Comparison of Allergic Rhinitis and Bronchial Asthma Impacts on Tympanometric Parameters in Children at Kano, Nigeria

Background: Allergic rhinitis (AR) is a multifocal IgE-mediated type I hypersensitivity reaction that affects sino-nasal mucosa and is characterized by excessive sneezing, watery rhinorrhea, nasal itching, nasal stuffiness and eyes itching. Bronchial asthma (BA) is one of the common childhood diseases that affects the respiratory system characterized by recurrent cough, wheezing, chest tightness and difficulty with breathing. The two conditions are different manifestations of allergic disease of the airway;the composition of the inflammatory substrate in the mucosa of allergic patients is similar to the late-phase allergic response seen elsewhere in the respiratory tract, such as in bronchial asthma. Aim: The aim was to compare the impacts of allergic rhinitis and bronchial asthma on tympanometric parameters in children. Patients & Methods: This is a hospital based comparative cross-sectional study. Two groups of participants aged 4 - 12 years, one group with documented clinical diagnosis of allergic rhinitis and the other group with documented clinical diagnosis of bronchial asthma were consecutively selected from ear, nose and throat (ENT) and pediatrics cardiopulmonary outpatient clinics of Aminu Kano Teaching Hospital Kano respectively. Equal number of children aged 4 - 12 years with no history of ENT diseases or bronchial asthma that were selected from elementary schools within the same community served as a control group. An interviewer-administered questionnaire was filled out for all the participants, complete ENT and chest examinations were carried out and subsequently all the selected participants had tympanometry done, findings were recorded and analyzed. Results: The mean age of participants with bronchial asthma was found to be 7.5 ± 2.6 years while participants with allergic rhinitis had the mean age of 6.8 ± 2.1 years. The mean middle ear pressure (MEP) of participants with bronchial asthma was found to be -15.22 dapa and -40.32 dapa in those with allergic rhinitis. Acoustic reflex was found to be absent in 15.4% of the participants with bronchial asthma and 29.6% of allergic rhinitis participants. Type B tympanogram was found in 2.8% of bronchial asthma participants and 7.3% in participants with allergic rhinitis. Type C tympanogram was found in 4.6% of participants with bronchial asthma and 15.5% of participants with allergic rhinitis. Type A tympanogram was found in 90% of participants with bronchial asthma and 75% of participants with allergic rhinitis. The difference between type A, B and C tympanograms of participants with bronchial asthma and those with allergic rhinitis was found to be statistically significant (Type A χ2 = 14.62, df = 4, p value = 0.01, Type B χ2 = 14.06, df = 4, p value = 0.01, Type C χ2 = 17.01, df = 6, p value = 0.01). Conclusion: Participants with allergic rhinitis were found to have more abnormalities of tympanometric parameters compared to participants with bronchial asthma which signifies allergic rhinitis conferred an increased risk of having middle ear diseases and otitis media with effusion compared to bronchial asthma.

Cross-sectional population based study examining the impact of children with asthma on US rural families

Introduction: Approximately 7.1 million US children have asthma. The burden of asthma is disproportionate with ruralUSpopulations experiencing a higher prevalence of the disease. Rural populations experience additional disparities regarding health care access, job availability, and daily living resources. Hence, the family impact of having a child with asthma may be influenced by geographic locale. This impact could be a result of health insurance tied to employment, out of pocket costs, and health care provider availability. Few studies have assessed the impact a child’s asthma has on a family. This study sought to answer the question: What is the impact of children with asthma on US rural families? Methods: Multivariate techniques were performed to examine a single year of data from two connected population-based datasets, the 2007-2008 National Survey of Children’s Health and the 2009-2010 Children with Special Health Care Needs Survey. Children with current asthma defined the study population for both datasets. A logistic regression model was performed for each database. The dependent variable for the first model was child in family currently has asthma, for the second it was rural children with current asthma. Results: The first logistic regression model confirmed that rural children were more likely to have asthma than non-rural children. The second logistic regression model yielded that rural families with a child diagnosed with asthma had greater odds of: not having health insurance, having a parent who stopped working, avoided a job change, or experienced financial problems because of the child’s health. Conclusions: This study demonstrated that rural families experience a disproportionate financial hardship as a result of their child’s asthma. Pharmacist intervention in asthma care in rural areas has the potential to decrease the financial burden for a family while also improving a child’s health.

