基于Th1/Th2失衡机制分析微生态制剂对咳嗽变异性哮喘患儿的作用  

Effects of probiotics on children with cough variant asthma based on Th1/Th2 imbalance mechanism

作　　者：杨美娟 何春风[1] 张怡丹 YANG Meijuan;HE Chunfeng;ZHANG Yidan(Department of Pediatrics,Lishui People's Hospital,Lishui 323000,China)

机构地区：[1]丽水市人民医院儿科,323000

出　　处：《浙江医学》2025年第8期872-876,共5页Zhejiang Medical Journal

摘　　要：目的探讨微生态制剂辅助治疗咳嗽变异性哮喘(CVA)的临床疗效,并基于辅助性T细胞(Th)1/Th2失衡机制分析微生态制剂对CVA的作用。方法回顾性选取2021年1月至2023年10月在丽水市人民医院治疗的136例CVA患儿为研究对象,其中采用布地奈德气雾剂治疗的68例为对照组,加用双歧杆菌乳杆菌三联活菌片治疗的68例为观察组。比较两组患儿临床疗效、肺功能指标[用力肺活量(FVC)、第1秒用力呼气量(FEV1)和呼气峰流速(PEF)]、Th1和Th2水平、炎症因子[白细胞介素(IL)-4、IL-10、IL-17、干扰素γ(IFN-γ)]水平、不良反应及复发情况。结果观察组患儿治疗总有效率高于对照组(92.6%比80.9%,P<0.05)。治疗后,两组患儿FVC、FEV1、PEF、Th1水平、Th1/Th2比值、血清IL-10、IFN-γ水平均高于治疗前,Th2水平、血清IL-4、IL-17水平均低于治疗前,且观察组患儿FVC、FEV1、PEF、Th1水平、Th1/Th2比值、血清IL-10、IFN-γ水平均高于对照组,Th2水平、血清IL-4、IL-17水平均低于对照组,差异均有统计学意义(均P<0.05)。两组患儿治疗期间均未发生明显不良反应。治疗后两组患儿随访3个月,观察组和对照组CVA复发率分别为4.8%和14.5%,两组比较差异无统计学意义(P=0.132)。结论微生态制剂辅助治疗CVA效果显著,有助于改善患儿咳嗽症状和肺功能水平,其机制可能与纠正Th1/Th2失衡、降低炎症因子水平有关。Objective To explore the clinical efficacy of probiotics as an adjuvant therapy for cough variant asthma(CVA),and to analyze the effect of probiotics on CVA based on the mechanism of helper T cell(Th)1/Th2 imbalance.Methods A total of 136 children with CVA who were treated in Lishui People's Hospital from January 2021 to October 2023 were retrospectively selected as the research subjects.Among them,68 cases who were treated with budesonide aerosol were included in the control group,and another 68 cases who were treated with bifidobacterium lactobacillus triple viable tablets additionally were included in the observation group.The clinical efficacy,lung function indicators[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),and peak expiratory flow(PEF)],Th1/Th2 levels,inflammatory cytokines[interleukin(IL)-4,IL-10,IL-17,and interferon-γ(IFN-γ)],adverse reactions,and recurrence were compared between the two groups.Results The total effective rate of treatment in the observation group was higher than that of the control group(92.6%vs.80.9%,P<0.05).After treatment,the FVC,FEV1,PEF,Th1 levels,Th1/Th2 ratio,serum IL-10 and IFN-γlevels in both groups of children were higher than those before treatment,while the Th2 levels,and serum IL-4 and IL-17 levels were lower than those before treatment.In addition,the FVC,FEV1,PEF,Th1 levels,Th1/Th2 ratio,serum IL-10 and IFN-γlevels in the observation group were higher than those of the control group,while the Th2 levels,and serum IL-4 and IL-17 levels were lower than those of the control group,and the differences were statistically significant(all P<0.05).No significant adverse reactions occurred during the treatment of both groups of children.After 3 months of follow-up,the recurrence rates of CVA in the observation group and control group were 4.8%and 14.5%,respectively,with no statistically significant difference between the two groups(P=0.132).Conclusion Probiotics have a significant effect in assisting the treatment of children with CVA,helping to im

关 键 词：微生态制剂 咳嗽变异性哮喘 儿童 肺功能 

分 类 号：R725.6[医药卫生—儿科]