Correlation Analysis of Traditional Chinese Medicine Syndrome Types and Influencing Factors of Asthmatic Bronchitis in Children

Objective:To explore the correlation between traditional Chinese medicine(TCM)syndrome types and the influencing factors of asthmatic bronchitis in children,as well as to provide clinical syndrome differentiation basis and reference for the treatment of children with asthmatic bronchitis.Methods:The clinical data of 197 inpatients with asthmatic bronchitis in our hospital from March 2021 to March 2022 were collected,referring to“Zhu Futang Practical Pediatrics”(7th Edition,2002)and“Chinese Medicine Industry Standards-Standards for Diagnosis and Efficacy of Pediatric Diseases and Syndromes of Traditional Chinese Medicine”(1994,State Administration of Traditional Chinese Medicine)for diagnosis,classification,and analysis of TCM syndrome types and the influencing factors of asthmatic bronchitis in children.Results:(i)cold asthma syndrome contributed to the majority of TCM syndrome types of pediatric asthmatic bronchitis;(ii)gender had a great influence on TCM syndromes types in children with asthmatic bronchitis,and the differences among the TCM syndrome types were statistically significant(P<0.05);(iii)there was no significant difference in the distribution of TCM syndrome types of pediatric asthmatic bronchitis among different age groups(P>0.05);(iv)birth status had no effect on the distribution of TCM syndrome types of pediatric asthmatic bronchitis(P>0.05);(v)no significant correlation was observed between the mode of delivery and the distribution of TCM syndrome types in children with asthmatic bronchitis(P>0.05);(vi)children with cold asthma syndrome,heat asthma syndrome,and mixed cold and heat syndrome were not breastfed,and there was no significant difference in the feeding methods of children with mixed deficiency and excess syndrome(P>0.05);(vii)no significant correlation was observed between the TCM syndrome types of pediatric asthmatic bronchitis and family history of asthma/allergy(P>0.05);(viii)a significant correlation was observed between different TCM syndrome types and history of drug and food allergy(P<0.05);(ix)normal or high eosinophil percentage was commonly observed in children with asthmatic bronchitis,and there was no significant difference among the different TCM syndrome types(P>0.05).Conclusion:The TCM syndrome types of pediatric asthmatic bronchitis are related to gender,feeding history,allergy history,and other factors,which may be influencing factors of the TCM syndrome types of pediatric asthmatic bronchitis.

