目的 探讨核酪口服溶液联合丙酸氟替卡松治疗小儿支气管哮喘的临床疗效。方法 选取2018年6月—2021年8月郑州阳城医院儿科门诊收治的90例支气管哮喘患儿，所有患儿按照随机数字表法分为对照组和治疗组，每组各45例。对照组经鼻腔吸入丙酸氟替卡松吸入气雾剂，50～100µg/次，2次/d。治疗组在对照组基础上口服核酪口服溶液，5 mL/次，2次/d。两组观察其连续用药7 d。比较两组临床效果和症状好转时间，比较两组治疗前后免疫功能指标、血清炎症因子水平和不良反应。结果 治疗后，治疗组总有效率97.78%，显著高于对照组的84.44%（P＜0.05）。治疗后，治疗组出现咳嗽、喘息、胸闷、呼吸困难好转时间均明显短于对照组（P＜0.05）。治疗后，两组血清免疫球蛋白A（IgA）、血清免疫球蛋白G（IgG）、血清免疫球蛋白E（IgE）均显著高于同组治疗前（P＜0.05）；治疗后，治疗组免疫功能指标改善优于对照组（P＜0.05）。治疗后，两组血清白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、肿瘤坏死因子α（TNF-α）水平均显著降低，而白细胞介素-2（IL-2）水平显著升高（P＜0.05）；治疗后，治疗组血清炎症因子水平改善优于对照组（P＜0.05）。治疗组不良反应发生率8.89%，显著低于对照组的17.78%（P＜0.05）。结论 核酪口服溶液联合丙酸氟替卡松治疗支气管哮喘患儿具有较好的临床疗效，可明显改善患儿免疫功能，降低气道炎症反应，值得临床推广。

Objective To investigate the effect of Nucleotide and Casein Oral Solution combined with fluticasone propionate in treatment of children with bronchial asthma. Methods A total of 90 children with bronchial asthma treated in the Pediatric Outpatient Department of Zhengzhou Yangcheng Hospital from June 2018 to August 2021 were selected. All children were divided into control group and treatment group according to random number table method, with 45 cases in each group. Patients in the control group were inhaled Fluticasone Propionate Inhalation Aerosol, 50 — 100 µg/time, twice daily. Patients in the treatment group were po administered with Nucleotide and Casein Oral Solution on the basis of the control group, 5 mL/time, twice daily. Patients in two groups were treated for 7 d. After treatment, the clinical effect and symptom improvement time were compared between the two groups, and the immune function indexes, serum inflammatory factor levels and adverse action were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the treatment group was 97.78%, significantly higher than that of the control group (84.44%) (P < 0.05). After treatment, the improvement time of cough, wheezing, chest tightness, and dyspnea in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, serum immunoglobulin A (IgA), serum immunoglobulin G (IgG), and serum immunoglobulin E (IgE) in two groups were significantly higher than before (P < 0.05). After treatment, the immune function index of the treatment group improved better than that of the control group (P < 0.05). After treatment, the serum levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α) were significantly decreased, while the level of interleukin-2 (IL-2) was significantly increased in two groups (P < 0.05). After treatment, the level of serum inflammatory factors in the treatment group was better than that in the control group (P < 0.05). The incidence of adverse reactions in treatment group was 8.89%, significantly lower than 17.78%in control group (P < 0.05). Conclusion Nucleotide and Casein Oral Solution combined with fluticasone propionate has good clinical efficacy in treatment of children with bronchial asthma, and can significantly improve immune function and reduce airway inflammation, which is worthy of clinical promotion.

R974

河南省医学科技攻关计划(联合共建)项目(LHGJ20190102)