多索茶碱注射联合布地奈德雾化对支气管哮喘急性发作的疗效及细胞因子水平的影响

Clinical Efficacy of Doxofylline Combined with Budesonide Atomization in Treating Acute Attack of Bronchial Asthma and Its Effect on Cytokines Levels

目的探讨多索茶碱注射联合布地奈德雾化吸入治疗支气管哮喘急性发作的临床疗效及对细胞因子γ干扰素(IFN-γ)和白细胞介素-4(IL-4)水平的影响。方法选取2012年1月至2013年10月医院收治的支气管哮喘急性发作患者168例,随机分为对照组82例和观察组86例。两组患者均采用基础治疗加布地奈德雾化吸入,对照组加用氨茶碱静脉滴注,观察组加用多索茶碱静脉滴注。观察两组患者的临床疗效、主要症状和体征改善情况,于治疗前后测定气道阻力、外周血IFN-γ和IL-4的水平。结果观察组的总有效率为89.53%,明显高于对照组的74.39%(P<0.05);两组患者咳嗽、喘息和肺内哮鸣音评分治疗后均较治疗前下降,且观察组下降更显著(P<0.05);两组患者治疗后气道阻力均明显减少,且观察组减少较对照组更显著(P<0.05);两组患者细胞因子水平治疗后均较治疗前改善,且观察组改善幅度更大(P<0.05)。治疗过程中,观察组不良反应发生率为9.30%,明显低于对照组的24.39%(P<0.05)。结论多索茶碱注射联合布地奈德雾化吸入治疗支气管哮喘急性发作的临床疗效好,能显著改善症状,且不良反应少,并可通过调节血清IFN-γ和IL-4水平调节免疫功能,值得推广。

Objective To investigate the clinical efficacy of doxofylline combined with budesonide atomization inhalation for treating acute attack of bronchial asthma and its effect on the cytokine IFN- γ and IL- 4 levels. Methods 168 patients with acute attack of bronchial asthma in the hospital from January 2012 to October 2013 were selected and randomly divided into the control group（82 cases） and the observation group（86 cases）. The two group all adopted the basic therapy plus budesonide atomization inhalation. On this basis,the control group was added with aminophyline by intravenous drip,while the observation group was given doxofylline by intravenous drip. The clinical efficacy and improvement of the main symptoms and signs were observed,the airway resistance,peripheral blood IFN- γ and IL- 4 levels were detected before and after treatment. Results The total effective rate of the observation group was89. 53%,which was significantty higher than 74. 39% in the control group（P〈0. 05）; the cough,wheezing and lung wheeze scores after treatment in the two groups were significantly decreased compared with before treatment（P〈0. 05）; the airway resistance after treatment in the two groups was significantly decreased,but the decrease in the observation group was more significant than that in the control group,the difference was statistically significant（P〈0. 05）; the cytokines levels after treatment were improved in the two groups,but which in the observation group were greatly improved（P〈0. 05）. The occurrence rate of adverse reactions was 9. 30% in the observation group,which was significantly lower than 24. 39% in the control（P〈0. 05）. Conclusion Doxofylline injection combined with budesonide atomization inhalation has better clinical effect for treating acute attack of bronchial asthma,can significantly improve the symptoms,has less adverse reactions,can regulate the immune function by regulating the serum IFN- γ and IL- 4 levels,which is worthy of clinical promotcon.