Mechanism of hypothalamic paraventricular nucleus in regulating asthmatic attack

BACKGROUND:It has been confirmed that c-fos expression increased markedly in hypothalamic paraventricular nucleus(PVN)during asthmatic attack in rats,and PVN has extensive physiological functions,involving in the regulation of respiratory system,etc.OBJECTIVE:To observe the alteration of electroencephalogram(EEG)and power spectra in PVN during the asthmatic attack,and the alteration of lung function and diaphragmatic muscle discharge after bilateral PVN lesion in asthmatic rats.DESIGN:A randomized control study.SETTING:Laboratory of Physiology and Pharmacology,School of Basic Medical Sciences,Southeast University.MATERIALS:Forty-eight male adult SD rats of 260-300 g were used.The rats were randomly divided into 6 groups(n=8):control group,asthma group,electrolytic lesion of PVN group,KA-induced lesion of PVN group,sham electrolytic lesion of PVN group and sham kainic acid(KA)-induced lesion of PVN group.KA,chicken ovalbumin and aluminum hydroxide were purchased from American Sigma Company.Bordetella pertussis vaccine(Institute of Biological Products of Shanghai);stereotaxic apparatus(JiangwanⅡ,China);lesion-producing device(YC-2 programmable stimulato,Chengdu Instrument Company);MD2000 signal processing system(Nanjing Medical School);data acquisition system(RM6240B,Chengdu Instrument Company).METHODs:The experiments were carried out in the Laboratory of Physiology and Pharmacology,School of Basic Medical Sciences,Southeast University from January to August in 2006.①Rats except for control group were sensitized with an intraperitoneal injection of 100 mg chicken ovalbumin and 100 mg aluminum hydroxide and Bordetella pertussis vaccine containing 5×10^(9) heat-killed in 1 mL of sterile saline.From the fifteenth to seventeenth days rats received three times aerosolized ovalbumin challenge.In rats of the control group and asthma group three steel electrodes were placed into the left PVN(AP-1.8 mm,LR 0.4 mm,OH-7.9 mm),parietal cortex and subcutaneous tissue in lower limb.Lung function tests were carried out simultaneously.Small holes were drilled in the skull to introduce a concentric bipolar electrode in the direction of the PVN in order to perform electrolytic lesion.The electrodes were connected to a lesion-producing device and a current of 1.0-1.5 mA was passed over a period of 10-15 s on each side of the PVN.The rats received 0.5μg/0.5μL of KA in phosphate buffer(0.1 mol/L,pH 7.4),and the speed of infusion was 0.1μL per minute in order to perform KA-induced lesion of PVN.②Three days after operation of lesion,lung function tests were carried out.All the electrode and transducer were connected with data acquisition system.This technique yielded airway resistance(Raw),dynamic compliance(Cdyn),the expiratory time(Te)/the inspiratory time(Ti),minute ventilation volume(MVV),EMGdi frequency and EMGdi integral.③The differences of the measurement data were compared using the t test.MAIN OUTCOME MEASURES:①The alteration of EEG and power spectrum of PVN during asthmatic attack in sensitized rats;②The effects of electrolytic lesion or KA-induced lesion of PVN on lung function in asthmatic rats.RESULTS:All the 48 rats were involved in the analysis of results.①Alteration of EEG and power spectrum:Five minutes after injection of ovalbumin into caudal vena,the breathing rate of the rat was obviously speeded up and the total power spectrum was increased[(18476.71±2140.94),(13838.75±2983.26)mV^(2),P<0.01],the percentage of theδpower andθpower decreased significantly(P<0.01),while the percentage ofαpower andβ1 power were enhanced(P<0.05,0.01).Ten minutes after injection,the EEG power spectrum of PVN further shifted rightward,the total power gradually increased(P<0.01)which suggesting that the intensive hypersynchrony activities of PVN neurons.The percentage ofδpower was decreased significantly(P<0.01),but theα,β1 andβ2 were increased(P<0.01).Twenty-five minutes later,the breathing movements became steady,and the EEG power spectrum of PVN returned to the control level step by step.②The alteration of lung function was detected during asthmatic attack after electrolytic lesion or KA-induced lesions of PVN respectively.It was found that EMGdi frequency,Te/Ti and RL were all decreased(P<0.01),EMGdi integral,MVV and Cdyn were all enhanced(P<0.01),while there were no significant changes in the sham surgery group(P>0.05).CONCLUSION:The excitability of PVN is increased during the asthmatic attack.PVN plays a key role in the regulation of asthma.Both electrolytic and KA lesions of PVN can significantly relieve the asthmatic symptoms of rats,and improve their lung function.

A Study to Assess the Psychosocial Problems and Quality of Life of Parents with Asthmatic Children in Opd’s of Ramaiah Hospitals, Bengaluru

The study was undertaken to assess the level of psychosocial problems and quality of life of parents with asthmatic children in Ramaiah hospitals, Bengaluru. Statement of the problem: “A study to assess the psychosocial problems and quality of life of parents with asthmatic children in opd’s of Ramaiah hospitals, Bengaluru”. Objectives of the study: 1) To assess the level of psychosocial problems and level of quality of life of parents with asthmatic children. 2) To find the correlation between scores of psychosocial problem and quality of life among parents with asthmatic children. 3) To find the association between level of psychosocial problem and selected socio demographic variables. 4) To find the association between level of quality of life and selected socio-demographic variable. Method: A descriptive survey approach was used for the study. Purposive sampling technique was used to select 50 parents with asthmatic children. Data was collected through interview schedule by using structured rating scale to assess psychosocial problems and quality of life. Data was collected and analyzed using descriptive and Inferential statistics in terms of frequencies, Percentage, Mean, Mean percentage, Standard deviation, Karl Pearson’s correlation co-efficient and chi-square test. Findings: The major findings of the study indicated that majority of the parents with asthmatic children that is 33 (66%) were having moderate psychosocial problems and 16 (32%) were having mild psychosocial problem and 1 (2%) were having severe psychosocial problem and 38 (76%) were having good quality of life, 8 (16%) were having better quality of life and 4 (8%) were having poor quality of life. Karl Pearson’s correlation co-efficient test revealed that there is a correlation that exists between psychosocial problem and quality of life of parents with asthmatic children 0.314 weak positive correlation. Chi-square test revealed that there was no significant association between level of psychosocial problems and quality of life with selected socio demographic variables at 0.05 level of significance. Interpretation and conclusion: The findings show that majority of the parents with asthmatic children had moderate level of psychosocial problems (66%) and majority had good quality of life (76%). There is no significant correlation between psychosocial problem and quality of life. There is no significant association between psychosocial problem and quality of life with selected socio demographic variable. This null hypothesis was accepted.

