特布他林联合匹多莫德治疗小儿咳嗽变异性哮喘的临床效果
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摘要
目的探讨特布他林联合匹多莫德治疗小儿咳嗽变异性哮喘的临床效果及其对IFN-γ、IL-4水平的影响,为临床小儿咳嗽变异性哮喘的治疗提供一定指导。方法选取我院2016年1月至2018年6月收治的104例咳嗽变异性哮喘患儿作为研究对象,根据住院号码尾数单双号将其分为对照组和观察组,每组52例。对照组采用常规治疗措施,观察组在对照组治疗的基础上采用特布他林联合匹多莫德治疗。比较两组临床疗效和治疗前、治疗3个月后IFN-γ、IL-4水平以及不良反应发生情况。结果治疗3个月后,观察组治疗总有效率明显高于对照组,差异有统计学意义(P<0.05)。治疗前,两组IFN-γ、IL-4水平比较,差异无统计学意义(P>0.05);治疗3个月后,两组IFN-γ水平均显著降低,但观察组高于对照组,差异有统计学意义(P<0.05);治疗后,两组IL-4水平均显著降低,且观察组低于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论特布他林联合匹多莫德治疗小儿咳嗽变异性哮喘疗效显著,可以通过改善IFN-γ、IL-4等水平实现纠正T淋巴细胞亚群比例失衡的目标,安全性较高,值得临床广泛推广应用。
Objective To explore the clinical effect of terbutaline combined with pidomide in the treatment of cough variant asthma in children and its influence on the levels of IFN-γ and IL-4, so as to provide some guidance for the treatment of cough variant asthma in children. Methods A total of 104 children with cough variant asthma admitted in our hospital from January 2016 to June 2018 were selected as the research objects. According to single and double number grouping method of hospitalization number, all children were divided into control group and observation group,with 52 cases in each group. The control group was treated with routine treatment, while the observation group was treated with terbutaline combined with pidotimod on the basis of the control group. The clinical efficacy, levels of IFN-γand IL-4 before treatment and after 3 months of treatment and incidences of adverse reactions were compared between the two groups. Results After 3 months of treatment, the total effective rate of treatment in the observation group was significantly higher than that in the control group, and the difference was statistically significant(P <0.05). Before treatment, there were no significant differences in the levels of IFN-γ and IL-4 between the two groups(P>0.05); after 3 months of treatment, the levels of IFN-γ in both groups decreased significantly, but that in the observation group was higher than the control group, and the differences were statistically significant(P<0.05); after treatment, the levels of IL-4 in both groups decreased significantly, and that in the observation group was lower than the control group, the differences were statistically significant(P<0.05). There was no significant difference in the total incidences of adverse reactions between the two groups(P>0.05). Conclusion Terbutaline combined with pidotimod is effective in the treatment of cough variant asthma in children. It can correct the imbalance of T lymphocyte subsets by improving the levels of IFN-γ and IL-4. It is safe and worthy of wide clinical promotion and application.
Objective To explore the clinical effect of terbutaline combined with pidomide in the treatment of cough variant asthma in children and its influence on the levels of IFN-γ and IL-4, so as to provide some guidance for the treatment of cough variant asthma in children. Methods A total of 104 children with cough variant asthma admitted in our hospital from January 2016 to June 2018 were selected as the research objects. According to single and double number grouping method of hospitalization number, all children were divided into control group and observation group,with 52 cases in each group. The control group was treated with routine treatment, while the observation group was treated with terbutaline combined with pidotimod on the basis of the control group. The clinical efficacy, levels of IFN-γand IL-4 before treatment and after 3 months of treatment and incidences of adverse reactions were compared between the two groups. Results After 3 months of treatment, the total effective rate of treatment in the observation group was significantly higher than that in the control group, and the difference was statistically significant(P <0.05). Before treatment, there were no significant differences in the levels of IFN-γ and IL-4 between the two groups(P>0.05); after 3 months of treatment, the levels of IFN-γ in both groups decreased significantly, but that in the observation group was higher than the control group, and the differences were statistically significant(P<0.05); after treatment, the levels of IL-4 in both groups decreased significantly, and that in the observation group was lower than the control group, the differences were statistically significant(P<0.05). There was no significant difference in the total incidences of adverse reactions between the two groups(P>0.05). Conclusion Terbutaline combined with pidotimod is effective in the treatment of cough variant asthma in children. It can correct the imbalance of T lymphocyte subsets by improving the levels of IFN-γ and IL-4. It is safe and worthy of wide clinical promotion and application.
引文
[1]李婕.玉屏风颗粒联合匹多莫德对儿童反复呼吸道感染的疗效及对免疫功能和炎性细胞因子水平的影响[J].中药材,2014,37(3):534-537.
[2]陈淼浦,李薇,钟顺平.咳嗽变异型哮喘患儿与Tc1/Tc2免疫平衡的关系[J].国际儿科学杂志,2014,41(4):444-445.
