虎奶菇提纯物联合布地奈德对小儿支气管哮喘发作期呼吸力学及细胞免疫功能的影响

Effects of Pleurotus Tuber Extract and Budesonide on Respiratory Mechanics and Cellular Immune Function in Children with Bronchial Asthma

目的:观察虎奶菇提纯物联合布地奈德对小儿支气管哮喘发作期呼吸力学及细胞免疫功能的影响,探讨虎奶菇提纯物联合布地奈德在小儿支气管哮喘发作期中的临床疗效。方法:选择2014年2月-2016年8月本院儿科门诊部支气管哮喘发作期的患儿180例,按照随机数字表法分为A观察组、B观察组和对照组,各60例,对照组给予对症治疗,A观察组在对照组治疗的基础上再给予布地奈德治疗,B观察组在对照组治疗的基础上再给予虎奶菇提纯物联合布地奈德治疗,比较分析三组疗效、呼吸力学参数及细胞免疫功能的改变。结果:治疗后,A观察组、B观察组和对照组总有效率分别为81.7%、96.7%和71.7%,B观察组的总有效率优于A观察组和对照组,A观察组的总有效率优于对照组,差异均有统计学意义(P<0.05);B观察组的动脉血氧分压(Pa O_2)、动脉血二氧化碳分压(Pa CO_2)、动脉血氧饱和度(Sa O_2)、动脉血气指标计算肺血分流率(Qs/Qt)、气道峰压(PIP)、气道阻力(Raw)、呼吸做功(WOB)和动态肺顺应性(Cdyn)改变均优于A观察组和对照组,差异均有统计学意义(P<0.05);A观察组Pa O_2、Pa CO_2、Sa O_2、Qs/Qt、PIP、Raw、WOB和Cdyn改变均优于对照组,差异均有统计学意义(P<0.05);B观察组的外周血T淋巴细胞亚群CD4^+、CD3^+和CD4^+/CD8^+的百分比数值较A观察组和对照组均显著降低,B观察组的CD8^+水平较A观察组和对照组均显著升高,差异均有统计学意义(P<0.05);A观察组的外周血T淋巴细胞亚群CD4^+、CD3^+和CD4^+/CD8^+的百分比数值较对照组均显著降低,A观察组的CD8^+水平较对照组显著升高,差异均有统计学意义(P<0.05)。结论:虎奶菇提纯物联合布地奈德治疗儿童支气管哮喘发作期,能明显改善细胞免疫功能,提高肺的顺应性和肺氧合率,改善体内缺氧状态,可以显著地缓解哮喘症状,值得临床推广。

Objective： To observe the effect of Pleurotus Tuber Extract combined with Budesonide on respiratory mechanics and cellular immune function in children with bronchial asthma, and to explore the clinical effect of Pleurotus Tuber Extract combined with Budesonide in children bronchial asthma.Method： 180 cases of children with bronchial asthma who were selected from February 2014 to August 2016 in our hospital pediatric outpatient department were randomly divided into A observation group, B observation group and the control group, 60 cases in each group, the control group was given symptomatic treatment, A observation group on the basis of in the control group was given Budesonide, B observation group on the basis of the control group was given Pleurotus Tuber Extract combined with Budesonide.The efficacy, respiratory mechanics parameters and changes in cellular immune function of three groups were compared.Result： After treatment, the total effective rates of A observation group, B observation group and the control group were 81.7%, 96.7% and 71.7%, and B observation group was better compared with A observation group and the control group, A observation group was better than that of the control group, the differences were statistically significant （ P〈O.05 ） .The changes of arterial oxygen （ PaO2 ）, arterial carbon dioxide tension （ PaCO2 ）, arterial oxygen saturation （ SaO2 ）, arterial blood gas index calculation pulmonary shunt fraction （ Qs/Qt ）, peak airway pressure （ PIP ）, airway resistance （ Raw ）, respiratory work （ WOB ） and dynamic lung compliance （ Cdyn ） in B observation group were better than those of A observation group and the control group, the differences were statistically significant （ P〈0.05 ） .The changes ofPaO2, PaCO2, SaO2, Qs/Qt, PIP, Raw, WOB and Cdyn in the observation group that were better than those in the control group, the differences were statistically significant （P〈0.05） .The percentage of CD4~, CD3＋ and CD4＋/CD8＋ in the peripheral blood T lymphocyte subsets of B observation group was significantly lower than those of A observation group and the control group, the level of CD8＋ in B observation group was significantly higher than that in A observation group and the control group （ P〈0.05 ） .The percentage of CD4＋, CD3~ and CD4＋/CD8＋ in the peripheral blood T lymphocyte subsets of A observation group were significantly lower than those of the control group, and the level of CD8＋ in A observation group was significantly higher than that in the control group （ P〈0.05 ）. Conclusion： Pleurotus Tuber Extract combined with Budesonide in the treatment of children with bronchial asthma attack, can significantly improve the children＇s cellular immune function, improve lung compliance and lung oxygenation rate, improve the body hypoxia, can significantly alleviate the suffering Children＇s asthma symptoms, it is worthy of clinical promotion.