匹多莫德联合沙美特罗替卡松对咳嗽变异性哮喘的临床疗效研究

Effect of Pidotimod and Salmeterol Fluticasone in Patients with Cough Variant Asthma

目的 观察匹多莫德联合沙美特罗替卡松对咳嗽变异性哮喘（CVA）的临床疗效,探讨其对患者免疫功能的调节作用。方法 选取2010年8月～2013年2月于笔者医院进行治疗的CVA患者112例,分为沙美特罗替卡松治疗对照组和匹多莫德联合沙美特罗替卡松治疗观察组,每组56例.一氧化氮分析仪检测呼出气一氧化氮（FeNO）,白介素-17（IL-17）表达水平的测定使用ELISA法,比较两组的临床疗效和不良反应发生率.结果 治疗前对照组和观察组日间和夜间咳嗽积分差异均无统计学意义（P＞0.05）,治疗后对照组日间和夜间咳嗽积分较治疗前出现显著减低（P＜0.05）,治疗后观察组日间和夜间咳嗽积分也较治疗前出现显著减低（P＜0.01）,但治疗后观察组的日间和夜间咳嗽积分均低于对照组（P＜0.05）.观察组治疗有效率为92.9％显著优于对照组的80.4％ （P ＜0.05）.治疗前对照组和观察组FeNO和IL-17差异均无统计学意义（P＞0.05）,治疗后对照组FeNO和IL-17较治疗前显著减低（P＜0.05）,治疗后观察组FeNO和IL-17也较治疗前显著减低（P＜0.01）,但治疗后观察组FeNO和IL-17均低于对照组（P＜0.05）.观察组和对照组不良反应发生率分别为8.93％和7.14％,两组之间比较差异无统计学意义（P＜0.05）.结论 匹多莫德联合沙美特罗替卡松可以显著减低咳嗽变异性哮喘患者IL-17的表达水平,临床安全、疗效显著,具有一定的临床应用价值。

Objective To observe the effect of pidotimod and salmeterol fluticasone in patients with cough variant asthma（CVA） and its regulation of immune function.Methods A total of 112 cases of CVA patients were enrolled in this study from August 2010 to February 2013.The patients were divided into：salmeterol fluticasone treatment control group（n =56） and pidotimod and salmeterol fluticasone treatment observation group（n =56）.The FeNO was detected by NO analyzer.IL-17 was by ELISA analysis.The clinic effects and side effects were compared between the two groups.Results Before treatment,the daytime and nighttime cough score was of no significant difference between control and observation group （P ＞ 0.05）.After treatment,the daytime and nighttime cough score was significantly reduced in control group （P ＜ 0.05） and also in observation group （P ＜ 0.01）,but,which was significantly lower in observation group than that in control group （P ＜ 0.05）.The clinic effective rate in observation was 92.9％,which was higher than that of 80.4％ in control group （P ＜ 0.05）.Before treatment,the FeNO and IL-17 was of no significant difference between control and observation group （P ＞0.05）.After treatment,the the FeNO and IL-17 was significantly reduced in control group （P ＜0.05） and also in observation group （P ＜ 0.01）,but,which was significantly lower in observation group than that in control group （P ＜ 0.05）.The rate of clinical adverse reactions in observation and control group was 8.93％ and 7.14％.The rate of clinical adverse reactions was not significantly different between the two group（P ＞ 0.05）.Conclusion Pidotimod and salmeterol fluticasone can reduce the expression of IL-17,with effectively clinical efficacy and safiy to treat CVA patients.