西替利嗪辅助治疗对支气管哮喘急性发作患儿小气道功能和免疫状态的改善效果

Efficacy of cetirizine adjuvant therapy in improving small airway function and immune status in children with acute bronchial asthma

目的探讨支气管哮喘急性发作患儿应用西替利嗪辅助治疗对小气道功能和免疫状态的影响。方法纳入河南省长垣市中医医院2020年10月至2022年10月收治的84例支气管哮喘急性发作期患儿,按随机数字表法分为对照组(42例,硫酸沙丁胺醇雾化吸入治疗)和研究组(42例,硫酸沙丁胺醇雾化吸入联合盐酸西替利嗪片治疗),2组患儿均进行为期7 d的治疗。比较2组患儿治疗效果,治疗前后气道重塑相关指标、免疫功能指标、炎症因子水平以及不良反应发生情况。结果研究组患儿临床总有效率为90%,较对照组74%上升;治疗后2组患儿骨桥蛋白(OPN)、血管内皮生长因子(VEGF)、基质金属蛋白9(MMP-9)、基质金属蛋白水解酶组织抑制因子(TIMP-1)、免疫球蛋白E(IgE)、白细胞介素-4(IL-4)、嗜酸性粒细胞(EOS)、呼出气一氧化氮(FeNO)相较于治疗前均下降,且研究组比对照低(P均<0.05);研究组患儿不良反应总发生率12%,对照组19%,差异无统计学意义(P>0.05)。结论支气管哮喘急性发作患儿应用西替利嗪辅助治疗,可对气道重塑起到抑制作用,调节免疫功能,减轻炎症反应,疗效显著,且不会增加不良反应,安全性良好。

Objective To explore the effects of adjuvantive cetirizine therapy on small airway function and immune status in children with acute bronchial asthma.Methods A total of 84 children with acute bronchial asthma admitted to Changyuan Hospital of Traditional Chinese Medicine from October 2020 to October 2022 were included in the study.They were randomly divided into a control group(42 cases,treated with salbutamol sulfate inhalation solution)and a study group(42 cases,treated with salbutamol sulfate inhalation solution combined with cetirizine hydrochloride tablets)based on a random number table.Both groups of children underwent a 7-day treatment.The treatment effect,airway remodeling-related indicators,immune function indicators,inflammatory factor levels,and adverse reactions were compared between the two groups before and after treatment.Results The clinical total effective rate of the study group was 90%,which was higher than the 74%of the control group.After treatment,the levels of osteopontin(OPN),vascular endothelial growth factor(VEGF),matrix metalloproteinase-9(MMP-9),tissue inhibitor of metalloproteinase-1(TIMP-1),immunoglobulin E(IgE),interleukin-4(IL-4),eosinophils(EOS),and exhaled nitric oxide(FeNO)in both groups decreased compared to before treatment,and the levels in the study group were lower than those in the control group(all P<0.05).The total incidence of adverse reactions in the study group was 12%,while that in the control group was 19%,with no statistically significant difference(P>0.05).Conclusion The adjuvantive theray of cetirizine in children with acute bronchial asthma can effectively inhibit airway remodeling,regulate immune function,and reduce inflammatory response,with significant therapeutic effects.Additionally,it does not increase adverse reactions and has good safety.