多索茶碱和氨茶碱静脉滴注与糖皮质激素类药物治疗支气管哮喘急性发作临床效果及安全性对比研究

Comparison of clinical efficacy and safety of intravenous infusion of doxeline and aminophylline and glucocorticoids in the treatment of acute asthmatic bronchial asthma

目的:探讨多索茶碱及氨茶碱联合糖皮质激素布地奈德治疗儿童急性发作期支气管哮喘(BA)的疗效及安全性。方法:将120例确诊为BA患儿均分为两组,其中对照组选择氨茶碱+布地奈德进行平喘治疗;试验组则选择多索茶碱+布地奈德进行治疗。观察两组主要临床症状体征消退时间、住院时间及期间不良反应情况;测定两种治疗前后肺功能指(PEFam、PEFpm、FEV1、FEV1/FVC)、血清学指标(Eotaxin、YKL40、TGF-β1、Th1、Treg)水平;统计两组临床有效率。结果:与对照比,试验组喘息、咳嗽、呼吸困难、哮鸣音消退时间和住院时间均明显缩短(P<0.05);临床总有效率明显升高,不良反应发生率明显下降(P<0.05)。治疗后,两组PEFam、PEFpm、FEV1、FEV1/FVC、血清Eotaxin、YKL40、TGF-β14水平均明显下降,Th1、Treg含量明显增加(P<0.05);且与对照组比,试验组肺功能指标及血清Eotaxin、YKL40、TGF-β1水平下降更明显(P<0.05),Th1、Treg含量上升更显著(P<0.05)。结论:与氨茶碱相比,多索茶碱+布地奈德治疗儿童急性发作期BA具有更好疗效,可显著缩短病程,更好的抑制机体炎症反应、改善患儿肺功能、促进免疫功能恢复,且安全性高。

Objective:To investigate the efficacy and safety of doxofylline and aminophylline combined with glucocorticoid budesonide in the treatment of children with acute exacerbation of bronchial asthma(BA).Methods:120 patients with BA diagnosed were divided into 2 groups.The control group was treated with aminophylline combined with budesonide for asthma treatment.The experimental group was treated with doxofylline combined with budesonide for treatment.The main clinical symptoms of the disappearance of the two groups,hospitalization time and adverse reactions during the period were observed;the pulmonary function indices(PEFam,PEFpm,FEV1,FEV1/FVC),serological markers(Eotaxin,YKL40,TGF-β1,Th1,Treg)before and after treatment were determinded in two groups;the clinical effectiveness were recorded.Results:Compared with the control group,wheezing,cough,dyspnea,wheezing time and hospitalization time were significantly shorter in the experimental group(P<0.05);clinical total effective rate increased significantly,and the incidence of adverse reactions decreased significantly(P<0.05).After treatment,the levels of PEFam,PEFpm,FEV 1,FEV 1/FVC,serum Eotaxin,YKL40,and TGF-β14 were significantly decreased in the two groups,the content of Th1,Treg content increased significantly(P<0.05).Compared with the control group,the lung function indexes and serum Eotaxin,YKL40 and TGF-β1 in the experimental group decreased more significantly(P<0.05),the Th1 and Treg levels increased more significantly(P<0.05).Conclusion:Compared with aminophylline,doxofylline combined with budesonide has a better curative effect on childhood acute exacerbation of BA,significantly shortens the course of disease,better inhibits the body's inflammatory response,improves the lung function of children,and promotes the recovery of immune function.And high security.