Primary study on correlation betweenβ_2-adrenoceptor haplotypes and asthma in children of Han nationality in Chongqing

Objective:To investigatethecorrelationbetweenβ 2 -adrenergicreceptors(β 2 -AR)haplotypesandasthmaof Hannationalitychildrenin Chongqingregion.Methods:PCRandrestrictionfragmentanalysiswereusedto study16,27lociof theβ 2 -ARpolymorphismin76unrelatedasthmaticchildrenandin100healthychildrenandadultsof Hannationali-ty as control.A statisticalanalysisof thecorrelationbetweenglycine(Gly)16allele,Gly16/glutamine(Gln)27haplotype andasthmaticclinicalstatuswas carriedout.Results:Therewas no significantincreaseof thefrequencyof Gly16and Gln27alleleintheasthmaticgroupas comparedwiththecontrolgroup(P>0.05).Therewasa significantincreaseof the frequencyof Gly16alleleandGly16/Gln27haplotypein severeasthmaticcasesthanin themildandmoderateasthmatic ones(P<0.01,0.05).Conclusion:Itis consideredthatasthmais notcausedby GlyandGlnallelesofβ 2 -ARpolymor-phisms.Gly16alleleandGly16/Gln27haplotypearepossiblycorrelatedwiththeseverityof theclinicalmanifestationsin thechildrenof HannationalityinChongqing.

Association between Asthma and Dental Caries amongst 12 - 15 Years Old Children: A School-Based Cross-Sectional Study in Karachi, Pakistan

Objective: The study aimed to determine an association between dental caries and asthma among 12 to 15 years old children. Methods: This is a school-based cross-sectional study conducted from January to February 2016. A random sample of 544 children aged 12 - 15 years were enrolled from five private schools of Karachi. Dental caries was assessed using DMFT Index (Decayed, Missing, Filled teeth). The main exposure variable was asthma and information on it was collected through the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Results: The data was analyzed using Cox Proportional Hazard algorithm. Crude and adjusted prevalence ratios with 95% CI were reported. Total 554 children, 306 (56.3%) boys and 43.7% girls participated in the study. Mean age of children was 13.2 ± 0.05 years. Total number of children with DMFT > 0 was 30.5%. The decayed component contributed largely (22.8%) to the DMFT score. Overall prevalence of asthma was 20%. Prevalence of caries in asthmatic children was 28.4% as compared to 31% among non-asthmatic children. Adjusted prevalence ratio of dental caries in asthmatic children was 0.8 (95% CI 0.6 - 1.3) after adjusting for carious food intake, age, oral hygiene index and dentist visit;the association between asthma and dental caries turned out to be in-significant. Conclusions: There was no association observed between asthma and dental caries among the children examined in this study.

Asthma in Children at the Pediatric Intensive Care Unit of University Hospital of Brazzaville (Congo)

Objectives: To describe the epidemiological, clinical and therapeutic aspects of asthma in children at the Pediatric Intensive Care Unit of University Hospital of Brazzaville. Patients and methods: We reviewed the records of children hospitalized in the Pediatric Intensive Care Unit of University Hospital of Brazzaville from January 1 to December 31, 2015, and retained those from two months to 17 years hospitalized for asthma. The study variables were: age, sex, influence of seasons, history of atopy;the factors triggering the crisis, the type of follow-up, the degree of severity of asthma exacerbation, the type of treatment instituted and the course of the disease. In total, out of 2012 hospitalized children, 65 children met the inclusion criteria. Results: The hospital prevalence of asthma was 3.5%. Among 65 children of study, 42 (59.2%) were male and 29 (40.8%) female. The mean age was 3.9 ± 2.9 years (range from 2 months to 14 years). Children aged 30 months to 5 years were the most represented (40%). They were known as asthmatics, n = 18 (27.7%). Family atopy was found, n = 11 (16.9%). Acute Otorhinolaryngologic infections were in all cases the factors triggering the crisis. The peak frequency of hospitalizations for asthma occurred during the short rainy season. The crisis was moderate n = 46 (70%) and severe n = 19 (29%). Beta 2 mimetics were administered in all cases, by subcutaneous in 18 cases (27.7%) and inhaled in 47 cases (72.3%). The outcome was favorable in all cases with a mean hospital stay of 1.46 ± 0.92 days. Conclusion: Childhood asthma remains a public health challenge and severe asthma is the paradigm of uncontrolled and costly asthma. This first work suggests that a large-scale study be carried out for a better knowledge of it.

