孟鲁斯特钠联合脾氨肽治疗儿童支气管哮喘的临床研究

Clinical research of montelukast sodium combined with spleen aminopeptide in the treatment of children with bronchial asthma

目的观察孟鲁斯特钠联合脾氨肽对哮喘患儿Th1/Th2细胞因子的影响及临床疗效。方法 106例支气管哮喘患儿随机分为对照组和观察组,各53例。对照组给予沙美特罗替卡松粉吸入剂吸入,观察组加服孟鲁司特钠和脾氨肽冻干粉,疗程均为3个月。治疗前后分别测定患儿外周血白细胞介素-4(IL-4)、干扰素-γ(INF-γ)、肺功能及哮喘控制测试评分(ACT)。结果两组治疗后IL-4均较治疗前明显降低,而INF-γ较治疗前明显升高,且观察组较对照组变化更为明显,差异有统计学意义(P<0.05)。两组治疗后肺功能均较治疗前明显好转,ACT评分均较治疗前明显增高,且观察组较对照组治疗后也有显著的肺功能改善和ACT评分增高,差异有统计学意义(P<0.05)。结论孟鲁司特钠联合脾氨肽能更有效地改善哮喘患儿的肺功能、调节细胞免疫及控制哮喘发作。

Objective To observe the effect of montelukast combined with spleen aminopeptide on peripheral blood Th1/Th2 cytokine in children with asthma and the clinical efficacy.Methods Divided 106 cases of bronchial asthma into control group and observation group with 53 cases in each. The control group were treated with salmeterol and fluticasone propionate powder for inhalation, the observation group were treated with montelukast and spleen aminopeptide oral lyophilized powder on the basis of the control group. Each group patients were treated for 3 months. The level of IL-4, INF-γ in peripheral blood of patients, lung function and the score of ACT（asthma control test） were determined before and after treatment.Results The level of IL-4 was significantly lower in two groups after treatment than that before treatment, the level of INF-γwas higher, and the level of IL-4, INF-γshowed more changes in observation group than in control group, the difference was statistically significant（P〈0.05）. The lung function in two groups was improved obviously after treatment than that before treatment, the scores of ACT were significantly increased, and the lung function was improved more significantly in the observation group than in the control group and the scores of ACT were significantly increased after treatment, the difference was statistically significant（P〈0.05）. Conclusion Montelukast combined with spleen aminopeptide can improve the lung function, regulate cell immunity and control asthma more effectively than single salmeterol and fluticasone propionate powder.