槐杞黄辅治哮喘疗效及对ILC2s上下游因子的影响

Clinical Efficacy of Huaiqihuang Particles on Asthma and its Effects on Upstream and Downstream Factors of ILC2s

目的探讨槐杞黄颗粒联合吸入糖皮质激素(inhaled corticosteroids,ICS)对轻度持续哮喘患儿的临床疗效及其机制。方法选取2020年3月~2021年2月在徐州医科大学附属医院门诊就诊的轻度持续哮喘患儿90例,将其按随机数字表法分为两组,即A组(ICS+槐杞黄)45例和B组(ICS)45例,监测治疗前及治疗3个月后血清白细胞介素(IL)-25、IL-33、IL-5、IL-13水平及肺功能情况,随访6个月记录喘息发作情况,分析比较各项监测指标变化。结果90例患儿中失访8例,实际收集有效病例82例,其中A组38例,B组44例。治疗后,A、B组IL-25、IL-33、IL-5、IL-13水平较治疗前降低(P<0.05);A组IL-25、IL-33、IL-5、IL-13降低较B组显著(P<0.05);治疗后,A、B组的第1秒用力呼气容积占预计值百分比(FEV 1%pred)、呼气峰流速占预计值百分比(PEF%pred)、最大呼气中期流量占预计值百分比(MMEF 75/25%pred)较治疗前升高(P<0.05),A组FEV 1%pred、PEF%pred、MMEF 75/25%pred升高较B组显著(P<0.05);A组治疗后3、6个月的喘息次数较治疗前减少(P<0.05)。结论槐杞黄颗粒联合ICS治疗哮喘的疗效显著,可能是通过降低IL-25、IL-33、IL-5、IL-13及抑制Ⅱ型固有淋巴细胞活化实现的。

Objective To investigate the clinical efficacy of Huaiqihuang particles combined with inhaled corticosteroids(ICS)in children with mild persistent asthma.Methods A total of 90 children with mild persistent asthma treated in the outpatient clinic of the Affiliated Hospital of Xuzhou Medical University from March 2020 to February 2021 were selected.And they were divided into 2 groups according to the random number table methed:group A of 45 cases(ICS+Huaiqihuang),group B of 45 cases(ICS).Serum IL-25,IL-33,IL-5,IL-13 levels,lung function before and after 3 months of treatment were monitored,and wheezing episodes were recorded at 6 months of follow-up,and changes in various monitoring indicators were analyzed and compared.Results Among 90 cases,8 cases dropped out on their own.A total of 82 cases were included in the study,including 38 cases in group A,44 cases in group B.After treatment,IL-25,IL-33,IL-5,IL-13 levels decreased in the A,B group compared with pre-treatment(P<0.05).The level of factors in group A decreased significantly compared with group B(P<0.05).After treatment,FEV 1%pred,PEF%pred,and MMEF 75/25%pred increased in the A、B group compared with pre-treatment(P<0.05),and the increased in FEV 1%pred,PEF%pred,MMEF 75/25%pred were more significantin group A(P<0.05).The number of respite decreased at 3 and 6 months after treatment in the A group compared with before treatment(P<0.05).Conclusion The remarkable efficacy of Huaiqihuang particles combined with inhaled corticosteroids for asthma treatment may be achieved by reducing the levels of IL-25,IL-33,IL-5,IL-13 and depressing type-2 innate lymphoid cells.