益生菌联合特异性免疫疗法治疗小儿尘螨过敏性哮喘临床观察  

Clinical Observation of Probiotics Combined with Specific Immunotherapy in the Treatment ofChildren with Dust Mite - Induced Allergic Asthma

作　　者：程建红[1] 蔡丽[1] CHENG Jianhong;CAI Li(Zigong Maternity and Child Health Care Hospital,Zigong,Sichuan,China 643010)

机构地区：[1]四川省自贡市妇幼保健院,四川自贡643010

出　　处：《中国药业》2024年第20期108-112,共5页China Pharmaceuticals

基　　金：四川省卫生和计划生育委员会科研课题[18PJ477]。

摘　　要：目的探讨益生菌联合特异性免疫疗法治疗小儿尘螨过敏性哮喘的临床疗效。方法选取医院2022年4月至2023年4月收治的104例尘螨过敏性哮喘患儿,按随机数字表法分为对照组和观察组,各52例。两组患儿均予常规对症治疗及特异性免疫疗法(屋尘螨变应原制剂皮下注射),观察组患儿加服双歧杆菌乳杆菌三联活菌片。两组患儿均连续治疗6个月。结果观察组总有效率为96.15%,略高于对照组的92.31%(P>0.05)。治疗后,两组患儿的呼气流速峰值及第1秒用力呼气容积占预测值百分比均显著升高,呼出气一氧化氮水平均显著降低(P<0.05);白细胞介素6、白细胞介素17水平均显著降低,白细胞介素10水平均显著升高(P<0.05);γ干扰素水平均显著升高,白细胞介素4水平均显著降低(P<0.05);气道阻力、气道峰压、呼吸功均显著降低,肺动态顺应性均显著升高(P<0.05);整合素α_(4)β_(1)、整合素α_(v)β_(6)、血管细胞黏附分子-1、细胞间黏附分子-1水平均显著降低(P<0.05);大肠杆菌数量均显著减少,乳酸杆菌、双歧杆菌数量均显著增多(P<0.05);且观察组上述指标改善均更显著(P<0.05)。两组患儿不良反应发生率无显著差异(P>0.05)。结论益生菌联合特异性免疫疗法治疗小儿尘螨过敏性哮喘,可进一步提高患儿机体免疫功能,改善肺功能及呼吸功能,作用机制可能与辅助性T细胞(Th)17/调节性T细胞(Treg)、Th1/Th2、肠道菌群调节等有关。Objective To investigate the clinical efficacy of probiotics combined with specific immunotherapy in the treatment of children with dust mite-induced allergic asthma.Methods A total of 104 children with dust mite-induced allergic asthma admitted to the hospital from April 2022 to April 2023 were selected and randomly divided into the control group and the observation group by the random number table method,with 52 cases in each group.The children in the two groups received routine symptomatic treatment and specific immunotherapy[subcutaneous injection of Mites Allergens ALK(503)D.p],on this basis,the children in the observation group received oral Live Combined Bifidobacterium and Lactobacillus Tablets.All children were treated continuously for six months.Results The total effective rate in the observation group was 96.15%,which was slightly higher than 92.31%in the control group(P>0.05).After treatment,the percentage of peak expiratory flow to predicted value(PEF%)and the percentage of forced expiratory volume in one second to predicted value(FEV_(1)%)in the two groups significantly increased,and the fractional exhaled nitric oxide(FeNO)level significantly decreased(P<0.05);the interleukin-6(IL-6)and interleukin-17(IL-17)levels significantly decreased,and the interleukin-10(IL-10)level significantly increased(P<0.05);the interferon-γ(IFN-γ)level significantly increased,and the interleukin-4(IL-4)level significantly decreased(P<0.05);the airway resistance(Raw),peak airway pressure(PIP)and work of breath(WOB)significantly decreased,and the dynamic lung compliance(Cdyn)significantly increased(P<0.05);the integrin α_(4)β_(1),integrin α_(v)β_(6),vascular cell adhesion molecule-1(VCAM-1),and intercellular cell adhesion molecule-1(ICAM-1)levels significantly decreased(P<0.05);the count of Escherichia coli decreased significantly,the counts of Lactobacillus and Bifidobacterium significantly increased(P<0.05);and those in the observation group were significantly better than those in the control group(P<0.05).There

关 键 词：益生菌 特异性免疫疗法 尘螨过敏性哮喘 小儿 肠道菌群 临床疗效 

分 类 号：R969.4[医药卫生—药理学]