干扰素联合益生菌对儿童特应性体质毛细支气管炎的疗效观察
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摘要
目的探讨联合药物方案应用对特应性体质毛细支气管炎患儿近期疗效及实验室指标的影响。方法研究对象选取我院2015年1月-2017年6月收治特应性体质毛细支气管炎患儿共136例,随机分为对照组(68例)和试验组(68例),分别在对症干预基础上采用干扰素单用和干扰素+益生菌方案治疗;比较两组患儿近期治疗总有效率、急性发作持续时间、随访喘息发作次数、治疗前后临床症状评分、RR、SpO_2、EOS、Ig E、IL-17、TGF-β1水平及药物毒副作用发生率。结果试验组患治疗总有效率、急性发作持续时间及随访喘息发作次数均显著优于对照组(P <0. 05);试验组治疗后临床症状评分、RR及SpO_2均显著优于对照组、治疗前(P <0. 05);试验组治疗后EOS、Ig E、IL-17及TGF-β1水平均显著优于对照组、治疗前(P <0. 05)。结论联合药物方案治疗特应性体质毛细支气管炎能够有效缩短急性发作持续时间,避免喘息反复发作,缓解临床症状,提高肺部通气功能,调节EOS、Ig E、IL-17及TGF-β1水平,且安全性值得认可。
Objective To investigate the influence of combined drug regimen on clinical effect for short-term and laboratory index of atopic children with bronchiolitis. Methods 136 atopic children with bronchiolitis were chosen from January 2015 to June 2017 and randomly divided into the control group( 68 cases) with interferon used alone and the experiment group( 68 cases) with probiotics + interferon. The clinical efficacy for short-term,the duration of acute attack,the episodes number of wheezing,the clinical symptoms scores,the levels of RR,Sp O2,EOS,Ig E,IL-17 and TGF-β1 before and after treatment and the incidence of drug side effect were compared between the two groups. Results The total clinical effect for short-term,the duration of acute attack and the episodes number of wheezing of the experiment group were significantly better than those of the control group( P < 0. 05). The clinical symptoms scores,the levels of RR and Sp O2 after treatment of the experiment group were significantly better than those of the control group and before treatment( P < 0. 05). The levels of EOS,Ig E,IL-17 and TGF-β1 after treatment of the experiment group were significantly better than those of the control group and before treatment( P <0. 05). There was no significant difference in the incidence of drug side effect between the two groups( P > 0. 05).Conclusion Combined drug regimen can efficiently shorten the duration of acute attack,avoid recurrent episodes of wheezing,relieve clinical symptoms,improve pulmonary ventilation function,and regulate the levels of EOS,Ig E,IL-17 and TGF-β1 in treatment of atopic children with bronchiolitis,with high safety.
Objective To investigate the influence of combined drug regimen on clinical effect for short-term and laboratory index of atopic children with bronchiolitis. Methods 136 atopic children with bronchiolitis were chosen from January 2015 to June 2017 and randomly divided into the control group( 68 cases) with interferon used alone and the experiment group( 68 cases) with probiotics + interferon. The clinical efficacy for short-term,the duration of acute attack,the episodes number of wheezing,the clinical symptoms scores,the levels of RR,Sp O2,EOS,Ig E,IL-17 and TGF-β1 before and after treatment and the incidence of drug side effect were compared between the two groups. Results The total clinical effect for short-term,the duration of acute attack and the episodes number of wheezing of the experiment group were significantly better than those of the control group( P < 0. 05). The clinical symptoms scores,the levels of RR and Sp O2 after treatment of the experiment group were significantly better than those of the control group and before treatment( P < 0. 05). The levels of EOS,Ig E,IL-17 and TGF-β1 after treatment of the experiment group were significantly better than those of the control group and before treatment( P <0. 05). There was no significant difference in the incidence of drug side effect between the two groups( P > 0. 05).Conclusion Combined drug regimen can efficiently shorten the duration of acute attack,avoid recurrent episodes of wheezing,relieve clinical symptoms,improve pulmonary ventilation function,and regulate the levels of EOS,Ig E,IL-17 and TGF-β1 in treatment of atopic children with bronchiolitis,with high safety.
引文
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[16]MUNIR M B,HASHIM R,CHAI Y H,et al.Dietary prebiotics and probiotics influence growth performance,nutrient digestibility and the expression of immune regulatory genes in snakehead(Channa striata)fingerlings[J].Aquaculture,2016,460:59-68.
[2]XI Y,DAY S L,JACKSON R J,et al.Role of novel typeⅠinterferon epsilon in viral infection and mucosal immunity[J].Mucosal Immumol,2012,5(6):610-622.
[3]ZUCCOTTI G,MENEGHIN F,ACETI A,et al.Probiotics for prevention of atopic diseases in infants:systematic review and meta-analysis[J].Allergy,2015,70(11):1356-1371.
[4]LEE S C,YANG Y H,CHUANG S Y,et al.Reduced medication use and improved pulmonary function with supplements containing vegetable and fruit concentrate,fish oil and probiotics in asthmatic school children:a randomised controlled trial[J].Br J Nutr,2013,110(1):145-155.
[5]王卫平,毛萌,李廷玉,等.儿科学[M].第8版.北京:人民卫生出版社,2013:269-271.
[6]江载芳,申昆玲,沈颖,等.诸福棠实用儿科学[M].北京.人民卫生出版社,2015:102-103.
[7]中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南(2016年版)[S].中华儿科杂志,2016,54(3):167-181.
[8]RUTTEN N B,GORISSEN D M,ECK A,et al.Long term development of gut microbiota composition in atopic children:impact of probiotics[J].PLo S One,2015,10(9):e0137681.
[9]GRAHAM B S.Biological challenges and technological opportunities for respiratory syncytial virus vaccine development[J].Immunol Rev,2011,239(1):149-166.
[10]XIAN G N,SUN Q P,CHEN H A.Contribution of serum IL-4 and Ig E to the early prediction of allergic reactions induced by chlorogenic acid[J].Eur J Pharmacol,2013,699(1/3):1-5.
[11]ST PAUL M,BARJESTEH N,PAOLUCCI S,et al.Toll-like receptor ligands induce the expression of interferon-gamma and interleukin-17 in chicken CD+4T cells[J].BMC Res Notes,2012,5:616-620.
[12]KIM H J,KIM Y J,LEE S H,et al.Effects of lactobacillus rhamnosus on allergic march model by suppressing Th2,Thl7,and TSLPresponses via CD+4CD+25Foxp3+Tregs[J].Clin Immunol,2014,153(1):178-186.
[13]LI J N,LIU K C,LIU Y,et al.Exosomes mediate the cell-to-cell transmission of IFN-α-induced antiviral activity[J].Nat Immunol,2013,14(8):793-803.
[14]SOICHI T.The effect of probiotics and gut microbiota on th17 cells[J].Int Rev Immunol,2013,32(5/6):511-525.
[15]KUGELMAN A,RAIBIN K,DABBAH H,et al.Intravenous fluids versus gastric-tube feeding in hospitalized infants with viral bronchiolitis:a randomized,prospective pilot study[J].J Pediatr,2013,162(3):640-642.
[16]MUNIR M B,HASHIM R,CHAI Y H,et al.Dietary prebiotics and probiotics influence growth performance,nutrient digestibility and the expression of immune regulatory genes in snakehead(Channa striata)fingerlings[J].Aquaculture,2016,460:59-68.