TCM Treatment of Asthma in Children with Yin Hua Wu Mei Tang——Professor Liu Bichen's Experience in Treating Asthma

Asthma is characterized by paroxysmaldyspnea,rales in the throat,difficulty in breathing,and inability to lie horizontally.It is commonly seenin children with a weak body constitution,and tendsto be intractable,thus being harmful to the

Comparison of treatment guidance based on bronchial responsiveness to mannitol, spirometry or exhaled nitric oxide in stable asthmatic children

Aim: The goal of this study was to compare asthma treatment guidance based on bronchial hyper-responsiveness to mannitol, spirometry or exhaled nitric oxide (FeNO) in stable asthmatic children. Methods: 60 stable allergic asthmatic children aged 7 to 16 years on a low to medium dose treatment with inhaled corticosteroids (ICS) were recruited to a double blind randomised controlled trial. At study entry (visit 1), the following was assessed: FeNO, spirometry, bronchial hyper-responsiveness to mannitol (MDP-?test), quality of life (paediatric asthma quality-of-life questionnaire;PAQLQ) and asthma control (asthma control test;ACT). Subjects were randomly assigned to one of three groups and treatment was modified by a blinded respiratory physician according to the test results of visit 1: ICS dose was doubled when FeNO was >22 ppb (group 1), in case of a positive MDP-test (group 2) or when FEV1 was <80% of a predicted one (group 3), respectively, or remained unchanged for the remaining subjects. After 3 months (visit 2), the subjects were reassessed and all tests were repeated. Results: 48 children successfully completed the study. At the first visit, 8 out of 16 (50%) children in group 1 showed a FeNO > 22 ppb, 8 children out of 16 (50%) in group 2 showed a positive MDP-test and 3 children out of 16 (18.7%) in group 3 had a FEV1 < 80% of that predicted and had their ICS-dose doubled. In group 1, FeNO decreased significantly after the intervention (p = 0.005), whereas the self-administered and the interviewer-administered PAQLQ (p = 0.02 resp. p = 0.033) as well as the ACT (p = 0.031) increased. Neither the number of children with a positive mannitol challenge nor spirometric results changed significantly. In group 2 and group 3, there were no significant changes in none of the assessed parameters. Conclusion: In this small pragmatic double blind randomised controlled study, we showed that ICS dose modification based on FeNO led to increased quality of life and enhanced asthma control, and to a reduction in airway inflammation and was superior to treatment modifications based on bronchial hyper-responsiveness to mannitol or on FEV1.

Pattern of Acute Asthma Seen in Children Emergency Department of the River State University Teaching Hospital Portharcourt Nigeria

Acute exacerbations of asthma are one of the leading causes of emergency room visits and hospitalizations in children. Asthma exacerbations also demonstrate a seasonal pattern in which high rates can be seen at a particular season and knowledge of the seasonal pattern of asthma exacerbation in any locality can improve asthma management. Objective: To determine the prevalence, management outcome and seasonal pattern of emergency department visits for acute exacerbation of asthma. Methods: This was a retrospective review of the emergency department register of all asthma admissions in the Rivers State University Teaching Hospital, Portharcourt, Nigeria over a five year period from January 2014 to December 2018. Results: A total of 205 (2.9%) asthma-related visits were recorded out of 7046 emergency room visits. The mean age of the patients was 6.1 (±4.2) yrs, with an M:F ratio of 1.97:1. The median length of hospital stay was 24 hrs. Children older than 11 yrs were more likely to be admitted for >48 hrs (OR 4.18, 95% CI;1.67, 10.39, P;0.003). Emergency department visits for asthma were more in the rainy season April-September 129 (63.9%) with a peak in May. There is a significant variation in the seasonal pattern of emergency room asthma admission with age (P = 0.018). Children >3 yrs have their highest admission rates in May while younger children experience two peaks in February and November. Conclusion: Asthma exacerbation is more in rainy season among children in Portharcourt although there is a variation in seasonal pattern of asthma exacerbation with age.

