益生菌联合布地奈德治疗对支气管哮喘患儿Th1/Th2细胞因子平衡的调控及疗效研究  

Clinical study on cytokines balance of Th1/Th2 and treatment of bronchial asthma in children with combination therapy of probiotics and budesonide powder for inhalation

作　　者：吕冰 王桂兰[2] 成学俊 梁欢容 刘新安 

机构地区：[1]广东省中山市西区医院儿科,中山528400 [2]中山市博爱医院儿科

出　　处：《临床医学》2016年第9期11-14,共4页Clinical Medicine

摘　　要：目的评估益生菌联合布地奈德对支气管哮喘患儿外周血Th1/Th2平衡的调节作用及其治疗儿童支气管哮喘的临床疗效。方法采用随机、开放、平行对照研究方法,将45例患儿分为对照组(布地奈德吸入剂组)22例和观察组(布地奈德吸入剂+益生菌联合治疗组)23例,通过检测血浆Ig E水平,血浆Th1细胞相关因子[γ-干扰素(IFN-γ)]和Th2细胞相关因子[白细胞介素(IL-4)]表达水平,观察临床症状评分、生活质量评分、临床疗效和不良事件发生情况,评估其临床效果和安全性。结果两组药物治疗都可改善患儿的临床症状,但观察组改善更明显;治疗前两组患儿的CD+3、CD+4、CD+8百分比,CD+4/CD+8比值,Ig E、Th1、Th2及Th1/Th2与IL-4、IFN-γ,生活质量评分,症状评分水平比较差异未见统计学意义(P>0.05);治疗后观察组的CD+4/CD+8比值,Th1、Th2及Th1/Th2与IL-4、IFN-γ,生活质量评分,症状评分水平改善情况明显优于对照组,组间比较差异均有统计学意义(P<0.05)。结论布地奈德吸入治疗和益生菌+布地奈德吸入剂联合治疗儿童支气管哮喘都具有良好的疗效和安全性,但益生菌+布地奈德吸入剂联合治疗方法疗效更好,能有效改善患儿Th1/Th2免疫失衡,值得在临床上推广应用。Objective To evaluate the clinical efficacy and safety of the combination therapy of probiotics and budesonide powder for inhalation in the treatment of bronchial asthma in children. Methods In this open, randomized, parallel control study, 45 patients were divided into control group （budesonide powder for inhalation group, 22 cases） and observation group （ combination of probiotics and budesonide powder for inhalation, 23 cases）. By detecting plasma IgE levels, expression of plasma Thl cell related factors [ γ-interferon （IFN-γ）] and Th2 cell related factor [ interleukin-4 （IL-4）] levels, the incidence of clinical symptom score, life quality score, clinical efficacy and adverse events were observed, and the clinical efficacy and safety were evaluated. Results The clinical symptoms were improved in both groups, but the improvement was more significant in the observation group（ P 〈 0.05）. Before treatment, the differences in the percentage of CD3^＋ , CD4^＋ and CD8^＋ , CD4^＋/CD8^＋ , clinical symptom scale, life quality score, symptom score, IgE, Th1, Th2, Th1/Th2, IL-4 and IFN-γ between the two groups had no significant difference （ P 〈 0.05 ）. After treatment, the improvement of percentage of CD3^＋, CD4^＋ and CD8^＋ , CD4^＋/CD8^＋, clinical symptom scale, life quality score, symptom score, IgE, Th1, Th2, Thl/Th2, IL-4 and IFN-γ in the observation group were significantly better than those in the control group （ P 〉 0. 05 ）. No adverse reaction were observed in the two groups. Conclusion The budesonide powder for inhalation group and the combination of probioties and budesonide powder for inhalation group both have good clinical efficacy and safety, but the latter provides better efficacy than the former. The combination of probiotics and budesonide powder for inhalation promote the balance of Th1/Th2 and is worthy of clinical application.

关 键 词：益生菌 布地奈德 支气管哮喘 TH1/TH2细胞因子平衡 

分 类 号：R725.6[医药卫生—儿科]