益生菌辅助治疗儿童支气管哮喘伴变应性鼻炎的疗效及机制研究

The Efficacy and Mechanism of Probiotics in Children with Bronchial Asthma Combined with Allergic Rhinitis

目的:探讨益生菌辅助治疗儿童支气管哮喘伴变应性鼻炎(AR)的疗效及机制。方法:选取100例哮喘伴AR患儿,随机分为观察组和对照组各50例,对照组给予常规治疗,观察组在对照组治疗基础上联合双歧杆菌乳杆菌三联活菌散治疗,连续治疗6个月。比较两组患儿哮喘控制测试(C-ACT)量表评分、第1秒用力肺活量(FEV1)、呼气峰值流速(PEF)、鼻部症状评分及血清干扰素-γ(IFN-γ)和白介素-4(IL-4)水平。结果:治疗后,观察组C-ACT评分、FEV1、PEF、鼻部症状评分、IFN-γ及IL-4分别为(24.6±2.3)分、123.7%±10.6%、(125.2±8.3)L/min、(0.5±0.2)分、(43.6±4.8)g/L及(32.4±3.9)ng/L,对照组分别为(20.1±2.0)分、108.4%±14.3%、(110.8±7.4)L/min、(0.9±0.3)分、(35.2±3.9)g/L及(44.8±4.7)ng/L,与对照组比较,观察组C-ACT评分、FEV1、PEF、IFN-γ提高(P<0.05),同时鼻部症状评分及IL-4降低(P<0.05)。结论:益生菌辅助治疗哮喘伴AR可有效缓解临床症状,纠正Th1/Th2免疫失衡是其可能的作用机制。

Objective： To investigate the efficacy and mechanism of probiotics in children with bronchial asthma combined with allergic rhinitis（AR）.Methods： One hundred children with bronchial asthma combined with AR were divided into observation group（n = 50）and control group（n = 50）.The control group was treated with conventional therapy,and the observation group was treated with conventional therapy combined with live combined bifidobacterium and lactobacillus tablets,for 6 months.The asthma control test（CACT） score,forced expiratory volume in 1 s（FEV1）,peak expiratory flow（PEF）,nasal symptom scores,interferon-γ（IFN-γ） and interleukin-4（IL-4） level were compared between the two groups.Results： The C-ACT score,FEV1,PEF,nasal symptom scores,IFN-γ and IL-4 of observation group respectively were（24.6 ± 2.3） scores,123.7% ± 10.6%,（125.2 ± 8.3） L / min,（0.5 ± 0.2）scores,（43.6±4.8） g / L and（32.4 ± 3.9） ng / L,those of control group respectively were（20.1 ± 2.0） scores,108.4% ± 14.3%,（110.8±7.4） L/min,（0.9±0.3） scores,（35.2± 3.9） g/L and（44.8± 4.7） ng/L.Compared with control group,the C-ACT,FEV1,PEF and IFN-γ of observation group significantly increased（P0.05）,and the nasal symptom scores and IL-4 of control group significantly decreased（P〈0.05）.Conclusion： Probiotics adjuvant therapy on bronchial asthma combined with AR can effectively relieve the clinical symptoms,regulating Th1 / Th2 immune imbalance may be its mechanism.