茶碱缓释片治疗支气管哮喘对患者小气道功能及气道壁细胞浸润的改善效果观察

Effect of theophylline sustained release tablets on small airway function and airway wall cell infiltration in patients with bronchial asthma

目的:观察茶碱缓释片治疗支气管哮喘对患者小气道功能及气道壁细胞浸润的改善效果。方法:选取108例支气管哮喘患者为研究对象,按照治疗方式分为对照组和观察组,每组各54例。对照组给予布地奈德/福莫特罗粉剂治疗;观察组在对照组基础上给予茶碱缓释片治疗,疗程均为3个月。比较两组患者炎症相关因子[血清细胞间黏附分子-1(ICAM-1)、血管细胞粘附分子1(VCAM-1)、协同刺激分子(B7-H3)、白细胞介素5(IL-5)、IL-33]、呼出气NO含量(FeNO)及嗜酸性粒细胞(EOS)计数、肺功能[第1秒用力呼气量(FEV1)、用力肺活量(FVC)]、小气道功能[呼出25%肺活量的呼气流速(FEF25)、FEF50、FEF75]、生活质量[哮喘控制调查(ACT)评分及圣乔治呼吸问卷(SGRQ)评分]、治疗有效率及不良反应发生情况。结果:治疗后,两组患者VCAM-1、B7-H3、IL-5、IL-33、FeNO、EOS计数、FEF25、FEF50、FEF75测定值及SGRQ评分均降低,且观察组低于对照组(P<0.05);FEV1、FVC及ACT评分均升高,且观察组高于对照组(P<0.05)。观察组总有效率高于对照组,差异有统计学意义(P<0.05)。两组患者不良反应发生情况比较,差异无统计学意义(P>0.05)。结论:茶碱缓释片治疗支气管哮喘可减轻气道壁细胞浸润,并通过改善小气道功能进而提高肺功能,机制可能与减轻炎症反应有关。

Objective:To observe the effect of theophylline sustained-release tablets on small airway function and airway wall cell infiltration in patients with bronchial asthma.Methods:108 patients with bronchial asthma were selected and divided into the control group(budesonide/formoterol powder treatment) and the observation group(budesonide/formoterolpowder+theophylline sustained-release tablets treatment) according to the treatment methods, 54 cases in each group.The course of treatment was 3 months.The inflammatory related factors [serum intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM-1),costimulatory molecules(B7-H3),interleukin-5(IL-5),IL-33],exhaled NO content(FeNO) and eosinophil(EOS) count, lung function [forced expiratory volume in the first second(FEV1),forced vital capacity(FVC)],small airway function [expiratory flow rate of 25% vital capacity(FEF25),FEF50,FEF75],quality of life [Asthma Control Survey(ACT) score and St.George’s Respiratory Questionnaire(SGRQ) score],treatment effectiveness and adverse reactions were compared between the two groups.Results:After treatment, the scores of VCAM-1,B7-H3,IL-5,IL-33,FeNO,EOS count, measured values of FEF25,FEF50 and FEF75 and SGRQ score in the two groups were lower than those before treatment, and the above indexes in the observation group were lower than those in the control group(P<0.05).The scores of FEV1,FVC and ACT were higher than those before treatment, and the above indexes in the observation group were higher than those in the control group(P<0.05).The total effective rate of the observation group was higher than that of the control group(P<0.05).There was no significant difference in the occurrence of adverse reactions between the two groups(P>0.05).Conclusion:Theophylline sustained-release tablets can reduce the infiltration of airway wall cells and improve lung function by improving small airway function in the treatment of bronchial asthma.The mechanism may be related to reducing inflammation.