The Association of PM2.5 and Surface Ozone with Asthma Prevalence among School Children in Japan: 2006-2009

Researches on asthma have found that air pollution increased asthma prevalence among sensitive age groups, including school children, and exposed them to the recognized health impacts. The aim of this study is to examine the association between elevated annual mean concentration of PM2.5 (particulate matter with aerodynamic diameter less than 2.5 micrometers) and surface ozone and asthma prevalence among school children in Japan from 2006 to 2009. Annual rates of asthma prevalence among preschool and school children (5 to 11 years) are obtained from the database of the Ministry of Education, Culture, Sports, Science and Technology—Japan (MEXT). Data on the concentrations of PM2.5 and surface ozone were obtained from 1,183 stations of air quality monitoring distributed in 47 prefectures. Annual means of these concentrations were compared to annual variations in asthma prevalence by using Pearson correlation coefficient. We found different associations between the annual mean concentration of PM2.5 and surface ozone and the annual rates of asthma prevalence among preschool and school children from 2006 to 2009. The positive values of the correlation coefficient in prefectures such as, Gumma, Shimane, and Niigata, are consistent with the previous knowledge. However, significant inverse associations were found in many prefectures. Our study suggests that the association between elevated concentrations of PM2.5 and surface ozone and asthma prevalence among school children in Japan is not strong enough to assume concretely a plausible and significant association.

Barriers of Asthma Care among Asthmatic Children in Saudi Arabia: Maternal Perspectives

Background Bronchial asthma is one of the most common chronic conditions among children. Despite the improvement in asthma treatment regimens, its prevalence and related morbidity are increasing, especially among underserved, minority children. There are barriers in the management of asthma, which may impact the quality of outcomes. The goal of this study is to explore these barriers. Methods A cross-sectional study was conducted on interview data collected through 2019 from mothers of children (aged 6 - 12 years) with asthma visiting, for convenience, a public shopping mall. The interviewees were randomly selected, because they met the inclusion criteria. Participants were considered if the mother answered “yes” to the following questions: Has your child had physician-diagnosed asthma? Is your child currently taking asthma medications of asthma? Two community nurses conducted the interviews. Data was obtained using administrative questionnaires. Data were analyzed using SPSS version 21.0 (IBM Inc., Chicago, IL, USA). Descriptive statistics of percentage, mean, frequency and standard deviation were applied for categorical and continuous variables. Results Three hundred mothers participated in this study. Their average age was 36.8 years, 55% were housekeepers by profession, and 34% had obtained less than high school education. The majority of children (61%) were males, 45% had moderate asthma, and 42% had mild asthma. The most frequent types of barriers identified by parents were environmental factors (67.7%), followed by health care providers (63%), the health care system (48%), and patient or family characteristics (43%). Mothers were specifically concerned about the use, safety, and long-term complications of medications, the impact of exercise limitation on their child’s quality of life, and their own quality of life. Conclusion This study showed several barriers against asthma care in Saudi Arabia, which mainly related to environmental or personal characteristics. This highlights the need to enhance current policies within the health care system in Saudi Arabia to overcome these barriers.

