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[摘要]
目的 探讨细菌溶解产物胶囊联合吸入用布地奈德混悬液治疗儿童反复呼吸道感染支气管炎的临床疗效。方法 选取2014年3月-2015年3月克拉玛依市中心医院收治的反复呼吸道感染支气管炎患儿78例,将所有患儿采用随机数字表法分为对照组和治疗组,每组各39例。对照组雾化吸入吸入用布地奈德混悬液1 mg,2次/d。治疗组在对照组基础上口服细菌溶解产物胶囊3.5 mg,1次/d,每月连用10 d,停20 d。两组患儿均连续治疗3个月。观察两组的临床疗效,同时比较两组治疗前后免疫球蛋白IgA、IgM、IgG、白介素4(IL-4)、白介素10(IL-10)、干扰素γ(IFN-γ)、肿瘤坏死因子α(TNF-α)水平及TNF-α mRNA表达量,记录12个月内呼吸道感染次数。结果 治疗后,对照组、治疗组的总有效率分别为74.36%、92.31%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组IL-4、TNF-α水平及TNF-α mRNA表达量均下降,IgA、IgM、IgG、IL-10、IFN-γ水平均上升,同组治疗前后比较差异具有统计学意义(P<0.05),且治疗组这些指标的改善情况优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗组上呼吸道感染次数、下呼吸道感染次数少于对照组,两组比较差异具有统计学意义(P<0.05)。结论 细菌溶解产物胶囊联合吸入用布地奈德混悬液治疗儿童反复呼吸道感染支气管炎具有较好的临床疗效,可明显改善体液免疫功能,降低炎性反应,具有一定的临床推广应用价值。
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[Abstract]
Objective To explore the clinical effect of Bacterial Lysates Capsules combined with Budesonide Suspension for inhalation in treatment of recurrent respiratory tract infection in children. Methods Children (78 cases) with recurrent respiratory tract infection in the Karamay Central Hospital from March 2014 to March 2015 were divided into the control and treatment groups according to the random number table, and each group had 39 cases. Children in the control group were given Budesonide Suspension for inhalation 1 mg, twice daily. Children in the treatment group were po administered with Bacterial Lysates Capsules on the basis of the control group 3.5 mg, once daily, used for 10 d, and stop for 20 d in one month. Children in two groups were treated for 3 months. After treatment, the efficacy was evaluated. The levels of immunoglobulin IgA, IgM, IgG, interleukin 4 (IL-4), interleukin 10 (IL-10), interferon gamma (IFN-γ), tumor necrosis factor (TNF-α), and TNF-α mRNA expression were detected. After 12 months of continuous observation, times of respiratory tract infection were recorded. Results After treatment, the efficacies in the control and treatment groups were 74.36% and 92.31%, respectively, and there was difference between two groups (P<0.05). After treatment, levels of IL-4 and TNF-α and TNF-α mRNA expression in the two groups were significantly decreased, while levels of IgA, IgM, IgG, IL-10, and IFN-γ were increased, and the differences were statistically significant in the same group (P<0.05). After treatment, the observational indexes were significantly better than those in the control group, with significant difference between two groups (P<0.05). The times of upper respiratory tract infection and lower respiratory tract infection in the treatment group were less than those in the control group, with significant difference between two groups (P<0.05). Conclusion Bacterial Lysates Capsules combined with Budesonide Suspension for inhalation has good clinical efficacy in treatment of recurrent respiratory tract infection in children, can obviously improve the humoral immune function, and reduce the inflammatory reaction, which has a certain clinical application value.
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