小儿推拿对哮喘患儿支气管肺泡灌洗嗜酸粒细胞相关因子的影响

The effect of massage on apoptosis of EOS and related factors of pediatric asthma

(1)目的观察小儿推拿对慢性持续期哮喘患儿支气管肺泡灌洗嗜酸粒细胞相关因子的影响。(2)方法慢性持续期哮喘患儿60例,按照随机分组原则分为雾化组30例和推拿组30例。雾化组为常规雾化治疗,推拿组在常规雾化治疗的基础上,应用小儿推拿法进行推拿治疗,各观察3周。治疗前后观察哮喘临床症状、肺功能及支气管肺泡灌洗嗜酸粒细胞上肿瘤坏死因子-α(TNF-α)、白细胞介素-5(IL-5)、干扰素-γ(INF-γ)等相关因子。(3)结果两组治疗后日、夜间症状较治疗前均有所改善,且推拿组治疗后日、夜间症状低于雾化组,差异均有统计学意义(P <0.05)。两组治疗后呼气流速(PEF)较治疗前均有所提高,差异有统计学意义(P <0.05);且推拿组较雾化组有所降低,差异有统计学意义。两组治疗后支气管肺泡灌洗(BALF)中嗜酸性粒细胞趋化因子(Eotaxin)、嗜酸粒细胞阳离子蛋白(ECP)较治疗前均有所减少,差异有统计学意义(P <0.05);且推拿组比雾化组低,差异有统计学意义(P <0.05)。两组治疗后嗜酸性粒细胞(EOS)、B细胞淋巴瘤(Bcl-2)蛋白表达较治疗前均有所提高,且推拿组治疗后效果优于雾化组,差异均有统计学意义(P <0.05)。两组治疗后Bax蛋白表达较治疗前均有所降低,差异有统计学意义(P <0.05);且推拿组低于雾化组,差异有统计学意义(P <0.05)。两组治疗后TNF-α、IL-5较治疗前均有所下降,差异有统计学意义(P <0.05),且推拿组治疗后优于雾化组,差异有统计学意义(P <0.05)。两组治疗后INF-γ较治疗前均有所升高,差异有统计学意义(P <0.05);且推拿组高于雾化组,差异有统计学意义(P <0.05)。两组前列腺素D2(PGD2)、停泊蛋白(DP)和CRTH2水平治疗后均较治疗前有所降低;而前列腺素DP1受体水平有所提高,差异均有统计学意义(P <0.05);推拿组治疗后PGD2、DP和CRTH2水平与雾化组比较有所降低,差异有统计学意义(P<0.05)。(4)结论小儿推拿可有效改善INF-γ/IL-5比例失衡,从而抑制EOS从骨髓-外周血-气道通路募集,诱导EOS释放ECP,降低BALF中PGD2、DP和CRTH2水平,抑制炎性介质前列腺素-EOS介导哮喘气道炎症反应,改善小儿哮喘的临床症状。

Objective To investigate the effect of massage on the apoptosis of EOS and related factors of pediatric asthma. Methods A total of 60 patients in different time were enrolled and divided into two groups randomly.The atomization group was treated with routine atomization,and the massage group was treated with pediatric massage on the basis of routine treatment.All patients were assessed with the apoptosis of EOS,TNF-α,IL-5 and INF-γ in BALF,at the beginning of the training and 3 weeks after treatment. Results The symptoms of day and night of the two groups after treatment were lower than those before treatment,and the symptoms of day and night in the massage group were lower than those in the atomization group,the difference was statistically significant （ P 〈 0.05 ）.After treatment, the PEF in the two groups was significantly higher than that before treatment,and the PEF in the massage group was lower than that of the atomization group after treatment,and there were significant difference.The Eotaxinand ECP level in the BALF after treatment were significantly lower than those before treatment （ P 〈 0.05 ）,and Eotaxin and ECP were lower in the massage group than those in the atomization group after treatment,there were significant difference.After treatment,the Bcl-2 protein on Eos was higher than that before treatment in the two groups,and the effect of the massage group was better than that of the atomization group.The difference were statistically significant（ P 〈 0.05 ）.The expression of Bax protein in the two groups was lower than that before treatment（ P 〈 0.05 ）,and the expression of Bax protein in the massage group was lower than that of the atomization group,the difference were statistically significant.After treatment,TNF-a and IL-5 were lower in the two groups than before the treatment and TNF-a and IL-5 in the massage group were lower than those in the atomization group after treatment.The difference was statistically significant（ P 〈 0.05 ）.After treatment,INF-γ was higher than before treatment in the two groups.After the treatment,the INF-γ in the massage group was higher than those in the atomization group.The difference was statistically significant.Two groups of DP total combination,DP1 and CRTH2 after treatment were lower than before treatment,the difference was statistically significant（ P 〈 0.05 ）,DP1 level after treatment was higher than that before treatment,the difference were statistically significant（ P 〈 0.05 ）;after treatment,DP summary and CRTH2 level in the massage group were lower than those in atomization group,the difference were statistically significant（ P 〈 0.05 ）. Conclusion Massage maybe improve the clinical symptoms of pediatric asthma by rescending the content of eotaxin,ECP,TNF-α,IL-5,INF-γ,PGD2, DP and CRTH2.