Phytopharmacological evaluation and anti-asthmatic activity of Ficus religiosa leaves

Objective:To discuss phytopharmacological potential and anti-asthmatic activity of Ficus religiosa(F.religiosa)(L.).Methods:Fresh leaves of F.religiosa were obtained from Vastrapur Lake,Ahmedabad,and dried to obtain powder.Histamine and acetylcholine were used to guinea pigs to establish bronchospasm model.In in vivo study,the aqueous extract of F.religiosa leaves (AEFR) at doses of 150 and 300 mg/ kg was administrated to guinea pigs,and the broncho-protective activity of AEFR was compared with aminophylline at 25 mg/kg.While in in vitro study,and 10 g/mL,20 g/mL,30 g/mL of AEFRL was administrated to guinea pigs,respectively, and mast cell stabilizing activity of AEFR was compared with ketotifen at 10 g/mL.Results: In the in-vivo model,pre-treatment with aminophylline(25 mg/kg,ip.) could significantly delay the onset of histamine induced pre-convulsive dyspnea,compared with vehicle control. Administration of AEFRL(150 and 300 mg/kg,ip.) also produced significant effect on latency to develop histamine & acetylcholine induced pre-convulsive dyspnea.In the mast cell stabilizing model,AEFRL at 10,20 and 30μg/mL could significantly increase the number of intact cells. Conclusions:It can be concluded that AEFRL is effective on histamine & acetylcholine induced bronchospasm in guinea pigs.In addition,AEFRL can potentiate the number of intact cells in the mast cell stabilizing model._____________________________________________________

Effect of 1,25-dihydroxyvitamin D3 on mast cells tryptase in asthmatic guinea pigs

Objective:To explore the effect of 1,25-dihydroxyvitamin D3 on the mast cell tryptase(MCT) in asthmatic guinea pigs.Methods:A total of 60 male or female healthy guinea pigs were randomly divided into control group(group A),asthmatic group(group B).and 1,25-dihydroxyvitamin D3 group(group C),with 20 cases in each group.To establish asthmatic guinea pig models,1ml peanut oil was tilled into stomach in the morning in group A and group B.and 1 ml peanut oil with 1,25-dihydroxyvitamin D3 was filled into stomach in group C.Airway resistance(Re) of asthmatic guinea pigs was detected,and the bronchoalveolar lavage fluid(BALF) cells were counted.Lung tissue with HE and MCT immunohistochemical staining were used to observe the pathological changes in lung tissue and the distribution of MCT.Results:After injection of different concentration of acetylcholine chloride,the Re in group B and group C were increased significantly compared with group A(P<0.05):compared with group B.the Re in group C were decreased significantly(t=-5.385.-5.761.-6.184.-13.574.P<0.05):the total number of BALF cells and eosinophils were increased significantly in group B and C(t=19.618.9.598.10.854.5.388.P<0.05);compared with group B.the total number of BALF cells and eosinophils in group C was decreased significantly(t=-5.555.-5.392.P<0.05):the number of tryptase positive cells in group B was increased significantly than that in group A(t=21.312,P<0.05),and in addition to the alveolar septum and submucosa,the cells were also distributed around blood vessels and outside the cells:the number of tryptase positive cells in group C was decreased significantly compared with group B.and the difference was statistically significant(t=5.043.P<0.05).Conclusions:After the asthmatic guinea pigs arc treated with 1,25-dihydroxyvitamin D3,their BALF.Re.infiltration degree of inflammatory cells in the trachea and lung tissue and airway inflammatory reaction are reduced significantly.1,25-dihydroxyvitamin D3 has a certain inhibiting effect on the activation of mast cells and the release of MCT granules.

Cellular Profiles in Peripheral Blood Accompanying Particular Asthmatic Response Types

Background: Patients with allergic bronchial asthma develop various asthmatic response types to bronchial challenge with allergen, such as immediate (IAR), late (LAR), dual late (DLAR) or delayed (DYAR), displaying different clinical, immunologic and pharmacologic features. This study deals with count changes of particular blood cells accompanying the IAR, LAR and DYAR. Methods: In 63 patients developing 22 IAR, 26 LAR and 15 DYAR, the repeated allergen challenges were supplemented with recording of blood cell counts, Th1/Th2 ratio, leukotrines B4 (LTB4) and C4 (LTC4), eosinophil cationic protein (ECP), myeloperoxidase (MPO), and histamine in blood, and intracellular IFN-γ and IL-4 in peripheral blood mononuclear cells. Results: The IAR was accompanied by increased eosinophil and basophil counts, increased serum concentrations of histamine, LTC4 and ECP, decreased Th1/Th2 ratio in favour of Th2 cells, and increased intracellular IL-4. The LAR was associated with increased eosinophil and neutrophil counts, increased serum concentrations of LTC4 and LTB4, unchanged Th1/Th2 ratio, and increased intra-cellular IL-4. The DYAR was accompanied by increased total leukocyte, neutrophil, monocyte, lymphocyte and thrombocyte counts, increased serum concentrations of LTB4 and MPO, increased Th1/Th2 ratio in favour of Th1 cells, and increased intracellular IFN-γ. Conclusions: These results provide evidence for different involvement of particular blood cell types and different hypersensitivity mechanisms in IAR, LAR and DYAR. The monitoring of peripheral blood cell counts seems to be an useful supplementary parameter to the bronchial challenge with allergen.

