肠道益生菌辅治支气管哮喘患儿的效果及其作用机制

Effectiveness of Enteric Probiotic Supplementation in the Treatment of Children with Bronchial Asthma and Its Mechanism of Action

目的:探讨肠道益生菌辅治支气管哮喘患儿的效果及其作用机制。方法:将2019年1月至2022年1月我院收治的105例支气管哮喘患儿采用简单随机法分为常规组52例和益生菌组53例。常规组给予常规治疗,益生菌组在常规基础上给予肠道益生菌辅助治疗。检测两组治疗前后肠道菌群、免疫功能及痰嗜酸性粒细胞占比(EOS%)、整合素α4β1、αvβ6的差异,统计不良反应及6个月内急性发作次数。结果:治疗前,两组肠道菌群比较,差异无统计学意义(P>0.05);治疗后,益生菌组双歧杆菌、乳酸杆菌较前升高,大肠杆菌较前下降,常规组肠道菌群与治疗前比较,差异无统计学意义(P>0.05);益生菌组双歧杆菌、乳酸杆菌、大肠杆菌治疗前后差值均较常规组大(P<0.05)。治疗前,两组痰EOS%、整合素α4β1、αvβ6及免疫功能比较,差异无统计学意义(P>0.05);治疗后,两组CD8^(+)及痰EOS%、整合素α4β1、αvβ6较前下降,CD4 Anhui^(+)、CD4^(+)/CD8^(+)较前升高(P<0.05);且益生菌组治疗前后差值均较常规组大(P<0.05)。益生菌组发生不良反应3例,发生率为5.66%,与常规组的不良反应率11.54%比较,差异无统计学意义(P>0.05)。随访6个月期间,益生菌组急性发作次数(0.41±0.16)次,明显低于常规组急性发作次数(0.87±0.23)次,差异有统计学意义(P<0.05)。结论:肠道益生菌辅治支气管哮喘可提高患儿免疫功能,降低急性发作次数,可能机制与改善肠道菌群结构及降低痰EOS%、整合素α4β1、αvβ6的表达有关。

Objective:To investigate the effect of enteric probiotics supplementation in children with bronchial asthma and its mechanism of action.Methods:A total of 105 children with bronchial asthma admitted to our hospital from January 2019 to January 2022 were randomly divided into routine group(52 cases)and probiotic group(53 cases).The routine group was given routine treatment,and the probiotic group was given intestinal probiotics adjuvant treatment on the basis of routine treatment.The two groups were detected the differences of intestinal flora,immune function and sputum eosinophil percentage(EOS%),integrinα4β1 andαvβ6 before and after treatment,and the adverse effects and the number of acute attacks within 6 months were counted.Results:Before treatment,there was no significant difference in intestinal flora between the two groups(P>0.05).After treatment,bifidobacterium and lactobacillus in probiotics group were higher than before,while Escherichia coli was lower.There was no statistical significance in intestinal flora in conventional group compared with before treatment(P>0.05).The difference values of bifidobacterium,lactobacillus and Escherichia coli before and after treatment in probiotic group were larger than those in conventional group(P<0.05).Before treatment,there were no significant differences in sputum EOS%,integrinα4β1,αvβ6 and immune function between the two groups(P>0.05).After treatment,CD8 Anhui^(+),EOS%of sputum,integrinα4β1,αvβ6 were decreased,and CD4 Anhui^(+),CD4 Anhui^(+)/CD8 Anhui^(+)were increased in both groups(P<0.05).The difference before and after treatment in probiotic group was larger than that in conventional group(P<0.05).There were 3 cases of adverse reaction in probiotics group,the incidence was 5.66%,and the adverse reaction rate was not statistically significant compared with 11.54%in conventional group(P>0.05).During the 6-month follow-up,the number of acute attacks in the probiotic group(0.41±0.16)was significantly lower than that in the conventional group(0.87±0.23),and the difference was statistically significant(P<0.05).Conclusion:Intestinal probiotics in the adjuvant treatment of bronchial asthma can improve the immune function of children and reduce the number of acute attacks.The possible mechanism is related to improving the structure of intestinal flora and reducing the expression of EOS%,integrinα4β1 andαvβ6 in sputum.