桔贝合剂联合氨茶碱对重症哮喘急性发作患者呼吸道纤毛清除功能及IFN-γ/IL-4、Th1/Th2的影响

Effects of Jubei Mixture Combined with Aminophylline on Respiratory Cilia Scavenging Function and IFN-γ/IL-4,Th1/Th2 in Patients with Acute Attack of Severe Asthma

目的:探讨桔贝合剂联合氨茶碱对重症哮喘急性发作患者呼吸道纤毛清除功能及γ干扰素(IFN-γ)/白细胞介素4(IL-4)、辅助性T细胞1/辅助性T细胞2(Th1/Th2)的影响。方法:选取2018年12月至2020年12月锦州市中心医院急诊科重症哮喘急性发作患者92例,以简单随机化法分为联合组(n=46)、常规组(n=46)。常规组患者给予氨茶碱治疗,联合组患者给予桔贝合剂联合氨茶碱治疗。比较两组患者疗效、不良反应,治疗前后哮喘症状评分、肺功能指标[第1秒用力呼气容积(FEV_(1))、FEV_(1)占预计值百分比(FEV_(1)%pred)、最大呼气流量(PEF)、PEF占预计值百分比(PEF%pred)]水平、糖精渡越时间(STT),以及血清IFN-γ、IL-4、IFN-γ/IL-4和Th1/Th2水平。结果:联合组患者的总有效率为95.65%(44/46),高于常规组(80.43%,37/46),差异有统计学意义(P<0.05)。治疗后,两组患者日间、夜间哮喘症状评分低于治疗前,且联合组患者低于常规组,差异均有统计学意义(P<0.05)。与治疗前相比,两组患者FEV_(1)、FEV_(1)%pred、PEF、PEF%pred、IFN-γ、IFN-γ/IL-4和Th1/Th2水平在治疗后明显升高,且联合组患者升高更显著,差异均有统计学意义(P<0.05)。治疗后,两组患者STT短于治疗前,IL-4水平低于治疗前,且联合组患者STT短于常规组,IL-4水平低于常规组,差异均有统计学意义(P<0.05)。联合组、常规组患者的不良反应发生率分别为4.35%(2/46)、8.70%(4/46),差异无统计学意义(P>0.05)。结论:桔贝合剂联合氨茶碱治疗重症哮喘急性发作患者,可调节Th1/Th2平衡向Th1优势漂移,促进炎症吸收,提高呼吸道纤毛清除功能,改善哮喘症状及肺功能,疗效显著,且安全性高。

OBJECTIVE: To probe into the effect of Jubei Mixture combined with aminophylline on respiratory cilia scavenging function, interferon-γ(IFN-γ)/interleukin-4(IL-4), helper T cell 1/helper T cell 2(Th1/Th2) in patients with acute attacks of severe asthma. METHODS: Totally 92 patients with acute attacks of severe asthma admitted into emergency department of Jinzhou Central Hospital from Dec. 2018 to Dec. 2020 were selected and divided into combined group(n=46) and routine group(n=46) via simple randomization method. The routine group was treated with aminophylline, while the combined group was given Jibei mixture combined with aminophylline. The efficacy and adverse drug reactions, asthma symptom scores, lung function indicators [forced expiratory volume in the first second(FEV_(1)), predict percentage of FEV_(1)(FEV_(1)%pred), peak expiratory flow(PEF), predict percentage of PEF(PEF%pred)], saccharin transit time(STT), serum IFN-γ, IL-4, IFN-γ/IL-4, Th1/Th2 levels before and after treatment were compared between two groups. RESULTS: The total effective rate of the combined group was 95.65%(44/46), which was higher than 80.43%(37/46) in the routine group, with statistically significant difference(P<0.05). After treatment, the daytime and nighttime asthma symptom scores of both groups were lower than those before treatment, and those of the combined group were lower than the routine group, with statistically significant differences(P<0.05). Compared with before treatment, the FEV_(1), FEV_(1)%pred, PEF, PEF%pred, IFN-γ, IFN-γ/IL-4 and Th1/Th2 levels of both groups were significantly increased after treatment, and those of the combined group were more significant, with statistically significant differences(P<0.05). After treatment, the STT was shorter and the IL-4 levels were lower in both groups than before treatment, the STT was shorter and the IL-4 level was lower in the combined group than the routine group, with statistically significant differences(P<0.05). The incidences of adverse drug reaction of combined group and routine group were respectively 4.35%(2/46) and 8.70%(4/46), the difference was not statistically significant(P>0.05). CONCLUSIONS: Jubei Mixture combined with aminophylline in the treatment of acute attacks of severe asthma can regulate the Th1/Th2 balance to Th1 dominant drift, promote inflammation absorption, improve respiratory cilia scavenging function, improve asthma symptom and lung function, with significant efficacy and high safety.