Impact of Asthma Educational Intervention on Self-Care Management of Bronchial Asthma among Adult Asthmatics

Asthma is one of the most common chronic diseases worldwide [1]. Despite advancement in science and technology and pharmacological revolutions, worldwide asthma prevalence is uncontrolled, morbidity and mortality from asthma. The most common reasons are non adherence to treatment, poor knowledge and skills in disease management [2]. Aim: The study aims to assess the impact of Asthma Education on self care management among Bronchial asthma patients. Objectives: 1) to assess the knowledge on self care management of Bronchial asthma;2) to develop and administer the Asthma educational intervention on self care management of asthma;3) to evaluate the impact of Asthma educational intervention on patient knowledge levels in comparison of pre and post test scores. Design: Quasi experimental Pre test-post test design was chosen. Methods: Study was done to assess the effectiveness of structured asthma education program on self care management of Bronchial asthma. Thirty patients, meeting the inclusive criteria, were selected by simple random sampling, and were tested for their knowledge levels on identification of asthma triggers, and warning signs, adherence to specified drugs, diet and breathing exercises. Based on the patient needs, structured education program was developed, validated and administered. Two weeks after administering structured asthma education, post-test was conducted. The Pre-test and Post-test scores were compared to evaluate the effectiveness of the Asthma education. Results: There was significant enhancement on knowledge levels on four areas of assessment and education. After asthma education the knowledge levels on disease process raised from minimum of 10% in the pre test to 77.50% in the post test. The knowledge scores on asthma triggers and warning signs enhanced 12% to 72%. The area of self monitoring and management records a rise in knowledge levels from 20% minimum scoring in pre test to 82.5% in the post test. The scores in diet, breathing exercises and adherence to drugs rose from 12.5% to 72.5% after asthma education. Conclusion: The findings reveal that educating patients remarkably increased their knowledge levels, which facilitate their behavioral modification thus enhances their self-care. Effective self care management at home level decreases asthma related morbidity and frequent visit to hospitals.

Cytokines Released from Allergen-Stimulated Blood Cells during the Delayed Asthmatic Response to Allergen Challenge

Background: Bronchial asthma patients may develop various asthmatic response types to bronchial challenge with allergen, such as immediate (IAR), late (LAR), dual (DAR) or delayed (DYAR), due to different immunologic mechanisms. The DYAR, beginning between 26-32 hrs and lasting up to 56 hrs after the allergen challenge, differs from the IAR, LAR and DAR in clinical, diagnostic and immunologic aspects. The aim of this study was to investigate the concentrations of the particular intracellular cytokines released by blood cells stimulated with relevant allergens “in vitro”, before and during the DYAR. Methods: In 23 patients, the repeated DYAR (p < 0.001) was supplemented with cytokine determination in the supernatants of the blood cells stimulated with relevant allergens before and up to 72 hours after the bronchial challenge, by means of enzyme-linked immunoassay. Results: The significantly elevated pre-challenge concentrations (p < 0.05) of IL-2, IL-17, IFN-γ and G-CSF released by allergen-stimulated blood cells “in vitro” were recorded in the DYAR patients as compared with healthy controls. The significantly increased post-challenge concentrations (p β, IL-2, IL-8, IL-12p70, IL-18, IFN-γ and TNF-α, whereas decreased concentrations of IL-4, IL-6 and IL-17, were released by blood cells stimulated with relevant allergens “in vitro”, as compared both with their pre-challenge concentrations and with the corresponding PBS control values. Conclusions: The profiles of cytokines released by allergen-stimulated peripheral blood cells during the DYAR would suggest an activation of Th1 cells, neutrophils, monocytes and probably also bronchial macrophages, epithelial and endothelial cells and their involvement in the immunologic mechanism(s) underlying the clinical DYAR.

