益生菌治疗尘螨过敏性变应性鼻炎儿童的临床观察及其对IgE、肺功能的影响

Clinical observation of probiotics in the treatment of children with dust mite allergic rhinitis and its impacts on IgE and pulmonary function

目的探讨益生菌治疗尘螨过敏性变应性鼻炎(AR)儿童的临床观察及对免疫球蛋白E(IgE)、肺功能的影响。方法回顾性选取2019年11月至2020年4月本院收治的尘螨过敏性AR儿童128例作为研究对象,根据治疗方法的不同分为两组,常规组(n=63)采取常规干预办法,益生菌组(n=65)在对照组的基础上给予双歧杆菌三联菌活菌胶囊干预,两组均治疗6个月,评价两组患儿干预前后症状评分、用药评分与主观感受视觉模拟评分法(VAS)评分,比较两组患儿干预前后血清IgE水平、肺功能指标的变化,并评估两组临床疗效。结果经6个月的治疗后,益生菌组总有效率为95.38%,显著高于常规组的82.54%,差异有统计学意义(P<0.05);治疗6个月后,两组症状评分、用药评分与VAS评分均有所下降,且治疗后益生菌组患儿低于常规组(P<0.05);治疗6个月后,两组总IgE、特异性IgE均有所降低,且治疗后益生菌组总IgE、特异性IgE均低于常规组(P<0.05);治疗6个月后,两组第一秒用力呼气容积/用力肺活量的比值(FEV1/FVC),最高呼气流速占预计值的百分比(PEF%)水平均升高,且治疗后益生菌组患儿高于常规组(P<0.05)。结论对于尘螨过敏性AR儿童适当使用益生菌,有助于减轻患儿症状,减少抗过敏药物的使用,同时能降低患儿血清IgE水平,改善患儿的肺功能,从而增强了患儿的治疗效果。

Objective To investigate the clinical observation of probiotics in the treatment of children with dust mite allergic rhinitis(AR)and its impacts on immunoglobulin E(IgE)and pulmonary function.Methods A total of 128 children with allergic AR caused by dust mites admitted to our hospital from November 2019 to April 2020 were selected retrospectively.And they were divided into the conventional group(n=63)and the probiotic group(n=65)according to different treatment methods.The conventional group was treated with conventional intervention,while the probiotic group was treated with Bifidobacterium triple viable capsule intervention on the basis of the control group.Both groups were treated for 6 months.The symptom scores,medication scores and subjective visual analogue scale(VAS)scores of the two groups of children were evaluated before and after intervention.The changes of serum IgE level and pulmonary function indices were compared between the two groups of patients before and after the intervention,and the clinical efficacy of the two groups was evaluated.Results After 6 months of treatment,the total effective rate of the probiotics group was 95.38%,which was significantly higher than 82.54%of the conventional group,with statistically significant difference(P<0.05).After 6 months of treatment,the symptom score,medication score and VAS score of the two groups all decreased to a certain extent.And after treatment,the scores of children in the probiotics group were lower than those in the conventional group(P<0.05).After 6 months of treatment,the total IgE and specific IgE in both groups decreased.And after treatment,the levels of the total IgE and specific IgE in the probiotics group were lower than those in the conventional group(P<0.05).After 6 months of treatment,the ratio of forced expiratory volume/forced vital capacity in the first second(FEV1/FVC)and the percentage of maximum expiratory flow rate to the predicted value(P EF%)in both groups increased.And after treatment,the values of children in the probiotics group were higher than those in the conventional group(P<0.05).Conclusion Appropriate use of probiotics for children with dust mite allergic AR is conducive to alleviating the symptoms of children,reducing the use of anti-allergic drugs,decreasing the serum IgE level of children at the same time and improving the pulmonary function of children,thus enhancing the therapeutic efficacy o f children.