小儿咳喘灵颗粒联合维生素D3治疗儿童支气管哮喘的效果及TLR4/NF-κB信号通路的干预作用

Effect of Xiaoer Kechuanling Granules combined with vitamin D3 in treatment of bronchial asthma in children and intervention effect of TLR4/NF-κB signaling pathway

目的:探讨小儿咳喘灵颗粒联合维生素D3治疗儿童支气管哮喘的综合效果,为临床治疗方案制定提供参考。方法:选取2019年6月至2021年2月于衡水市人民医院就诊的支气管哮喘患儿126例,随机分为观察组、对照组,每组63例。对照组在常规治疗基础上给予小儿咳喘灵颗粒,观察组给予小儿咳喘灵颗粒联合维生素D3治疗,均治疗2周。比较两组疗效、症状缓解时间与治疗前、治疗2周后儿童哮喘控制测试(C-ACT)评分、哮喘日间、夜间症状评分、肺功能指标[第1秒用力呼气量(FEV)、最大呼气流量(PEF)、PEF、PEF、PEF]、血清变态反应指标[白三烯B4(LTB4)、单核细胞趋化蛋白-1(MCP-1)、嗜酸细胞阳离子蛋白(ECP)]水平、Toll样受体4(TLR4)/核转录因子-κB(NF-κB)信号通路有关蛋白表达。结果:观察组总有效率为95.24%(60/63),高于对照组82.54%(52/63),气促、喘息、胸闷、咳嗽、肺部啰音消失及退热时间均短于对照组(P<0.05)。与治疗前比较,治疗2周后两组C-ACT评分升高,哮喘日间、夜间症状评分降低,FEV、PEF、PEF、PEF、PEF明显升高,血清LTB4、MCP-1、ECP水平均呈降低趋势,TLR4、NF-κB蛋白表达均降低,观察组均优于对照组(P<0.05)。结论:小儿咳喘灵颗粒联合维生素D3治疗儿童支气管哮喘临床疗效显著,可有效控制病情,促进临床症状缓解,改善肺功能,缓解变态反应,且可显著调节TLR4/NF-κB信号通路表达,综合效果理想。

Objective:To explore comprehensive effect of Xiaoer Kechuanling Granules combined with vitamin D3 in treatment of children with bronchial asthma,and to provide references for formulation of clinical treatment programs.Methods:A total of 126 children with bronchial asthma in Hengshui People’s Hospital from June 2019 to February 2021 were selected and randomly divided into observation group and control group,with 63 cases in each group. Control group was treated with Xiaoer Kechuanling granules on basis of conventional treatment,and observation group was treated with Xiaoer Kechuanling Granules combined with vitamin D3,both for 2 weeks. Efficacy,symptom remission time,C-ACT score,daytime and nighttime symptom scores,lung function indexes(FEV,PEF,PEF,PEF,PEF),serum allergy indexes(LTB4,MCP-1,ECP)levels,Toll-like receptor 4(TLR4)/nuclear transcription factor-κB(NF-κB)signal pathway related proteins expressions at before treatment and 2 weeks after treat ment were compared between two groups.Results:Total effective rate in observation group was 95.24%(60/63),which was higher than 82.54%(52/63)in control group,shortness of breath,wheezing,chest tightness,coughing,disappearance of pulmonary rales,and antipyretic time were shorter than those in control group(P<0.05). Compared with before treatment,C-ACT scores of two groups were increased,day and night symptoms of asthma were decreased,FEV,PEF,PEF,PEF,PEFwere significantly increased,serum LTB4,MCP-1 and ECP levels showed a decreasing trend,TLR4 and NF-κB protein expressions were decreased after 2 weeks of treatment,and observation group was better than control group(P<0.05).Conclusion:Xiaoer Kechuanling Granules combined with vitamin D3 has a significant clinical effect in treatment of bronchial asthma in children,which can effectively control disease,promote relief of clinical symptoms,improve lung function and relief allergies,which can also significantly regulate expressions of TLR4/NF-κB signaling pathway,whose overall effect is ideal.