The expression of CD40 and CD40L on the surface of peripheral blood mononuclear cells in asthmatic rats and the effect of anti-CD40L McAb on Th1 and Th2 cytokines

Objective： To investigate the expression of CD40 and CD40 ligand （CD4OL） on the surface of peripheral blood mononuclear cells（PBMCs） in asthmatic rats and the effect of anti-CD40L McAb on cytokines of PBMCs. Methods： Flow cytometry and RT-PCR were used to detect the expression of CD40 and CD40L of PBMCs in asthmatic rats. After the PBMCs was treated with anti-CD40L McAb, ELISA was used to detect the IL-4 and IFN-γ levels of culture supernatants. Results： Compared with the normal control group, the expression of CD40 and CD40L of PBMCs in asthmatic rats increased （P 〈 0.05）. Compared with the untreated group, the level of IL-γ and the ratio of IL-4/IFN-γ decreased after the PBMCs was treated with anti-CD40L McAb（P 〈 0.05）. Conclusion： The expression of CD40 and CD40L on the surface of PBMCs in asthmatic rats was up-regulated. Anti-CD40L McAb can rectify the imbalance of Th1 and Th2 cytokines.

Phytochemistry, anti-asthmatic and antioxidant activities of Anchomanes difformis(Blume) Engl. leaf extract

Objective: To study the phytochemistry, anti-asthmatic and antioxidant activities of the aqueous leaf extract of Anchomanes difformis(Blume) Engl.(A. difformis) and to verify claims of use in folk medicine.Methods: For anti-asthmatic activity, male and female guinea pigs with average body weight of(451.4 ± 118.1) g were divided into six groups of six animals each. Group 1served as control(distilled water); Group 2 was administered with salbutamol(reference drug) only; Group 3 served as ovalbumin sensitized group, Group 4, 5 and 6 were treated with A. difformis extract at doses of 100, 200 and 400 mg/kg, respectively. Described methods were used to test fluid viscosity, fluid volume and quantitative phytochemistry analysis. Absorbance was read using a UV–Vis spectrophotometer and results computed in percentage. Total antioxidant assays [2, 2-diphenyl-1-picrylhydrazyl(DPPH) and lipid peroxidation assay], were carried out using reported procedures.Results: The anti-asthmatic evaluation showed that protection from asthma of the animals in Group 6(400 mg/kg, 32.7%) were similar to that in Group 2(salbutamol, 33.0%).Excised trachea was free of mucus secretion in Group 5(200 mg/kg) as was observed in the control group. Fluid volume increase in Groups 3 and 6 indicated mucus secretion.DPPH radical scavenging activity of extract was effective as ascorbic acid which served as standard at 20 mg/m L. But, the extract elicited low lipid peroxidation activity compared with the reference(tocopherol) at concentrations tested.Conclusions: A. difformis aqueous leaf extract is safe and possesses positive antiasthmatic and antioxidant activities as claimed by traditional herbal practitioners in Delta State.

A study on utilization of anti-asthmatic drugs at a medical college hospital in India

Objective:To study the usage of anti-asthmatic dugs and enumerate the patients’ noncompliance. Methods:The study was conducted from 5th Feb,2006 to 5th Mar,2006.The samples were from the general medicine ward.All patients with respiratory tract infection who received anti-asthmatic drugs were included in the study.Data were collected from clinical notes and structured patient’s data,and patient interview utilizing a piloted questionnaire data collection form.The questionnaire included patient demographics,anti-asthmatics prescribed, dose,frequency and previous treatment if any and its duration,concomitant medications etc. Results:26.31%of patients were 61-70 years old.Among 57 patients,91.23%of patients received multi-therapy,8.77%of patients received mono-therapy,59.65%of patients took over the counter(OTC) drugs and 57.89%of patients were non compliant.Anti-asthmatic drugs were prescribed to asthmatic patients as oral,inhalation and others(injections),and more than one route were used for administration of drugs.Conclusion:The anti-asthmatics are used to treat breathing difficulties such as allergy.Poor compliance to treatment is common among the patients,which makes it difficult to manage asthma and increases both morbidity and mortality.It is suggested that interventions have to be done by providing counseling and improving the current prescribing trend for better and rational utilization.

