特布他林与布地奈德序贯雾化吸入治疗儿童支气管哮喘急性发作的疗效及对肺功能、T淋巴细胞亚群指标的影响

Efficacy of Terbutaline and Budesonide Sequential Nebulized Inhalation in the Treatment of Acute Bronchial Asthma Attacks in Children and the Effects on Lung Function and T-lymphocyte Subpopulation Indexes

目的:分析特布他林与布地奈德序贯雾化吸入治疗儿童支气管哮喘急性发作的疗效及对肺功能、T淋巴细胞亚群指标的影响。方法:选取2019年8月-2021年4月焦作市人民医院收治的124例支气管哮喘患儿作为研究对象,应用随机数表法分为两组。给予对照组(62例)特布他林与布地奈德同时雾化治疗,研究组(62例)实施特布他林与布地奈德序贯雾化治疗。观察两组患儿肺功能、T淋巴细胞亚群指标、临床症状缓解消失时间及治疗有效率情况。结果:两组患儿治疗前达峰时间比(TPEF/TE)、达峰容积比(VPEF/VE)、呼吸频率(RR)比较,差异无统计学意义(t=0.023、0.017、0.017,P>0.05)。治疗后两组患儿TPEF/TE、VPEF/VE水平高于治疗前,RR水平低于治疗前,差异有统计学意义(t=2.972、4.246、4.002,P<0.05),且研究组TPEF/TE、VPEF/VE水平高于对照组,RR水平低于对照组。两组患儿治疗前T淋巴细胞亚群指标水平比较,差异无统计学意义(t=0.282、0.266、0.073、0.259,P>0.05)。治疗后两组患儿CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于治疗前,CD8^(+)水平低于治疗前,且研究组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组,CD8^(+)水平低于对照组,差异有统计学意义(t=8.318、8.114、5.065、7.669,P<0.05)。研究组胸闷缓解消失时间、咳嗽缓解消失时间、哮鸣音消失时间、喘憋消失时间均短于对照组,差异有统计学意义(t=14.712、5.921、3.925、13.602,P<0.05)研究组总有效率(91.94%)高于对照组(79.03%),异有统计学意义(χ^(2)=4.159,P<0.05)。结论:特布他林与布地奈德序贯雾化吸入治疗儿童支气管哮喘急性发作可有效改善患儿肺功能,提高其免疫功能,缩短恢复进程。

Objective:To analyze the efficacy of sequential nebulized inhalation of terbutaline and budesonide in the treatment of acute exacerbations of bronchial asthma in children and the effects on lung function and T-lymphocyte subpopulation indexes.Methods:A total of 124 children with bronchial asthma admitted to the hospital from August 2019 to April 2021 were selected and divided into two groups by applying the random number table method.In the control group(62 cases),terbutaline and budesonide were administered simultaneously,and in the study group(62 cases),terbutaline and budesonide were administered sequentially.The pulmonary function,T-lymphocyte subpopulation index,the time of clinical symptom relief and treatment efficiency of the children in both groups were observed.Results:There was no statistically significant difference in the pre-treatment time to peak ratio(TPEF/TE),peak volume ratio(VPEF/VE),and respiratory rate(RR)between the two groups of children(t=0.023,0.017,0.017,P>0.05).After treatment,the TPEF/TE and VPEF/VE levels of children in both groups were higher than before treatment,and the RR levels were lower than before treatment,with statistically significant differences(t=2.972,4.246,4.002,P<0.05).TPEF/TE and VPEF/VE levels were higher in the study group than in the control group,and RR levels were lower than in the control group.There was no statistically significant difference in the levels of T-lymphocyte subpopulation indicators between the two groups before treatment(t=0.282,0.266,0.073,0.259,P>0.05).After treatment,CD3^(+)CD4^(+),CD4^(+)/CD8^(+)levels were higher and CD8^(+)levels were lower in both groups than before treatment,and CD3^(+),CD4^(+),CD4^(+),/CD8^(+)levels were higher and CD8^(+)levels were lower in the study group than in the control group,with statistically significant differences(t=8.318,8.114,5.065,7.669,P<0.05).The time to disappearance of chest tightness relief,time to disappearance of cough relief,time to disappearance of asthma sounds,and time to disappearance of wheezing were shorter in the study group than in the control group,with statistically significant difference(t=14.712,5.921,3.925,13.602,P<0.05).The total effective rate was higher in the study group(91.94%)than in the control group(79.03%),with statistically significant difference(χ^(2)=4.159,P<0.05).Conclusion:Sequential nebulized inhalation treatment of terbutaline and budesonide for acute bronchial asthma attacks in children can effectively improve lung function,enhance their immune function and shorten the recovery process.