孟鲁司特片联合布地奈德雾化吸入治疗对儿童支气管哮喘呼吸道功能及血清IL-17、TGF-β2水平的影响
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摘要
目的 :观察孟鲁司特片联合布地奈德雾化吸入治疗对儿童支气管哮喘呼吸道功能及血清IL-17、TGF-β2水平的影响。方法 :将我院儿科收治300例支气管哮喘患儿按随机数字表法分为观察组和对照组,每组150例,对照组患儿给予雾化吸入布地奈德喷,观察组在对照组基础上给予口服孟鲁司特钠片,治疗3个月后观察比较两组患儿临床疗效、用力肺活量(FVC)、1秒用力呼气容积(FEV1)、最大呼气流量(PEF)指标及血清中IL-17、TNF-α、TGF-β2和不良反应发生情况。结果 :观察组患者临床总有效率(96.67%)显著高于对照组(87.33%),治疗后观察组患儿FVC、FEV1、FEV1/FVC和PEF指标改善程度均显著优于对照组,治疗后观察组IL-17、TNF-α、TGF-β2及EOS水平较对照组显著降低,观察组中患儿不良反应发生率(5.33%)与对照组(3.33%)相比,差异不具有统计学意义。结论 :孟鲁司特片联合布地奈德雾化吸入治疗在减轻气道炎症和缓解儿童支气管哮喘症状具有协同作用,联合使用效果优于单独布地奈德雾化吸入治疗,值得临床推广使用。
Objective To observe the effect of montelukast sodium tablets combined with budesonide aerosol inhalation on respiratory function and levels of serum IL-17 and TGF-β2 in children with bronchial asthma(BA). Methods 300 cases of BA children in our hospital were divided into the observation group and the control group by random number table method, 150 cases in each group. The control group were treated with budesonide aerosol inhalation and the observation group were treated with oral montelukast sodium tablets, based on the treatment in the control group. After 3 months of treatment, the curative effect, forced vital capacity(FVC), forced expiratory volume in 1 second(FEV1), peak expiratory flow(PEF), serum IL-17, TNF-α and TGF-β2 and the incidence of adverse reactions were compared between the two groups. Results The total effective rate of the observation group(96.67%) was significantly higher than that of the control group(87.33%). After treatment, the improvement of FVC, FEV1, FEV1/FVC and PEF in the observation group was significantly better than that in the control group. After treatment, the levels of IL-17, TNF-α, TGF-β2 and EOS were significantly lower in the observation group than the control group. The incidence of adverse reactions showed no significant difference between the observation group(5.33%) and the control group(3.33%). Conclusion Montelukast sodium tablets combined with budesonide aerosol inhalation therapy has synergistic effect in reducing airway inflammation and relieving the symptoms of BA, and the effect is better than that of budesonide aaerosol inhalation alone.
Objective To observe the effect of montelukast sodium tablets combined with budesonide aerosol inhalation on respiratory function and levels of serum IL-17 and TGF-β2 in children with bronchial asthma(BA). Methods 300 cases of BA children in our hospital were divided into the observation group and the control group by random number table method, 150 cases in each group. The control group were treated with budesonide aerosol inhalation and the observation group were treated with oral montelukast sodium tablets, based on the treatment in the control group. After 3 months of treatment, the curative effect, forced vital capacity(FVC), forced expiratory volume in 1 second(FEV1), peak expiratory flow(PEF), serum IL-17, TNF-α and TGF-β2 and the incidence of adverse reactions were compared between the two groups. Results The total effective rate of the observation group(96.67%) was significantly higher than that of the control group(87.33%). After treatment, the improvement of FVC, FEV1, FEV1/FVC and PEF in the observation group was significantly better than that in the control group. After treatment, the levels of IL-17, TNF-α, TGF-β2 and EOS were significantly lower in the observation group than the control group. The incidence of adverse reactions showed no significant difference between the observation group(5.33%) and the control group(3.33%). Conclusion Montelukast sodium tablets combined with budesonide aerosol inhalation therapy has synergistic effect in reducing airway inflammation and relieving the symptoms of BA, and the effect is better than that of budesonide aaerosol inhalation alone.
引文
[1]李福,罗文娟,赵晓瑞,等.儿童支气管哮喘发病的危险因素分析[J].临床儿科杂志,2013,31(4):384-384.
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[3]董艳鹏,张晓.布地奈德联合孟鲁司特治疗小儿咳嗽变异性哮喘的疗效分析[J].医学综述,2013,19(20):3790-3791.
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[7]洪建国.中国儿童支气管哮喘防治指南修订要点的探讨[J].临床儿科杂志,2014,32(2):101-103.
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[9]贾建厚,郭岩,刘丹,等.孟鲁司特钠辅助治疗支气管哮喘的临床研究[J].湖南师范大学学报(医学版),2015,12(6):45-47.
[10]陈斌华.孟鲁司特钠联合布地奈德治疗儿童咳嗽变异性哮喘的临床疗效和安全性[J].国际医药卫生导报,2013,19(9):1292-1294.
[11]郑贵浪,吴家兴.孟鲁司特治疗儿童支气管哮喘的临床疗效及肺功能和细胞因子变化研究[J].中国全科医学,2015,18(12):1387-1389.
