醒鼻凝胶剂治疗儿童变应性鼻炎及对胸腺基质淋巴生成素和白细胞介素4、13的影响

Xingbi gel in the treatment of allergic rhinitis and its effect on the expression of interleukin 4,13 and thymic stromal lymphopoietin in children

目的观察中药醒鼻凝胶剂治疗儿童变应性鼻炎及对白细胞介素4(IL-4)、白细胞介素13(IL-13)、胸腺基质淋巴生成素(TSLP)水平的影响,探讨其可能的作用机制。方法选取2015年6月至2016年10月福建中医药大学附属人民医院儿科门诊收治变应性鼻炎患儿60例为研究对象,随机分为中药治疗组和西药对照组各30例。同期选取健康体检儿童志愿者10例为健康对照组。中药治疗组采用中药醒鼻凝胶剂治疗,西药对照组采用布地奈德鼻喷雾剂进行治疗,2周为1个疗程,连续2个疗程后,检测治疗前后血清IL-4、IL-13、TSLP水平,评估症状总分、视觉模拟量表,观察其临床疗效。结果治疗4周后,中药治疗组和西药对照组临床总有效率比较差异无统计学意义(P>0.05)。治疗4周后,中药治疗组和西药对照组血清IL-4、IL-13、TSLP水平显著低于治疗前,差异有统计学意义(P<0.05);中药治疗组和西药对照组血清IL-4、IL-13、TSLP水平高于健康对照组,差异有统计学意义(P<0.05);中药治疗组血清IL-4、IL-13水平显著低于西药对照组,差异有统计学意义(P<0.05);中药治疗组和西药对照组血清TSLP水平比较差异无统计学意义(P>0.05)。治疗4周后,中药治疗组症状总分、视觉模拟量表评分均低于治疗前,差异有统计学意义(P<0.05);中药治疗组视觉模拟量表评分低于西药对照组,差异有统计学意义(P<0.01)。结论中药醒鼻凝胶剂对变应性鼻炎患儿血清IL-4、IL-13及TSLP起下调作用,调节机体免疫平衡机制,以此干预变应性鼻炎,从而改善临床症状。

Objective To investigate the clinical efficacy of Chinese medicine ＂Xingbi gel nasal drops＂ in treating allergic rhinitis（AR） in children and find out the correlation of IL-4, IL-13, and TSLP with AR, and in turn to reveal the mechanism of the onset of AR and the mechanism of Chinese traditional medicine ＂Xingbigel nasal drops＂ for treating allergic rhinitis in children. Methods Totally 60 children diagnosed with allergic rhinitis were included in the study, and divided into two groups： the group of traditional Chi- nese medicine（30 children） and that of western medicine（30 children）. Ten healthy volunteer children were included as the control group. The TCM group was treated with Xingbi gel and the western group was trea- ted with budesonide nasal spray, the treatment lasting for 2 courses, with 2 weeks in each course. Before and after treatment, the level of serum IL-4, IL-13 and TSLP was determined, the symptom score and visu- al analog scale were evaluated, and the clinical effect was observed. Results After 4 weeks of treatment, the difference in total effective rate was of no statistical significance between the two treatment groups （P 0.05）. After 4 weeks of treatment , the level of IL-4, IL-13 and TSLP in the two treatment groups was sig-nificantly lower than before treatment（P〈0. 05）; their levels were higher than the healthy control group, and the difference was statistically significant（P〈0.05）. The level of IL-4 and IL-13 in TCM group was significantly lower than that in western group（P〈0.05）. There was no statistical difference in the TSLP level between the TCM group and western group（P〈0.05）. After 4 weeks of treatment, the total symptom score and visual analog scale score of TCM group were lower than before treatment, and there was statistical difference（P〈0.05） ; the visual analog scale score was lower in the TCM group than that in the western group, and the difference was of statistical significance（P〈0.05）. Conclusion The Chinese medicine, Xingbi gel, down-regulates the level of IL-4, IL-13 and TSLP in children with allergic rhinitis and regulate the immune balance mechanism of the body, thus intervening allergic rhinitis, and improving the clinical symptoms.