Effects of interleukin-18 on airway inflammation and the Th1/Th2 cytokine imbalance in guinea pig asthmatic model

In order to investigate the effects of interleukin-18 （IL-18） on airway inflammation and the Th1/Th2 cytokine balance in guinea pig asthmatic model as well as its possible mechanisms, the asthmatic model was established by intraperitoneal injection of ovalbumin （OVA） and aerosol challenges into guinea pigs, and 30 treated animals were randomly divided into three groups of 10 animals in each groups, in which group A served as the asthmatic model, group B as the controls and group C as the group treated with IL-18. The counting and categorization of the inflammatory cells in bronchoalveolar lavage fluid （BALF） were performed by using light microscopy, and the contents of cytokines （ IFN-γ, IL- 2, IL-4 and IL-5） were assayed by means of the ELISA kit. The experimental results showed that the numbers of eosinophils （ESO） in BALF of group A, B and C were （97.70 ± 58.03） × 10^6/L, （11.68 × 9.95） × 10^6/L and （28.62 ± 10.46） × 10^6/L, respectively, in which the number of eosinophils in group A was significantly higher than those of group B and C. Also, the number of neutrophils in BALF of group A was even higher than those in group B and C. In addition, the contents of IFN-7 and IL-2 in group A were lower than those in group B and C, but the contents of IL-4 as well as IL-5 were rather higher than those in group B and C. It is evident from the above observations that IL-18 can effectively inhibit the asthmatic inflammatory cells in BALF with an imbalance of the Thl/Th2 cytokines, thus offer- ing the experimental basis for the clinical application of IL-18 in the prevention and treatment of asthma.

咳喘药学服务门诊哮喘患者有效性评价指标体系构建

目的构建咳喘药学服务门诊(CWPC)哮喘患者有效性评价指标体系,为提高患者哮喘控制水平和规范化药学服务水平提供测评工具和理论依据。方法采用文献分析、半结构访谈等多种研究方法,建立CWPC哮喘患者有效性评价指标体系;采用德尔菲法进行两轮专家函询,以层次分析法确定指标权重;采用问卷调查法对所建指标体系进行信效度分析。结果本研究在河南省三级甲等医院选择了29名医、药、护3个学科的专家,进行了2轮专家函询后,最终从结构水平、功能水平、素养管理水平3个核心维度确定了CWPC哮喘患者有效性评价指标体系(包括9个子维度,如肺功能、症状等;35个测量条目,如哮鸣音、呼吸频率等),并确定了各维度指标的权重;信效度分析的结果证实了指标体系的科学合理性。结论构建的CWPC哮喘患者有效性评价指标体系具有较高的认可度和信效度,可作为哮喘患者有效性评价的测量工具。

糖皮质激素对哮喘控制作用的实验研究

目的:探讨糖皮质激素对哮喘的控制作用。方法:将30只大鼠随机分为正常对照组(A组)、哮喘组(B组)及地塞米松干预组(DXM组),观察其临床表现,比较三组大鼠血嗜酸性粒细胞(eosinophil,EOS)、血清中IgE、VEGF、IL-4、IFN-γ的水平变化,并留取肺做组织病理学检查。结果:从临床表现上看糖皮质激素对哮喘具有控制作用,三组大鼠IgE、EOS、VEGF、IL-4、IFN-γ水平差异均具有统计学意义(F值分别为1014.726、894.408、38.693、308.489和2546.543,P<0.001);B组与A组相比较,IgE、EOS、VEGF、IL-4水平升高、IFN-γ水平降低(P<0.001);DXM组与B组相比较,IgE、EOS、VEGF、IL-4水平降低、IFN-γ水平升高(P<0.001);DXM组与A组相比较,IgE、EOS、VEGF、IL-4水平升高、IFN-γ水平降低(P<0.001)。大鼠肺组织病理示:B组见明显的炎性改变和气道重塑,DXM组炎性改变和气道重塑较B组减轻。结论:糖皮质激素可通过上调IFN-γ,下调IgE、EOS、VEGF、IL-4,减轻炎性改变和气道重塑控制哮喘。

哮喘-慢阻肺重叠综合征患者血清SIRT1、α-SMA水平及临床意义研究

目的检测哮喘-慢阻肺重叠综合征(ACOS)患者血清沉默信息调节因子1(SIRT1)、α-平滑肌肌动蛋白(α-SMA)水平,并分析其临床意义。方法对52例ACOS患者(A组)、50例单纯哮喘患者(B组)、51例单纯慢阻肺患者(C组)、50例健康体检者(健康组)的资料进行回顾性分析。4组均检测血清SIRT1、α-SMA水平,肺功能[第1s用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC],血清炎症因子水平[肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-1β(IL-1β)],气道可逆性和气道重塑指标[血清碱性成纤维生长因子(b-FGF)、基质金属蛋白酶9(MMP-9)、神经生长因子(NGF)、基质金属蛋白酶组织抑制因子1(TIMP-1)],对比4组上述指标差异;分析A组患者血清SIRT1、α-SMA水平与上述指标的相关性。结果A组血清SIRT1、α-SMA,血清TNF-α、IL-6、IL-1β水平,血清b-FGF、MMP-9、NGF、TIMP-1水平均高于其余3组,B组和C组均高于健康组,差异均有统计学意义(P均<0.05);A组FEV1%、FVC、FEV1/FVC均低于其余3组,B组和C组均低于健康组,差异均有统计学意义(P<0.05);A组与B组支气管舒张试验阳性率均高于其余2组,C组高于健康组,差异均有统计学意义(P<0.05);A组患者中血清SIRT1、α-SMA水平与FEV1%、FVC、FEV1/FVC均呈负相关性,与血清TNF-α、IL-6、IL-1β水平,血清b-FGF、MMP-9、NGF、TIMP-1水平均呈正相关性。结论在ACOS患者中血清SIRT1、α-SMA水平偏高,且均明显高于单纯哮喘和单纯慢阻肺患者,且与肺功能、血清炎症因子水平及气道重塑指标均相关。

