盐酸氨溴索联合阿奇霉素治疗小儿支气管炎效果研究

Therapeutic effect of ambroxol hydrochloride combined with azithromycin in treating children with bronchiolitis

目的探讨盐酸氨溴索联合阿奇霉素治疗小儿支气管炎疗效及其对IgE、IL-4、IL-13和IFN-γ水平的影响。方法选取2014年1月至2016年12月台州市中心医院收治的小儿支气管炎患儿86例,按照随机数字表法将患儿分为对照组(42例)和研究组(44例),对照组给予布地奈德雾化吸入和地塞米松糖皮质激素等常规治疗,研究组在对照组治疗基础上给予阿奇霉素10mg/kg+盐酸氨溴索15mg,静脉滴注,治疗7d后比较两组患儿疗效以及患者血清IgE、IL-4、IL-13和IFN-γ水平。结果研究组总有效率(90.91%)高于对照组(71.43%),差异有统计学意义(χ~2=5.382,P<0.05)。治疗后研究组IgE、IL-4和IL-13水平均低于治疗前,差异有统计学意义(t=16.954、16.208、9.236,P<0.05)低于对照组治理后,差异有统计学意义(t=7.485、12.238、5.764,P<0.05)。研究组治疗后IFN-γ水平高于治疗前,差异有统计学意义(t=12.010,P<0.05)和对照组治疗后,差异有统计学意义(t=15.839,P<0.05),差异均有统计学意义。结论盐酸氨溴索联合阿奇霉素治疗小儿支气管炎可有效调节患者IgE、IL-4、IL-13和IFN-γ水平,改善其免疫功能。

Objective To explore the clinical effect of ambroxol hydrochloride combined with azithromycin in treating children with bronchiolitis and its influence on serum levels of IgE,IL-4,IL-13 and IFN-γ. Methods A total of 86 children with bronchiolitis were enrolled from January 2014 to December 2016 in Taizhou Central Hospital and were randomly divided into control group(n=42)and study group(n=44).Patients in control group were treated with conventional method(budesonide inhalation and dexamethasone),while patients in study were treated with ambroxol hydrochloride(10 mg/kg)combined with azithromycin(15 mg)besides conventional treatment.The clinical effect was assessed and serum levels of IgE,IL-4,IL-13 and IFN-γwere determined and compared 7 days after the treatment. Results The overall treatment effective rate was significantly higher among patients in study group than that of those in control group(90.91% vs 71.43%,χ^2=5.382,P<0.05).After the treatment,the serum levels of IgE,IL-4 and IL-13 in study group decreased(t=16.954,16.208,9.236,P<0.05)and were much lower compared with control group(t=7.485,12.238,5.764,P<0.05),however,the level of IFN-γincreased(t=12.010,P<0.05)and was much higher compared with control group(t=15.839,P<0.05). Conclusions Ambroxol hydrochloride combined with azithromycin is effective in treating children with bronchiolitis by regulating the serum levels of IgE,IL-4,IL-13 and IFN-γand improving the immune function of patients