泛福舒治疗稳定期支气管扩张症的疗效观察
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摘要
目的研究泛福舒(细菌溶解产物)对稳定期支气管扩张症患者的急性发作相关指标和免疫功能的影响。方法将62例支气管扩张症病人随机分成治疗组34例和对照组28例。对照组给予常规平喘和祛痰的西医治疗,治疗组则在对照组基础上加用泛福舒(7mg/d口服,每月连续10天,停20天,持续3个月)治疗。治疗前后分析两组急性加重次数、持续天数和抗生素使用的时间、以及血清中C3、C4和Ig水平差异。结果治疗后急性发作次数、持续天数和抗生素使用时间,治疗组各指标均优于对照组(P<0.05);对照组在治疗前后血清中的各观察指标水平未见明显改变(P>0.05),治疗组治疗前后补体C3、C4、血清免疫蛋白(IgM、IgG、IgA)明显升高,IgE水平明显下降(P<0.05);与对照组比较(P<0.05)。结论泛福舒治疗稳定期支气管扩张症可明显提高患者的免疫功能,增强机体的抗感染能力,减少急性发作次数、急性发作持续天数和抗生素使用的时间,临床疗效较好。
Objective To evaluate the efficacy of OM-85(bacterial lysate) on acute attacks-related indicators and immune function in patients with stable bronchiectasis.Methods 62 patients with bronchiectasis were randomly divided into treatment group(N=34) and control group(N=28). The control group received standard optimized care and the treatment group received treatment with OM-85 oral(dten consecutive days per month, for 3 months). The serum levels of C3, C4, and Ig were observed before and after treatment. The number and duration of acute exacerbations, and time for the use of antibiotics were compared between the two groups after treatment.Results The indexes in the treatment group were lower than those in the control group(P<0.05). There were no significant changes in the various indicators before and after treatment in the control group(P>0.05). In the treatment group, complement C3, C4, serum immune proteins(IgM, IgG and IgA) were significantly increased and IgE levels were significantly decreased before and after treatment(P<0.05). The levels of C3, C4,IgM, IgG and IgA in the treatment group were significantly higher than those in the control group, and the IgE level was lower than that in the control group(P<0.05).Conclusion The application of OM-85 in the stable bronchiectasis can improve the patient's immune function, enhance the body's anti-infective ability, reduce the number of acute attacks, the duration of acute attacks and the use of antibiotics.
Objective To evaluate the efficacy of OM-85(bacterial lysate) on acute attacks-related indicators and immune function in patients with stable bronchiectasis.Methods 62 patients with bronchiectasis were randomly divided into treatment group(N=34) and control group(N=28). The control group received standard optimized care and the treatment group received treatment with OM-85 oral(dten consecutive days per month, for 3 months). The serum levels of C3, C4, and Ig were observed before and after treatment. The number and duration of acute exacerbations, and time for the use of antibiotics were compared between the two groups after treatment.Results The indexes in the treatment group were lower than those in the control group(P<0.05). There were no significant changes in the various indicators before and after treatment in the control group(P>0.05). In the treatment group, complement C3, C4, serum immune proteins(IgM, IgG and IgA) were significantly increased and IgE levels were significantly decreased before and after treatment(P<0.05). The levels of C3, C4,IgM, IgG and IgA in the treatment group were significantly higher than those in the control group, and the IgE level was lower than that in the control group(P<0.05).Conclusion The application of OM-85 in the stable bronchiectasis can improve the patient's immune function, enhance the body's anti-infective ability, reduce the number of acute attacks, the duration of acute attacks and the use of antibiotics.
引文
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[7] 李晓云,刘双.支气管扩张病因的研究进展[J].心肺血管病杂志,2014,33(1):124-126.
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[9] MJ Mcdonnell,C Ward,JL Lordan.Non-cystic fibrosis bronchiectasis[J].Qjm Monthly Journal of the Association of Physicians,2013,106(8):709-715
[10] K earneY Sc,D ZieKieWicZ M,F eLeSZKo W.Immunoregulatory and immunostimulatory responses of bacterial lysates in respiratory infections and asthma[J].Ann Allergy Asthma Immunol,2015,114:364-369.
[11] DB Fernando,S Gianfranco.Prevention of respiratory tract infections with bacterial lysate OM-85 bronchomunal in children and adults:a state of the art[J].Multidisciplinary Respiratory Medicine,2013,8(1):1-9.
[12] 郭庆玲,蔡杰,赵一菊.细菌溶解产物对慢性阻塞性肺疾病急性加重期患者免疫功能的影响[J].中国老年学,2017,37(9):2205-2207.
[13] 何宇梅,李先花.泛福舒联合莫西沙星防治高龄慢阻肺急性发作的临床观察[J].中国老年保健医学,2016,14(2):53-55.
[14] 陈刚.细菌溶解产物对慢性阻塞性肺疾病患者免疫功能的影响观察[J].中国实用医药,2016(8):44-45
[15] 徐鹏,张骅,陈星华.细菌溶解产物对慢性阻塞性肺疾病稳定期患者免疫功能影响[J].中华实用诊断与治疗杂志,2010,24(11):1117-1118.