呼出气一氧化氮、肺泡一氧化氮和嗜酸性粒细胞对3~6岁儿童呼吸系统疾病的鉴别诊断价值

目的探讨呼出气一氧化氮(FeNO)、肺泡一氧化氮(CaNO)和嗜酸性粒细胞(EOS)在甘肃省兰州市3~6岁儿童呼吸系统疾病鉴别诊断中的应用价值。方法选取确诊哮喘或过敏性鼻炎或下呼吸道感染的360例3~6岁儿童作为研究对象,采用斯皮尔曼秩相关系数评估FeNO、CaNO、EOS的相关性,通过随机森林模型、受试者工作特征(ROC)曲线、多因素逻辑回归分析评估FeNO、CaNO和EOS对3种疾病的鉴别诊断价值。结果哮喘患儿的FeNO、CaNO中位数高于其他疾病患儿,过敏性鼻炎患儿的EOS中位数最低,下呼吸道感染患儿的FeNO、CaNO中位数最低。相关性分析结果显示,FeNO与CaNO呈正相关(r=0.59,P<0.05),FeNO与EOS呈负相关(r=-0.61,P<0.05),CaNO与EOS呈负相关(r=-0.63,P<0.05)。随机森林模型显示,FeNO在疾病分类中的重要性最高。ROC曲线分析结果显示,3种疾病中,FeNO、CaNO、EOS对下呼吸道感染的诊断效能均最高(曲线下面积分别为0.86、0.91、1.00)。多因素逻辑回归模型诊断哮喘的曲线下面积为0.96,灵敏度为0.902,特异度为0.881。结论FeNO、CaNO和EOS在鉴别诊断兰州地区3~6岁儿童哮喘、过敏性鼻炎、下呼吸道感染方面展现出较好的潜力,且基于三者构建的多因素逻辑回归模型可有效提升对哮喘的诊断准确性。

孟鲁司特钠单用、布地奈德/福莫特罗单用及两者联用治疗对儿童咳嗽变异型哮喘的疗效比较

目的本研究旨在比较孟鲁司特钠(Mon)单用、布地奈德/福莫特罗(BF)单用及两者联用治疗儿童咳嗽变异型哮喘(CVA)的疗效。方法选取2021年6月至2023年6月北京市海淀医院诊治的CVA患儿为研究对象。根据治疗方案,将CVA患儿分为Mon组、BF组和联合组。观察治疗8周后的治疗总有效率(TER)、不良反应发生率(TAER)、咳嗽症状评分[日间咳嗽症状评分(DCSS)和夜间咳嗽症状评分(NCSS)]、免疫功能[肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)和免疫球蛋白E(IgE)]、肺功能[第1秒用力呼出气体容量(FEV_(1))、肺活量(FVC)和呼气峰值流速(PEF)]和血清嗜酸性粒细胞计数(EOS)。结果共选取180例CVA患儿,Mon组62例,BF组60例,联合组58例。治疗后,3组TER、TAER、DCSS、NCSS、血清TNF-α、血清IL-4和血清IgE水平差异无统计学意义(P>0.05)。联合组患儿FEV_(1)、FVC和PEF显著高于Mon组和BF组(P<0.05),EOS显著低于Mon组和BF组(P<0.05);而Mon组和BF组FEV1、FVC、PEF和EOS学差异无统计学意义(P>0.05)。结论Mon或BF可有效改善CVA患儿咳嗽症状和免疫功能,其镇咳作用和抗炎作用同Mon和BF联用相似。此外,Mon和BF联用可进一步改善CVA患儿肺功能,减少血清EOS水平。

超重和肥胖与哮喘患儿肺功能的相关性研究

目的 研究超重和肥胖与哮喘患儿肺功能的相关性。方法 选取2022年7月—2022年9月在呼吸科门诊就诊的368例哮喘患儿,根据体重指数(BMI)分为非超重肥胖组235例(63.8%)、超重组57例(15.5%)、肥胖组76例(20.7%),检测3组患儿肺功能的指标。包括用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、1秒率(FEV_(1)/FVC),用力呼出25%肺活量时的瞬间流量(FEF_(25))、用力呼出50%肺活量时的瞬间流量(FEF_(50))、用力呼出75%肺活量时的瞬间流量(FEF_(75)),用力呼气中期流量(FEF_(25~75)),呼气峰值流量(PEF)。结果 在超重和肥胖患儿中,哮喘控制不良的比例更高,与非超重肥胖组比较,差异有统计学意义(P<0.05)。在368例哮喘患儿中,BMI数值和FEV_(1)/FVC呈负相关(r=-0.22,P<0.05),与FVC、FEV_(1)、FEF_(25)、FEF_(50)、FEF_(75)、FEF_(25~75)各指标呈正相关(P<0.05)。在急性发作期及缓解期患儿中,BMI数值和肺功能各指标的相关性表现结果同前。结论 超重和肥胖患儿中,哮喘控制不良的比例更高。随着BMI数值的升高,哮喘患儿的FEV_(1)/FVC呈下降趋势,超重和肥胖对哮喘患儿的负面影响主要表现在中央气道。