[12]余红,杨惠英,刘银梅.孟鲁司特钠联合糖皮质激素治疗儿童支气管哮喘的疗效观察[J].山西医药杂志,2016,45(17):2025-2026.
[13]李永春,张文礼.支气管哮喘患者治疗前后血清TNF-α和hs-CRP水平变化及意义[J].西部医学,2012,24(1):52-53.
[14]陈璐,陈艳萍,黄建宝.喘息性支气管肺炎患儿T细胞亚群变化的相关性研究[J].医学临床研究,2012,29(1):60-61.
[15]薛涛.Th1/Th2型细胞因子及免疫状态在支气管哮喘患儿治疗前后的变化[J].中国医药导报,2013,10(33):81-83.
[16]高阳,杨帆.支气管哮喘患者外周血Th1、Th2与Th17细胞表达水平及临床意义[J].解放军医药杂志,2017,29(1):76-79.
[17]管敏昌,汤卫红,王惠庭,等.嗜酸性粒细胞计数在哮喘儿童支气管肺泡灌洗液中的变化及孟鲁司特对其调节作用[J].中国医院药学杂志,2012,32(24):1993-1996.
[18]陆彬彬,陆超,沈燕.小呼吸道功能和痰嗜酸性粒细胞在儿童咳嗽变异性支气管哮喘缓解期测定的意义[J].中华实用儿科临床杂志,2013,28(16):1224-1226.
[19]陈玲,张丙宏.儿童支气管哮喘EOS、IL-17和Ig E表达水平临床意义[J].临床肺科杂志,2015,20(6):1067-1069.
[20]蒋鲲,陈和斌,王莹,等.IL-17和TGF-β1在支气管哮喘患儿血清及支气管肺泡灌洗液中的变化及临床意义[J].中国当代儿科杂志,2013,15(8):604-608.
[2]陈爱欢,陈荣昌,湛洁谊,等.雾化吸人高剂量糖皮质激素对儿童中重度支气管哮喘急性发作的疗效[J].中华结核和呼吸杂志,2012,35(4):269-274.
[3]董艳鹏,张晓.布地奈德联合孟鲁司特治疗小儿咳嗽变异性哮喘的疗效分析[J].医学综述,2013,19(20):3790-3791.
[4]高明,任章平,谢彩,等.孟鲁司特钠治疗小儿咳嗽变异性哮喘的疗效分析[J].检验医学与临床,2014,11(21):3059-3060.
[5]薛满,马春利,梁宽,等.孟鲁司特钠治疗小儿咳嗽变异性哮喘的临床疗效及安全性研究[J].现代生物医学进展,2012,12(17):3317-3319.
[6]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.
[7]洪建国.中国儿童支气管哮喘防治指南修订要点的探讨[J].临床儿科杂志,2014,32(2):101-103.
[8]陈爱欢,陈荣昌,湛洁谊,等.雾化吸入高剂量糖皮质激素对儿童中重度支气管哮喘急性发作的疗效[J].中华结核和呼吸杂志,2012,35(4):269-274.
[9]贾建厚,郭岩,刘丹,等.孟鲁司特钠辅助治疗支气管哮喘的临床研究[J].湖南师范大学学报(医学版),2015,12(6):45-47.
[10]陈斌华.孟鲁司特钠联合布地奈德治疗儿童咳嗽变异性哮喘的临床疗效和安全性[J].国际医药卫生导报,2013,19(9):1292-1294.
[11]郑贵浪,吴家兴.孟鲁司特治疗儿童支气管哮喘的临床疗效及肺功能和细胞因子变化研究[J].中国全科医学,2015,18(12):1387-1389.
[12]余红,杨惠英,刘银梅.孟鲁司特钠联合糖皮质激素治疗儿童支气管哮喘的疗效观察[J].山西医药杂志,2016,45(17):2025-2026.
[13]李永春,张文礼.支气管哮喘患者治疗前后血清TNF-α和hs-CRP水平变化及意义[J].西部医学,2012,24(1):52-53.
[14]陈璐,陈艳萍,黄建宝.喘息性支气管肺炎患儿T细胞亚群变化的相关性研究[J].医学临床研究,2012,29(1):60-61.
[15]薛涛.Th1/Th2型细胞因子及免疫状态在支气管哮喘患儿治疗前后的变化[J].中国医药导报,2013,10(33):81-83.
[16]高阳,杨帆.支气管哮喘患者外周血Th1、Th2与Th17细胞表达水平及临床意义[J].解放军医药杂志,2017,29(1):76-79.
[17]管敏昌,汤卫红,王惠庭,等.嗜酸性粒细胞计数在哮喘儿童支气管肺泡灌洗液中的变化及孟鲁司特对其调节作用[J].中国医院药学杂志,2012,32(24):1993-1996.
[18]陆彬彬,陆超,沈燕.小呼吸道功能和痰嗜酸性粒细胞在儿童咳嗽变异性支气管哮喘缓解期测定的意义[J].中华实用儿科临床杂志,2013,28(16):1224-1226.
[19]陈玲,张丙宏.儿童支气管哮喘EOS、IL-17和Ig E表达水平临床意义[J].临床肺科杂志,2015,20(6):1067-1069.
[20]蒋鲲,陈和斌,王莹,等.IL-17和TGF-β1在支气管哮喘患儿血清及支气管肺泡灌洗液中的变化及临床意义[J].中国当代儿科杂志,2013,15(8):604-608.