沙丁胺醇注射液联合硫酸镁注射液雾化吸入治疗支气管哮喘的临床研究
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摘要
目的观察沙丁胺醇注射液联合硫酸镁注射液雾化吸入治疗支气管哮喘的临床疗效及安全性。方法将78例支气管哮喘患者随机分为对照组和试验组,每组39例。对照组予以沙丁胺醇每次0.6 m L,tid,雾化吸入,每次20 min;试验组在对照组治疗的基础上,予以硫酸镁每次0.6 m L,tid,雾化吸入,每次20min。2组患者均治疗5 d。比较2组患者的临床疗效、CD_4~+CD~+_(25)调节性T细胞(Treg)、辅助性T细胞17(Th17)、Th22、白细胞介素(IL)-17、IL-22和IL-35的水平,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为94.87%(37例/39例)和79.49%(31例/39例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组的Treg分别为(4.69±1.24)%和(3.21±1.15)%,Th17分别为(1.02±0.38)%和(1.43±0.41)%,Th22分别为(0.85±0.31)%和(1.16±0.34)%,IL-17分别为(161.52±24.59)和(183.62±31.12)pg·mL~(-1),IL-22分别为(131.26±35.14)和(179.62±36.85)pg·mL~(-1),IL-35分别为(29.63±4.51)和(22.69±4.23)pg·mL~(-1),差异均有统计学意义(均P<0.05)。对照组发生的药物不良反应主要有胃部不适、恶心和皮疹,试验组发生的药物不良反应主要有恶心、胃部不适、低血压和发热。试验组和对照组的总药物不良反应发生率分别为20.51%和15.38%,差异无统计学意义(P>0.05)。结论沙丁胺醇注射液联合硫酸镁注射液雾化吸入治疗支气管哮喘的临床疗效显著,其能有效地降低外周血Th17、Th22、IL-17和IL-22水平,提高Treg和IL-35水平,且不增加药物不良反应的发生率。
Objective To observe the clinical efficacy and safety of atomization inhalation of salbutamol injection combined with magnesium sulfate injection inhalation in the treatment of bronchial asthma.Methods Seventy-eight patients with bronchial asthma were randomly divided into control and treatment groups with 39 cases per group. Control group was given salbutamol 0. 6 mL per time,tid,atomization inhalation,20 min per time. Treatment group was given magnesium sulfate 0. 6 mL per time,tid,atomization inhalation,20 min per time,on the basis of control group. Two groups were treated for 5 d. The clinical efficacy,the levels of CD_4~+CD_(25)~+ regulatory T( Treg) cells,T helper cell 17( Th17),Th22,interleukin( IL)~(-1)7,IL-22 and IL-35,and adverse drugreactions were compared between two groups. Results After treatment,the total effective rates of treatment and control groups were 94. 87%( 37 cases/39 cases) and 79. 49%( 31 cases/39 cases) with significant difference( P < 0. 05).After treatment,the main indexes of treatment and control groups were compared: Treg cells were( 4. 69 ± 1. 24) % and( 3. 21 ± 1. 15) %, Th17 were( 1. 02 ± 0. 38) % and( 1. 43 ± 0. 41) %, Th22 were( 0. 85 ± 0. 31) % and( 1. 16 ± 0. 34) %,IL~(-1)7 were( 161. 52 ± 24. 59) and( 183. 62 ± 31. 12) pg·m L~(-1),IL-22 were( 131. 26 ± 35. 14)and( 179. 62 ± 36. 85) pg·m L~(-1),IL-35 were( 29. 63 ± 4. 51) and( 22. 69 ± 4. 23) pg·mL~(-1),the differences were statistically significant( all P < 0. 05). The adverse drug reactions of control group were stomach discomfort,nausea and rash,which in treatment group were nausea,stomach discomfort,hypotension and fever. The total incidences of adverse drug reactions in the treatment and control groups were 20. 51% and 15. 38% without significant difference( P > 0. 05).Conclusion Atomization inhalation of salbutamol injection combined with magnesium sulfate injection has a definitive clinical efficacy in the treatment of bronchial asthma,which can effectively reduce the levels of Th17,Th22,IL~(-1)7 and IL-22 and improve the levels of Treg and IL-35,without increasing the incidence of adverse drug reactions.
Objective To observe the clinical efficacy and safety of atomization inhalation of salbutamol injection combined with magnesium sulfate injection inhalation in the treatment of bronchial asthma.Methods Seventy-eight patients with bronchial asthma were randomly divided into control and treatment groups with 39 cases per group. Control group was given salbutamol 0. 6 mL per time,tid,atomization inhalation,20 min per time. Treatment group was given magnesium sulfate 0. 6 mL per time,tid,atomization inhalation,20 min per time,on the basis of control group. Two groups were treated for 5 d. The clinical efficacy,the levels of CD_4~+CD_(25)~+ regulatory T( Treg) cells,T helper cell 17( Th17),Th22,interleukin( IL)~(-1)7,IL-22 and IL-35,and adverse drugreactions were compared between two groups. Results After treatment,the total effective rates of treatment and control groups were 94. 87%( 37 cases/39 cases) and 79. 49%( 31 cases/39 cases) with significant difference( P < 0. 05).After treatment,the main indexes of treatment and control groups were compared: Treg cells were( 4. 69 ± 1. 24) % and( 3. 21 ± 1. 15) %, Th17 were( 1. 02 ± 0. 38) % and( 1. 43 ± 0. 41) %, Th22 were( 0. 85 ± 0. 31) % and( 1. 16 ± 0. 34) %,IL~(-1)7 were( 161. 52 ± 24. 59) and( 183. 62 ± 31. 12) pg·m L~(-1),IL-22 were( 131. 26 ± 35. 14)and( 179. 62 ± 36. 85) pg·m L~(-1),IL-35 were( 29. 63 ± 4. 51) and( 22. 69 ± 4. 23) pg·mL~(-1),the differences were statistically significant( all P < 0. 05). The adverse drug reactions of control group were stomach discomfort,nausea and rash,which in treatment group were nausea,stomach discomfort,hypotension and fever. The total incidences of adverse drug reactions in the treatment and control groups were 20. 51% and 15. 38% without significant difference( P > 0. 05).Conclusion Atomization inhalation of salbutamol injection combined with magnesium sulfate injection has a definitive clinical efficacy in the treatment of bronchial asthma,which can effectively reduce the levels of Th17,Th22,IL~(-1)7 and IL-22 and improve the levels of Treg and IL-35,without increasing the incidence of adverse drug reactions.
引文
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[7]李中燕.气道上皮细胞在支气管哮喘发病机制中的研究进展[J].实用医学杂志,2012,28(20):3485-3487.
[2]钟远芹,蓝伟峰.布地奈德联合沙丁胺醇治疗支气管哮喘的效果及对患者TGF-β1、CRP水平和肺功能的影响[J].广东医学,2016,37(6):915-917.
[3]周光红,龙怀聪.硫酸镁用于支气管哮喘急性发作:老药新问题[J].中国呼吸与危重监护杂志,2017,16(2):181-185.
[4]中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南(2016年版)[J].中华结核和呼吸杂志,2016,39(9):675-697.
[5]KROEGEL C.Global Initiative for Asthma(GINA)guidelines:15years of application[J].Expert Rev Clin Immu,2014,5(3):239.
[6]李学良,许朝霞,王忆勤.支气管哮喘发病机制的研究进展[J].中华中医药学刊,2012,31(9):1960-1963.
[7]李中燕.气道上皮细胞在支气管哮喘发病机制中的研究进展[J].实用医学杂志,2012,28(20):3485-3487.