泉州地区支气管哮喘儿童过敏情况分析

目的调查泉州地区支气管哮喘患儿的过敏情况。方法分析2012年1月至2023年6月我院收治的320例支气管哮喘患儿过敏原以及其他系统过敏情况。结果320例患儿过敏原检测阳性率为89.38%,吸入性过敏原主要为尘螨、屋尘、蟑螂,分别占74.38%、20.94%、14.69%;食物性过敏原主要为鸡蛋白、牛奶、蟹,分别占19.69%、19.02%、12.81%。不同年龄组户尘螨、屋尘、狗毛鸡蛋白阳性分布存在差异,婴幼儿组尘螨阳性率低于学龄前组和学龄组(χ^(2)=29.24、33.87,P<0.05);婴幼儿组屋尘阳性率低于学龄组(χ^(2)=4.59,P=0.030);与学龄组相比,学龄前组狗毛、鸡蛋白阳性率更高(χ^(2)=10.07,10.54,P<0.05)。共病221例(69.06%),3个以上系统过敏75例(23.44%)。需要耳鼻喉科诊疗165例,其中鼻炎162例,需要皮肤科诊疗118例,营养科11例,眼科6例,消化科4例,药剂科4例。结论泉州地区支气管哮喘儿童最主要的过敏原为尘螨,不同年龄患儿户尘螨、屋尘、狗毛、鸡蛋白阳性分布存在差异,支气管哮喘容易合并多系统过敏表现,评估和管理需注意多学科联合。

小儿咳嗽变异性哮喘标准治疗后停药1年复发的影响因素及其交互效应

目的研究咳嗽变异性哮喘(CVA)患儿标准治疗后停药一年复发的影响因素及其交互效应。方法回顾性分析2018年1月-2020年1月玉林市红十字会医院收治的167例CVA患儿的临床资料,所有患儿均接受吸入性糖皮质激素(ICS)规范治疗(疗程≥6个月),停药后随访观察≥2年,按照患儿2年的随访结果,将CVA标准治疗后停药1年复发的98例患儿纳为CVA复发组,69例未复发纳为CVA未复发组,进行对照研究,分析CVA复发影响因素及其交互效应。结果单因素分析得出两组患儿反复呼吸道感染病史、变应性鼻炎、过敏性皮炎及停药时呼出气一氧化氮(FeNO)比较,差异有统计学意义(P<0.05)。多因素分析得出,有反复呼吸道感染病史(OR=4.543,P=0.001)、有变应性鼻炎(OR=7.146,P<0.001)、FeNO>20.00 ppb(OR=3.770,P=0.001)为CVA标准治疗后停药一年复发独立危险因素。反复呼吸道感染病史与变应性鼻炎、反复呼吸道感染病史与FeNO、变应性鼻炎与FeNO的交互作用指数S分别为2.152、1.527、1.397。结论有反复呼吸道感染、变应性鼻炎和FeNO>20.00ppb均是影响CVA标准治疗后停药1年复发的影响因素,且两两因素间有正向交互作用。