[16] 杨欣,鲁利群,黄莉泛,等.泛福舒胶囊辅助治疗小儿支气管哮喘的临床研究[J].现代生物医学进展,2017,17(10):1949-1952.
[17] 郝莉霞.细菌溶解产物联合糖皮质激素及白三烯调节剂治疗小儿哮喘的临床研究[J].临床肺科杂志,2016,21(4):694-697.
[18] 吕燕青,詹平,谷红梅,等.泛福舒胶囊辅治儿童支气管哮喘疗效及其对细胞免疫和炎性因子的影响[J].疑难病杂志,2016,15(11):1170-1173.
[19] Russi EW,Leuenberger P,Brndli O,et al.Management of chronic obstructive pulmonary disease:the Swiss guidelines[J].Official Guidelines of the Swiss Respiratory ociety,2002,132(5-6):67-68.
[20] Ana M.Koatz,Noem A.Coe,Alberto Cicera′n,et al.Clinical and Immunological Benefits of OM-85 Bacterial Lysate in Patients with Allergic Rhinitis,Asthma,and COPD and Recurrent Respiratory Infections[J].Lung,2016,194(4):687-697.
[2] 叶银存,江佩芳.泛福舒对小儿反复呼吸道感染免疫机制、炎症机制影响研究及疗效观察[J].全科医学临床与教育,2016,14(4):424-426
[3] 徐小勇,施毅支气管张的诊断和治疗进展[J].中国呼吸与危重监护杂志,2017(2):186-190.
[4] Yin J,Zeng B Xu X,Shen K.Broncho-Vaxom in pediatric recurrent respiratory tract infections:A systematic review and meta-analysis[J].International Immunopharmacology,2017,54:198-209.
[5] Abd M A D,Adam T H,Claudia C D et al.Prevention of exacerbations in patients with stable non-cystic fibrosis bronchiectasis:a systematic review and meta-analysis of pharmacological and non-pharmacological therapies[J].BMJ Evidence-Based medicine,2018,doi:10.1136/bmjebm-2018-110893.
[6] Tsang KW,Bilton D.Clinical challenges inmanaging bronchiec-tasis[J].Respirology,2009,14:637-650.
[7] 李晓云,刘双.支气管扩张病因的研究进展[J].心肺血管病杂志,2014,33(1):124-126.
[8] JD Chalmers,S Aliberti,F Blasi.Management of bronchiectasis in adults[J].European Respiratory Journal,2015,45(5):1446-1462
[9] MJ Mcdonnell,C Ward,JL Lordan.Non-cystic fibrosis bronchiectasis[J].Qjm Monthly Journal of the Association of Physicians,2013,106(8):709-715
[10] K earneY Sc,D ZieKieWicZ M,F eLeSZKo W.Immunoregulatory and immunostimulatory responses of bacterial lysates in respiratory infections and asthma[J].Ann Allergy Asthma Immunol,2015,114:364-369.
[11] DB Fernando,S Gianfranco.Prevention of respiratory tract infections with bacterial lysate OM-85 bronchomunal in children and adults:a state of the art[J].Multidisciplinary Respiratory Medicine,2013,8(1):1-9.
[12] 郭庆玲,蔡杰,赵一菊.细菌溶解产物对慢性阻塞性肺疾病急性加重期患者免疫功能的影响[J].中国老年学,2017,37(9):2205-2207.
[13] 何宇梅,李先花.泛福舒联合莫西沙星防治高龄慢阻肺急性发作的临床观察[J].中国老年保健医学,2016,14(2):53-55.
[14] 陈刚.细菌溶解产物对慢性阻塞性肺疾病患者免疫功能的影响观察[J].中国实用医药,2016(8):44-45
[15] 徐鹏,张骅,陈星华.细菌溶解产物对慢性阻塞性肺疾病稳定期患者免疫功能影响[J].中华实用诊断与治疗杂志,2010,24(11):1117-1118.
[16] 杨欣,鲁利群,黄莉泛,等.泛福舒胶囊辅助治疗小儿支气管哮喘的临床研究[J].现代生物医学进展,2017,17(10):1949-1952.
[17] 郝莉霞.细菌溶解产物联合糖皮质激素及白三烯调节剂治疗小儿哮喘的临床研究[J].临床肺科杂志,2016,21(4):694-697.
[18] 吕燕青,詹平,谷红梅,等.泛福舒胶囊辅治儿童支气管哮喘疗效及其对细胞免疫和炎性因子的影响[J].疑难病杂志,2016,15(11):1170-1173.
[19] Russi EW,Leuenberger P,Brndli O,et al.Management of chronic obstructive pulmonary disease:the Swiss guidelines[J].Official Guidelines of the Swiss Respiratory ociety,2002,132(5-6):67-68.
[20] Ana M.Koatz,Noem A.Coe,Alberto Cicera′n,et al.Clinical and Immunological Benefits of OM-85 Bacterial Lysate in Patients with Allergic Rhinitis,Asthma,and COPD and Recurrent Respiratory Infections[J].Lung,2016,194(4):687-697.