羧甲司坦口服溶液联合重组人干扰素α1b治疗小儿急性喘息性支气管炎的效果

目的分析急性喘息性支气管炎患儿接受重组人干扰素α1b单药与联合羧甲司坦口服溶液治疗的效果。方法回顾性分析2021年6月至2023年6月医院收治的100例急性喘息性支气管炎患儿资料,按不同治疗方案分为对照组、观察组,各50例。对照组接受重组人干扰素α1b治疗,观察组接受羧甲司坦口服溶液联合重组人干扰素α1b治疗。比较两组临床疗效、主要症状缓解时间、气道炎症相关因子[趋化因子配体3(CCL3)、高迁移率族蛋白B1(HMGB1)、α1-酸性糖蛋白(α1-AG)]、T淋巴细胞(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))及不良反应。结果观察组临床总有效率高于对照组(P<0.05)。治疗后观察组气促、喘息、咳嗽、肺部音等症状缓解时间降低(P<0.05)。治疗4、7 d后,两组CCL3、HMGB1、α1-AG较治疗前下降,且观察组低于对照组(P<0.05);两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)较治疗前升高,且观察组高于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论羧甲司坦口服溶液联合重组人干扰素α1b治疗急性喘息性支气管炎,可抑制气道炎症,调节机体免疫,促进症状缓解,疗效确切,且安全性高。

小儿喘息性支气管炎雾化吸入治疗的康复护理措施效果评价

目的:探讨小儿喘息性支气管炎雾化吸入治疗的康复护理措施应用效果,为临床护理提供依据。方法:选取2020年1月—2022年1月河南大学第一附属医院收治的108例采用雾化吸入治疗的小儿喘息性支气管炎患儿作为研究对象,采用随机数表法将其分为对照组和观察组,每组各54例。对照组患儿采用常规护理干预,观察组患儿采用康复护理干预。比较两组患儿临床症状改善时间、患儿监护人护理满意度、患儿治疗依从性。结果:观察组患儿咳嗽咳痰消失时间、胸闷喘息消失时间、肺鸣音消失时间均明显短于对照组,差异有统计学意义(t=10.748、5.665、6.512,P<0.05)。观察组患儿监护人护理满意度明显高于对照组,差异有统计学意义(χ^(2)=4.860,P<0.05)。观察组患儿治疗依从性明显高于对照组,差异有统计学意义(χ^(2)=5.723,P<0.05)。结论:小儿喘息性支气管炎雾化吸入治疗采用康复护理干预,能够缩短患儿咳嗽咳痰消失时间、胸闷喘息消失时间、肺鸣音消失时间,提高患儿监护人护理满意度与患儿治疗依从性。

甲泼尼龙琥珀酸钠联合硫酸镁治疗小儿喘息性支气管肺炎的临床疗效及对患者炎症指标的影响

目的探讨甲泼尼龙琥珀酸钠联合硫酸镁治疗小儿喘息性支气管肺炎的疗效对患者炎症指标的影响。方法选取2021年10月至2022年10月东台市人民医院收治的130例喘息性支气管肺炎患儿作为研究对象,按照随机数字表法分为常规组与观察组,每组65例。常规组给予甲泼尼龙琥珀酸钠治疗,观察组给予甲泼尼龙琥珀酸钠联合硫酸镁治疗,比较两组临床疗效、炎症指标[超敏C-反应蛋白(hypersensitive C-reactive protein,hs-CRP)、中性粒细胞百分比(percentage of neutrophils,NEUT%)、降钙素原(procalcitonin,PCT)]及不良反应发生情况。结果观察组治疗总有效率高于常规组,差异有统计学意义(P<0.05)。观察组咳嗽、气喘、肺啰音、气促症状消失时间及肺部炎症消失时间、住院时间均短于常规组,差异有统计学意义(P<0.05)。治疗后,两组hs-CRP、NEUT%及PCT均低于治疗前,且观察组低于常规组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论甲泼尼龙琥珀酸钠联合硫酸镁治疗喘息性支气管肺炎患儿疗效显著,可缩短症状改善时间,改善炎症反应程度,值得临床推广应用。