苏葶止喘汤联合西医治疗小儿支气管哮喘急性发作期(痰热阻肺证)38例

目的探讨苏葶止喘汤联合西医治疗小儿支气管哮喘急性发作期(痰热阻肺证)临床疗效。方法收集2020年2月至2022年3月河北省沧州中西医结合医院就诊的急性发作期的支气管哮喘病儿78例,根据随机数字表法分为对照组与治疗组各39例,对照组病儿给予硫酸沙丁胺醇、异丙托溴铵、布地奈德雾化吸入等西医治疗,治疗组在对照组基础上给予苏葶止喘汤治疗,观察两组治疗前后的临床疗效,症状缓解时间(咳痰消失时间、哮鸣音消失时间、咳嗽消失时间、喘息消失时间),肺功能指标[用力肺活量(FVC)、第1秒用力呼吸容积(FEV_(1))、第1秒用力呼气量占所有呼气量的比例(FEV_(1)/FVC)、最大呼气流量(PEF)、呼气中断流速(PEF25%)、呼吸中期瞬间流速(PEF50%)、呼吸后期瞬间流速(PEF75%)],血清炎症因子指标[C反应蛋白(CRP)、白细胞介素-22(IL-22)、白细胞介素-4(IL-4)],Toll样受体2(TLR2)、Toll样受体4(TLR4)表达水平。结果治疗后治疗组总有效率94.74%显著高于对照组71.05%(P<0.05);治疗组症状缓解时间快于对照组(P<0.05);治疗后两组FVC、FEV_(1)、FEV_(1)/FVC、PEF、PEF25%、PEF50%、PEF75%值均较治疗前升高且治疗组高于对照组(P<0.05);治疗后两组血清CRP、IL-22、IL-4、TLR2、TLR4水平均较治疗前降低,且治疗组CRP[(10.23±3.26)mg/L比(15.25±5.37)mg/L]、IL-22[(37.13±9.84)ng/L比(45.46±11.08)ng/L]、IL-4[(48.15±12.28)ng/L比(56.07±14.36)ng/L]、TLR2[(16.78±1.91)ng/L比(21.15±2.08)ng/L]、TLR4[(18.05±2.53)ng/L比(22.44±3.27)ng/L]低于对照组(P<0.05)。结论苏葶止喘汤联合西医治疗小儿支气管哮喘急性发作期临床疗效显著。

品管圈活动提高门诊哮喘患儿用药依从率应用效果分析

目的探索品管圈对门诊哮喘患儿用药依从率的应用效果。方法成立品管圈(2022年2~8月),以“提高门诊哮喘患儿用药依从率”为主题,运用质量管理工具开展活动。结果实施品管圈活动后,门诊哮喘儿童用药依从率由45%提高至72.5%,完成设定目标;患者满意度由92%提高到98%,健康教育知晓率由86%提高到98%;圈员们在解决问题能力、品管手法、沟通协调能力较前大幅上升。结论品管圈活动可有效提高门诊哮喘患儿用药依从率,同时能完善相关制度和流程,药师在专业能力及职业素养方面得到全面提升。

“互联网+”药学服务模式对哮喘患儿用药依从性及病情控制的影响

目的 探讨“互联网+”药学服务模式对哮喘患儿用药依从性及病情控制的影响。方法 本研究为随机对照试验,收集2020年6月至2023年6月在我院治疗的183例支气管哮喘患儿作为研究对象,按照随机数字表法平均分为对照组和观察组。对照组行常规药学服务,观察组接受“互联网+”药学服务模式,对比两组哮喘患儿用药依从性、儿童哮喘控制测试(C-ACT)评分、肺功能指标和血清生物标志物的变化。结果 与对照组相比,观察组治疗后用药依从性和C-ACT得分提升,肺功能指标改善,血清IgE、IL-4、TNF-α等指标降低,组间差异均具有统计学意义(P<0.05)。结论 “互联网+”药学服务模式可以改善哮喘患儿的用药依从性,改善哮喘控制水平,适合用于儿童哮喘的长期管理。

儿童支气管哮喘的药物治疗研究进展

支气管哮喘是儿科常见呼吸系统疾病,严重危害儿童身心健康、生活质量,甚至危及生命。目前,临床上对于儿童支气管哮喘常选用药物治疗,以达到缓解病痛、抑制病情持续恶化的目的。其常用药物主要分为两类,一类是控制性药物,一类是缓解性药物,分别通过不同的方式产生相应功效,从而平稳地控制病情发展,提高患儿的生活质量。随着临床对儿童支气管哮喘的深入研究,未来其药物的利用将越来越合理化,并研发出各种新药。

儿童哮喘诊断标准及预测工具的研究进展

近年来我国儿童支气管哮喘(哮喘)患病率明显上升且控制水平尚不理想,由于哮喘诱因多样、表现形式多样、预后不一等导致即使目前有明确的诊断标准,仍难以被基层或非专科医生掌握,因此建立明晰的诊断标准非常迫切。哮喘预测工具主要用于预测喘息患儿在学龄期被诊断哮喘的风险,其临床实用性、有效性以及局限性仍有待进一步研究。本文对目前国内外儿童哮喘诊断标准和哮喘预测工具的相关研究进展进行总结,为儿童哮喘的规范诊断和治疗奠定基础,保证哮喘患儿的临床控制及肺功能正常,促进患儿健康成长。