间隔与同时雾化吸入TER和BUD对哮喘急性发作患者IL-6CRP IFN-γ水平的影响

目的探讨哮喘急性发作应用特布他林（TER）联合布地奈德（BUD）分别以间隔与同时雾化吸入治疗的临床效果及对患者血清白细胞介素-6（IL-6）、C反应蛋白（CRP）、干扰素-γ（IFN-γ）水平的影响。方法选取2015年1月至2017年2月收治的126例哮喘急性发作患者，采用随机数字表法均分为两组。同时组（63例）采用TER联合BUD同时雾化吸入治疗，间隔组（63例）采取TER联合BUD间隔5min雾化吸入治疗。记录比较两组临床综合疗效，治疗前后血清IL-6、CRP、IFN-γ水平，不良反应情况。结果治疗7d后，观察组总有效率为95．2％，较对照组明显升高（84．1％，P〈0．05）。与治疗前比较，两组治疗7d后血清IL-6、CRP水平，均显著下降（P〈0．01），IFN-γ水平均明显升高（P〈0．05），且间隔组以上指标改善较同时组均更显著（P〈0．01）。与对照组的9．5％比较，观察组不良反应率为7．9％，差异无统计学意义（P〉0.05）。结论与TER联合BUD同时雾化吸入比较，哮喘急性发作患者应用TER联合BUD间隔雾化吸入治疗更能迅速消除或缓解其症状体征、降低机体炎症反应、增强免疫功能，疗效更优，且安全性相当。

Objective To explore effects of intermittent and simultaneous atomization of terbutaline （ TER ） and budesonide （ BUD ） in patients with acute attack of asthma and its impacts on serum interleukin-6 （ IL-6 ） , C-reactionprotein （ CRP ） and interferon- γ （ IFN- γ ） . Methods 126 cases with acute attack of asthma in our hospital from January 2015 to February 2017 were selected as research objectives and divided them into two groups randomly. The simultaneous atomization of TER and BUD were provided to meanwhile group （ 63 cases ） while interval group （ 63 cases ） was treated with TER combined with BUD interval of 5 minutes. The two groups＇ clinical effect, serum IL-6, CRP and IFN- γ levels were recorded and compared before and after treatment, as well as adverse reaction. Results Interval group＇ s overall effect rate was 95.2% after receiving treatment for 7 days which was significant higher than meanwhile group＇ s 84.1% （P〈0.05） . Compared with before treatment, the serum IL-6 and CRP levels on 7th treatment day of two groups were significantly decreased （P〈0.01） , IFN-γ levels were significantly increased （P〈0.05） , and the improvement of the above indexes in interval group were more significant than those in meanwhile group. The difference was not statistically significant compared with two groups＇ adverse reaction rate, as observation group＇ s was 7.9% while control group＇ s was 9.5%. Conclusion Comparing with the performance of simultaneous atomization of TER and BUD, the application of intermittent atomization of TER and BUD on patients with acute attack of asthma can eliminate or alleviate its symptoms and signs, reduce the body＇ s inflammatory response and enhance immune function much quickly. It is more effective and the safety is quite.