双歧杆菌四联活菌片辅助ICS对儿童哮喘的干预性研究

Interventional effect of tetralogy of viable bifidobacterium tablets assisted ICS on childhood asthma

目的探讨双歧杆菌四联活菌片辅助吸入性糖皮质激素(ICS)对儿童支气管哮喘的治疗效果。方法选取2016年10月～2018年1月因急性哮喘发作来我院就诊的84例哮喘儿童,年龄6～12岁,将其随机分为实验组与对照组各42例,实验前均查血常规及EOS%、肺炎支原体抗体、IgE、T淋巴细胞亚群、肺功能及胸片,两组患儿均采用雾化吸入生理盐水2ml+布地奈德混悬液0.5mg,2次/d,实验组在此基础上给予口服双歧四联活菌片,每次0.5g,3次/d,嘱1个月时随访,复查EOS%、IgE、T淋巴细胞亚群、肺功能,并行C-ACT评分,其中实验组和对照组各有3例失访,被剔除,最后共78例完成实验。结果治疗1个月复查,实验组EOS%较对照组明显下降,差异有统计学意义(P<0.05);实验组和对照组比较,IgE水平无明显统计学差异(P>0.05);CD4和CD8百分率两组比较,无统计学差异(P>0.05),但实验组CD4/CD8比值较对照组明显下降,差异有统计学意义(P<0.05);实验组C-ACT评分提高比对照组更明显,差异有统计学意义(P<0.05)。结论双歧杆菌四联活菌片通过调节肠道Th1/Th2平衡,抑制促炎性介质及细胞因子产生,维持CD4^+/CD8^+水平稳定,从而改善肺功能,减轻炎性反应,可尝试在临床推广应用。

Objective To explore the effect of tetralogy of viable bifidobacterium tablets tablet assisted ICS in the treatment of children with bronchial asthma.Methods Eighty-four cases of children because of acute asthma attack to our hospital in October 2016 to January 2018 were selected,which has no fever before the asthma,aged from 6 to 12 years old.The cases were randomly divided into experimental group and control group,and each group consists of 42 cases.Before the experiment,every child had been checked routine blood test and EOS%,mycoplasma pneumoniae antibody,IgE,T lymphocyte subgroup,pulmonary function and the X-ray.Both groups were treated with aerosol inhalation of normal saline 2 ml and budesonide suspension of 0.5 mg twice a day.The experimental group were given oral tetralogy of viable bifidobacterium tablets three times a day on the basis of control group.After one month,every children were reviewed the EOS%,IgE,T lymphocyte subgroup,pulmonary function,at the same time we estimated the C-ACT score.But there are 3 patients were not reviewed after a month in each group,so 78 cases of the final experiment were completed.Results After the treatment,the level of EOS%in the experimental group was lower than that in the control group(P<0.05).There was no significant difference in the level of IgE between the two groups(P>0.05).The difference of the percentage of CD4 and CD8 in the two groups was no significant.In terms of the ratio of CD4/CD8,the decrease was more obvious in the experimental group than in the control group,and the difference was significant(P<0.05).Thepulmonary function indexes in the experimental group were higher than that in the control group,and the difference was significant(P<0.05).There was significant difference between the two groups in improving the C-ACT scores(P<0.05).Conclusion Tetralogy of viable bifidobacterium tablets can be tried in clinic by regulating intestinal Th1/Th2 balance,inhibiting the production of inflammatory mediators and cytokines,and maintaining the stable level of CD4^+/CD8^+to improve lung function and reduce inflammatory response.