[3]王淙垲,刘汉嘉,黄永智,等.哮喘患儿外周血单核细胞中Toll样受体4表达及意义[J].中华实用诊断与治疗杂志,2015,29(12):1212-1214.
[4]傅发展,吕笑俏,柳俊瑾,等.匹多莫德和脾氨肽对呼吸道反复感染儿童外周血T细胞亚群及其细胞因子的影响[J].中华医院感染学杂志,2017,27(1):201-204.
[5]LI W,BAN C,ZHANG J,et al.Correlation study of cough variant asthma and mycoplasma pneumonia infection in children[J].Pak J Pharm Sci,2017,30(3(Special)):1099-1102.
[6]吴延雷,凌杰.匹多莫德对儿童哮喘患者血清白介素-4和γ-干扰素水平的影响及疗效观察[J].中国医药导报,2013,10(24):101-102.
[7]YILMAZ O,BAKIRTAS A,ERTOY KARAGOL HI,et al.Children with chronic nonspecific isolated cough[J].Chest,2014,145(6):1279-1285.
[8]周文波.特布他林联合复方甲氧那明胶囊治疗咳嗽变异性哮喘的临床研究[J].现代药物与临床,2017,32(10):1881-1884.
[9]张红艳,赵淑景,田菲.槐杞黄颗粒佐治小儿咳嗽变异性哮喘对免疫球蛋白、T淋巴细胞亚群及细胞因子的影响[J].海南医学院学报,2017,23(3):404-407.
[10]张颖,王伟.咳嗽变异型哮喘的研究进展[J].国际呼吸杂志,2004,24(3):160-161.
[11]赵一菊,肖正伦.咳嗽变异性哮喘的研究进展[J].医学综述,2012,18(13):2067-2069.
[12]赵力力,张至大,侯红颜,等.匹多莫德对儿童哮喘患者血清IL4、IFN-γ和IgE水平的影响及疗效观察[J].中国临床研究,2016,29(1):65-67.
[13]杨英.匹多莫德治疗小儿呼吸系统反复感染的疗效观察[J].中国医药科学,2013,23(24):70-71.
[14]王远明,杜惠容.匹多莫德治疗小儿反复下呼吸道感染疗效观察及免疫功能变化[J].重庆医学,2012,41(35):3758-3759.
[2]陈淼浦,李薇,钟顺平.咳嗽变异型哮喘患儿与Tc1/Tc2免疫平衡的关系[J].国际儿科学杂志,2014,41(4):444-445.
[3]王淙垲,刘汉嘉,黄永智,等.哮喘患儿外周血单核细胞中Toll样受体4表达及意义[J].中华实用诊断与治疗杂志,2015,29(12):1212-1214.
[4]傅发展,吕笑俏,柳俊瑾,等.匹多莫德和脾氨肽对呼吸道反复感染儿童外周血T细胞亚群及其细胞因子的影响[J].中华医院感染学杂志,2017,27(1):201-204.
[5]LI W,BAN C,ZHANG J,et al.Correlation study of cough variant asthma and mycoplasma pneumonia infection in children[J].Pak J Pharm Sci,2017,30(3(Special)):1099-1102.
[6]吴延雷,凌杰.匹多莫德对儿童哮喘患者血清白介素-4和γ-干扰素水平的影响及疗效观察[J].中国医药导报,2013,10(24):101-102.
[7]YILMAZ O,BAKIRTAS A,ERTOY KARAGOL HI,et al.Children with chronic nonspecific isolated cough[J].Chest,2014,145(6):1279-1285.
[8]周文波.特布他林联合复方甲氧那明胶囊治疗咳嗽变异性哮喘的临床研究[J].现代药物与临床,2017,32(10):1881-1884.
[9]张红艳,赵淑景,田菲.槐杞黄颗粒佐治小儿咳嗽变异性哮喘对免疫球蛋白、T淋巴细胞亚群及细胞因子的影响[J].海南医学院学报,2017,23(3):404-407.
[10]张颖,王伟.咳嗽变异型哮喘的研究进展[J].国际呼吸杂志,2004,24(3):160-161.
[11]赵一菊,肖正伦.咳嗽变异性哮喘的研究进展[J].医学综述,2012,18(13):2067-2069.
[12]赵力力,张至大,侯红颜,等.匹多莫德对儿童哮喘患者血清IL4、IFN-γ和IgE水平的影响及疗效观察[J].中国临床研究,2016,29(1):65-67.
[13]杨英.匹多莫德治疗小儿呼吸系统反复感染的疗效观察[J].中国医药科学,2013,23(24):70-71.
[14]王远明,杜惠容.匹多莫德治疗小儿反复下呼吸道感染疗效观察及免疫功能变化[J].重庆医学,2012,41(35):3758-3759.