中麻黄的化学成分研究

研究中麻黄(Ephedra intermedia Schrenk et C.A.Mey.)干燥草质茎的化学成分及其抗哮喘活性。应用硅胶柱色谱、Sephadex LH-20柱色谱、Toyopreal HW-40C柱色谱以及半制备型高效液相色谱等多种手段对中麻黄草质茎的50%丙酮提取物进行化学成分研究,从中分离鉴定了22个化合物,根据其理化性质和波谱学数据鉴定其结构,分别为4-甲氧基肉桂酸(1)、肉桂酸(2)、ω-hydroxypropioguaiacone(3)、threo-8 S-7-methoxysyringylglycerol(4)、3-(2,4′-dihydroxy-3′,5′-dimethoxyphenyl)propanoic acid(5)、8-hydroxy-9-methyl-7-(4-hydroxy-3,5-dimethoxyphenyl)-7-propanone(6)、3-羟基-1-(4-羟基-3,5-二甲氧基苯基)-1-丙酮(7)、2-羟基-1-(4-羟基-3-甲氧基)苯基-1-丙酮(8)、异咖啡酸甲酯(9)、trans-syringin(10)、cis-syringin(11)、(4 R)-4-hydroxy-4-(2-hydroxypropan-2-yl)cyclo-hex-1-ene-1-carboxylic acid(12)、7-羟基-α-松油醇(13)、去氢吐叶醇(14)、脱落酸(15)、黑麦草素内脂(16)、(E)-3-(3-hydroxybut-1-enyl)-2,4,4-trimethylcyclohexa-2,5-dienone(17)、3-(3′-hydroxybutyl)-2,4,4-trimethylcyclohexa-2,5-dienone(18)、对异丙基苯甲酸(19)、p-cymen-7-ylβ-D-glucopyranoside(20)、acyclic 7-hydroxygeranic acid(21)、7,7-dimethylbicyclo[3.1.1]hept-2-ene-1-carboxylic acid(22),其中化合物3~6、8、10~14、17~19、21、22为首次从该植物中分离得到,同时经体外抗哮喘活性筛选,结果显示化合物11和14能够显著抑制β-氨基己糖苷酶的释放。

基于EMS管理模式的延续性护理在学龄前喘息性疾病儿童中的应用观察

目的·探讨基于EMS[环境管理(environment management,E)、用药指导(medicine direction,M)与自我监测(self monitoring,S)]管理模式的延续性护理在学龄前喘息性疾病儿童中的应用效果。方法·选取2019年12月至2020年11月,在上海交通大学医学院附属儿童医院呼吸科收治的67例0~6岁喘息性疾病患儿,按照随机数字表分为观察组33例和对照组34例,其中失访3例,最终每组32例。观察组采用基于EMS管理模式的延续性护理,对照组给予常规护理和出院电话随访。2组患儿出院后1、3、6个月随访评估儿童呼吸和哮喘测试(Test for Respiratory and Asthma Control in Kids,TRACK)结果、喘息复发情况;出院后6个月随访采用支气管哮喘用药依从性评分表(Medication Adherence Report Scale for Asthma,MARS-A)和护理工作满意度调查表评估用药依从性及护理工作满意度。结果·2组患儿人口学特征及临床基线特征差异无统计学意义。重复测量方差分析结果显示,时间、组别、组别×时间的交互作用对TRACK总分的影响均有统计学意义;出院后1、3、6个月,观察组TRACK总分均显著高于对照组(均P=0.000);2组患儿TRACK总分均随时间推移逐渐上升(P=0.000)。观察组1、3、6个月随访发现喘息复发率分别为25.0%、18.7%、9.4%,均显著低于对照组(分别为50.0%、43.7%、31.3%,均P<0.05);广义估计方程分析显示组间比较差异有统计学意义(P=0.013),观察组干预效果优于对照组(OR=0.292)。出院后6个月观察组MARS-A得分为(4.519±0.395)分,显著高于对照组[(3.994±0.739)分,P=0.001]。护理工作满意度调查结果显示,观察组显著高于对照组(P=0.000)。患儿MARS-A得分与护理工作满意度呈中度正相关(r=0.389,P=0.001)。结论·基于EMS管理模式的延续性护理可显著提高学龄前喘息性疾病儿童的用药依从性和喘息控制水平,明显降低喘息复发率,以及提高护理工作满意度。