脾氨肽联合吸入糖皮质激素治疗儿童过敏性鼻炎-哮喘综合征的疗效及对其外周血嗜酸性粒细胞计数水平与肺功能的影响

Curative effect of spleen aminopeptide oral solution combined with inhaled glucocorticoid in treatment of allergic rhinitis-asthma syndrome and the influence on peripheral blood eosinophil count and pulmonary function

目的探讨脾氨肽联合吸入糖皮质激素治疗儿童过敏性鼻炎-哮喘综合征的疗效及对其外周血嗜酸性粒细胞(EOS)计数水平与肺功能的影响,为临床治疗提供参考依据。方法选取2013年6月-2016年12月在邢台市第三医院治疗,经检查明确诊断为过敏性鼻炎-哮喘综合征的158例患儿为研究对象,随机分为观察组与对照组各79例。观察组行脾氨肽联合吸入糖皮质激素治疗,对照组单纯行吸入糖皮质激素治疗。在治疗前后定期检测两组患儿肺功能、外周血EOS、血清嗜酸性粒细胞阳离子蛋白(ECP)等指标;并根据C-ACT问卷、控制水平等指标评估两组患儿及家属满意率及治疗有效率。结果患儿主要临床表现有:鼻痒、喷嚏、鼻塞、喘息等。两组治疗1个月、2个月、3个月的有效率高于治疗前,差异有统计学意义(均P<0.05),且观察组治疗1个月、2个月的有效率高于对照组,差异有统计学意义(均P<0.05)。治疗后两组患儿肺功能指标与治疗前比较均有不同程度的升高,且观察组治疗后肺功能指标高于对照组,差异有统计学意义(均P<0.05)。治疗后两组外周血EOS计数水平、血清ECP水平均有不同程度的降低,与治疗前比较差异有统计学意义(均P<0.05),且观察组治疗后的EOS计数水平、血清ECP水平低于对照组,差异有统计学意义(均P<0.05)。两组治疗1个月、2个月、3个月满意率与治疗前比较差异有统计学意义(均P<0.05),且观察组在这三个时间段的满意率均高于对照组,差异有统计学意义(均P<0.05)。结论脾氨肽联合吸入糖皮质激素能够有效治疗儿童过敏性鼻炎-哮喘综合征,能够有效地降低外周血EOS计数水平,同时大大改善患儿肺功能,使肺功能指标均有不同程度的提高。

Objective To explore the curative effect of spleen aminopeptide oral solution combined with inhaled glucocorticoid in treatment of allergic rhinitis-asthma syndrome and the influence on peripheral blood eosinophil（ EOS） count and pulmonary function,provide a reference basis for clinical treatment. Methods From June 2013 to December 2016,158 children diagnosed as allergic rhinitis-asthma syndrome definitely and treated in the Third Hospital of Xingtai were selected and randomly divided into observation group and control group,79 children in each group. The children in observation group were treated with spleen aminopeptide oral solution combined with inhaled glucocorticoid,and the children in control group were treated with inhaled glucocorticoid. Pulmonary function,peripheral blood EOS count,and serum eosinophilic cationic protein（ ECP） before and after treatment in the two groups were detected regularly. C-ACT questionnaire,control level and other indicators were used to evaluate satisfaction rate and effective rate. Results The main clinical manifestations included nasal itching,sneezing,nasal congestion,and wheezing. The effective rates after one,two,and three months of treatment in the two groups were statistically significantly higher than those before treatment（ P〈0. 05）. The effective rates after one and two months of treatment in observation group were statistically significantly higher than those in control group（ P〈0. 05）. After treatment,pulmonary function indexes in the two groups were improved to varying degrees compared before treatment. Pulmonary function indexes after treatment in observation group were statistically significantly higher than those in control group（ P〈0. 05）. After treatment,peripheral blood EOS counts and serum ECP levels in the two groups decreased to varying degrees,compared with before treatment,there were statistically significant differences（ P〈0. 05）. Peripheral blood EOS count and serum ECP level after treatment in observation group were statistically significantly lower than those in control group（ P〈0. 05）. There were statistically significant differences in the satisfaction rates in the two groups between before treatment and after one,two,three months of treatment（ P〈0. 05）. The satisfaction rates after one,two,and three months of treatment in observation group were statistically significantly higher than those in control group（ P〈0. 05）. Conclusion Spleen aminopeptide oral solution combined with inhaled glucocorticoid can effectively treat children with allergic rhinitis-asthma syndrome and reduce peripheral blood EOS count,significantly improve pulmonary function to varying degrees.