 230-232.
[13] 李静,董艳,张晶洁,等.小儿肺热咳喘口服液对小儿毛细支气管炎Th1/Th2细胞的影响研究[J].实用心脑肺血管病杂志,2015,23(4):114-117.
[14] 张义堂,杨峰,杨红.小儿毛细支气管炎中西医综合疗法的疗效及预后分析[J].中华中医药学刊,2017,23(6):1479-1481.
[15] 付宏,李锋,曾闽榕,等.多索茶碱联合重组人干扰素α1b治疗婴幼儿中重度毛细支气管炎的临床观察[J].中国药房,2017,28(2):227-230.
[16] 符佩华.小儿肺热咳喘口服液佐治小儿喘息性支气管炎[J].现代中西医结合杂志,2012,21 (5):503-504.
[17] 徐东,许华平,胡俊杰,等.雾化吸入重组人干扰素α-2b治疗婴幼儿毛细支气管炎的多中心研究[J].中国妇幼保健,2016,31(22):4770-4771.
[18] 李志刚.小儿肺咳颗粒辅助治疗急性小儿支气管炎临床观察[J].中国妇幼保健,2016,31(9): 1975-1977.
[19] 金瑄,王丽.干扰素α_1b联合孟鲁司特钠治疗小儿喘息性支气管炎疗效观察[J].海南医学, 2017,28(4):654-655.
[20] Bondue B,Vosters O, de NadaiP, et al. ChemR23 dampens lung inflammation and enhances an ti-viral immnuity in a mouse model of acute viral pneumonia[J].PLoS Pathog,2011,7(11): el002358.
[21] Ralston SL, Lieberthal AS, Meissner HC, et al. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis[J].Pediatrics,2014,134(5):1474-1502.
[22] Beigelman A, Bacharier LB. The role of early life viral bronchiolitis in the inception of asthma[J]. Cur Opin Alergy Clin Immunol, 2013,l3(2):211-216.
[23] 叶再青,杨玲利,周绍珍.肺力咳合剂与宣肺止嗽合剂治疗小儿支气管炎痰热壅肺型的临床疗效观察[J].中国药师,2016,19(5):933-935.
[24] 叶再青.宣肺止嗽合剂辅助治疗小儿支气管炎的疗效观察及分析[J].药学实践杂志,2016, 34(3):275-277.
[25] 王晓敏,蔡建新,徐和祥,等.小儿宣肺止咳颗粒治疗小儿急性支气管炎的理论发微[J].世界中医药,2016,11(5):917-918.
[26] 熊雪芹,罗健.616例毛细支气管炎患儿临床特征分析[J].重庆医学,2016,45(14):1961-1964.
[27] 张志伟.异丙托溴铵与孟鲁司特纳联合治疗毛细支气管炎患儿临床疗效观察[J].标记免疫分析与临床,2017,24(10):1180-1182.
[28] 赵德育,刘红霞,刘峰,等.雾化吸入重组人干扰素α2b治疗小儿毛细支气管炎有效性和安全性的随机对照多中心研究[J].中华实用儿科临床杂志,2016,31(14):1095-1100.
[29] 郭雪松,胡永峰.宣肺止嗽汤治疗小儿咳嗽56例[J].中医药导报,2010,16(4):77.
[30] 张雅凤,林忠嗣,陈爱丰,等.中医综合疗法治疗小儿肺炎临床疗效评价[J].中医儿科杂志, 2010,6(4):13-16.