咳喘胶囊对支气管哮喘慢性持续期疗效及气道炎症、微RNA-21表达的影响

The effects of Kechuan capsules in the treatment of chronic persistent bronchial asthma and its effects on airway inflammation and microRNA-21 expression

目的探讨咳喘胶囊对支气管哮喘慢性持续期疗效及气道炎症、微RNA-21表达的影响。方法选择2016年3月至2019年3月我院呼吸科门诊收治的120例支气管哮喘慢性持续期患者,随机分为观察组(n=60)和对照组(n=60)。对照组给予布地奈德治疗,观察组在对照组治疗方案基础上联合咳喘胶囊,两组连续治疗4周。比较两组中、西医临床疗效、肺功能[第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、用力肺活量(forced vital capacity,FVC)、FEV1%(FEV1/FVC)、最大呼气流量(peak expiratory flow,PEF)日变异率]、血清炎症因子[白介素(interleukin,IL)-4、干扰素(interferon,INF)-γ、嗜酸性粒细胞阳离子蛋白(eosinophil cationic protein,ECP)]、微RNA-21、哮喘控制测试(asthma control test,ACT)评分及不良反应。结果治疗后,观察组中、西医临床疗效总有效率均高于对照组;观察组FEV1%高于对照组,PEF日变异率低于对照组;观察组血清IL-4、ECP、微RNA-21相对表达量低于对照组,INF-γ高于对照组;两组ACT评分比较具有交互作用(P均<0.05)。两组不良反应比较差异无统计学意义(P>0.05)。结论联合布地奈德及咳喘胶囊治疗支气管哮喘慢性持续期效果显著,有助于调节和改善气道炎症、微RNA-21的表达,促进肺功能恢复,控制哮喘发作,具有较好的安全性,值得临床推广应用。

Objective To study the effect of Kechuan capsules in the treatment of chronic persistent bronchial asthma and its effect on airway inflammation and the expression of microRNA-21.Methods A total of 120 patients with chronic persistent bronchial asthma admitted to respiratory department in our hospital from March 2016 to March 2019 were selected and randomly divided into observation group (n=60) and control group (n=60).The control group was treated with budesonide aerosol,while the observation group was treated with Kechuan capsules combined with budesonide aerosol.Both groups were treated for 4 weeks The clinical efficacy,pulmonary function[forced expiratory volume in one second(FEV1),forced vital capacity[FVC,FEV1%(FEV1/FVC),daily variation rate of peak expiratory flow(PEF)],serum inflammatory factors[interleukin(IL)-4,interferon(INF)-γ,eosinophil cationic protein(ECP)],microRNA-21,asthma control test(ACT) and adverse reactions were compared between the two groups.Results After 4 weeks’ treatment,the total effective rate in the observation group was significantly higher than the control group.The FEV1% in the observation group was significantly higher than the control group,while the daily variation rate of PEF was significantly lower than the control group.The serum levels of IL-4,ECP and the relative expression of microRNA-21 in the observation group were significantly lower than the control group,and INF-γ was significantly higher than the control group.There was interaction between the two groups in ACT scores (P<0.05).However,there was no significant difference in adverse reaction between the two groups(P>0.05).Conclusion Combined budesonide with Kechuan capsules has a significant effect on the treatment of chronic persistent bronchial asthma,which is more helpful to regulate and improve airway inflammation,the expression of microRNA-21,promote the recovery of lung function,and control asthma attack.It is safe and worthy of clinical application.