细菌溶解产物联合孟鲁司特治疗儿童哮喘的疗效观察

中国临床药理学与治疗学 ›› 2010, Vol. 15 ›› Issue (5): 547-550.

细菌溶解产物联合孟鲁司特治疗儿童哮喘的疗效观察

高原¹, 钱旭波², 俞晨艺³, 宣妙燕³, 林振浪³

¹金华市中心医院儿科, 金华 321000,浙江;
²义乌东方医院, 义乌 322000,浙江;
³温州医学院附属育英儿童医院, 温州 325027,浙江

收稿日期:2010-03-17 修回日期:2010-04-22 出版日期:2010-05-26 发布日期:2020-09-16
通讯作者: 林振浪,男,主任医师,硕士生导师,研究方向:小儿呼吸科疾病及脑损伤研究。Tel: 0577-88816211 E-mail: linzhenlang@hotmail.com
作者简介:高原,女,医学硕士,副主任医师,从事新生儿科及小儿呼吸科疾病研究。Tel: 0579-82552513 E-mail: gaoyuan0579@qq.com
基金资助:
浙江省义乌市科研计划项目(08-3-05)

Therapeutic efficacy of bacterial lysates and montelukast treatment in children with intermittent asthma

GAO Yuan¹, QIAN Xu-bo², YU Chen-yi³, XUAN Miao-yan³, LIN Zhen-lang³

¹Department of Paediatrics, Jinhua Central Hospital, Jinhua 321000, Zhejiang,China;
²Yiwu Dongfang Hospital, Yiwu 322000, Zhejiang,China;
³The Yuying Children's Hospital of Wenzhou Medical College, Wenzhou 325027,Zhejiang, China

Received:2010-03-17 Revised:2010-04-22 Online:2010-05-26 Published:2020-09-16

摘要/Abstract

摘要： 目的: 探讨细菌溶解产物(泛福舒)联合孟鲁司特口服对间歇发作的支气管哮喘患儿的临床疗效及安全性。方法: 173例间歇发作的支气管哮喘患儿随机分为两组:实验组87例,用孟鲁司特咀嚼片口服12个月,前3个月同时服用细菌溶解产物;对照组86例,仅给予孟鲁司特咀嚼片口服12个月。两组均随访12个月,记录两组患儿临床表现、血液淋巴细胞亚群、免疫球蛋白及不良反应情况。结果: 173例中有156例(实验组76例, 对照组80例)完成随访12个月。与对照组比较,实验组的哮喘发作次数、呼吸道感染次数、发热天数、咳嗽天数与抗生素使用天数均少于对照组,差异均有统计学意义(P＜0.05)。治疗后3个月时,实验组CD₃⁺%、CD₄⁺%、CD₄⁺/CD₈⁺比值、血清IgA和唾液sIgA高于对照组,差异均有统计学意义(P＜0.01);两组CD₈⁺%、IgG、IgM和IgE差异无统计学意义(P＞0.05)。两组不良反应发生率比较差异无统计学意义(校正χ²=0.856,P＞0.05)。结论: 间歇发作的支气管哮喘患儿联合使用细菌溶解产物和孟鲁司特口服可显著减少哮喘发作次数,疗效明显优于单独使用孟鲁司特,两种药物联合使用无明显不良反应。

关键词: 儿童, 哮喘, 淋巴细胞亚群, 免疫球蛋白, 细菌溶解产物

Abstract: AIM: To determine the therapeutic efficacy of bacterial lysates (Broncho-Vaxom) plus montelukast treatment in children with bronchial asthma. METHODS: With parental approval, 173 children with intermittent asthma were randomized to receive montelukast plus bacterial lysates treatment as experimental group or receive montelukast treatment as a control group. The episodes of respiratory tract infection and asthma exacerbation, T lymphocyte subsets, immunoglobulin and the adverse events were recorded in the following 12 months. RESULTS: A total of 156 patients (76 in the experimental group, 80 in the control group) were completed in the study. Compared with control group, The frequencies of asthma exacerbation and respiratory tract infection,duration of fever, cough and antibiotics usage in experimental patients with bronchial asthma were significantly reduced (P＜0.05), and the levels of CD₃⁺%, CD₄⁺%, CD₄⁺/CD₈⁺, serum IgA and salivary slgA were obvious increased in the experimental group (P＜0.01).There were no significant differences in the level of CD₈⁺%, serum IgM and serum IgG between two groups(P＞0.05). No serious adverse events was reported in both groups (χ²=0.939, P＞0.05). CONCLUSION: The results of this study suggest that treatment with bacterial lysates and montelukast may be effective and safe in children withintermittent asthma.

Key words: Child, Asthma, Subsets of lymphocyte, Immunoglobulin, Bacterial lysates

中图分类号:

R562

高原, 钱旭波, 俞晨艺, 宣妙燕, 林振浪. 细菌溶解产物联合孟鲁司特治疗儿童哮喘的疗效观察[J]. 中国临床药理学与治疗学, 2010, 15(5): 547-550.

GAO Yuan, QIAN Xu-bo, YU Chen-yi, XUAN Miao-yan, LIN Zhen-lang. Therapeutic efficacy of bacterial lysates and montelukast treatment in children with intermittent asthma[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2010, 15(5): 547-550.

参考文献

[1] Bisgaard H, Zielen S, Garcia-Garcia ML, et al. Montelukast reduces asthma exacerbations in 2- to 5-year-old children with intermittent asthma[J]. Am J Respir Crit Care Med, 2005, 171(4): 315-322.
[2] Kumar A, Grayson MH. The role of viruses in the development and exacerbation of atopic disease[J]. Ann Allergy Asthma Immunol, 2009, 103(3):181-186.
[3] 全国儿科哮喘防治协作组. 中国城区儿童哮喘患病率调查[J]. 中华儿科杂志,2003, 41(2):123-127.
[4] Gutiérrez-Tarango MD, Berber A . Safety and efficacy of two courses of OM-85 BV in the prevention of respiratory tract infections in children during 12 months[J]. Chest, 2001, 119(6): 1742-1748.
[5] 全国儿科哮喘防治协作组. 儿童哮喘防治常规(试行) [J]. 中华儿科杂志,2004,42(2): 100-106.
[6] Holt PG, Sly PD. Th2 cytokines in the asthma late-phase response[J]. Lancet, 2007,370 (9596): 1396-1398.
[7] Wegmann M. Th2 cells as targets for therapeutic intervention in allergic bronchial asthma[J]. Expert Rev Mol Diagn, 2009, 9(1): 85-100.
[8] 吕小华, 吴铁, 覃冬云. 甘草对慢性小鼠哮喘模型气道炎症及外周血Th1/Th2失衡的影响[J]. 中国临床药理学与治疗学, 2006, 11(5): 532-534.
[9] Huber M,Mossmann H,Bessler WG.Th1-orientated immunological properties of the bacterial extract OM-85-BV[J].Eur J Med Res, 2005, 10(5): 209-217.
[10] Appay V, van Lier RA, Sallusto F, et al. Phenotype and function of human T lymphocyte subsets: consensus and issues[J]. Cytometry A, 2008, 73(11): 975-983.
[11] Balzar S, Strand M, Nakano T, et al. Subtle immunodeficiency in severe asthma: IgA and IgG2 correlate with lung function and symptoms[J]. Int Arch Allergy Immunol, 2006, 140(2): 96-102.
[12] Brandtzaeg P. Role of secretory antibodies in the defence against infections[J]. Int J Med Microbiol, 2003, 293(1): 3-15.

[1]	吴雄志, 王宣, 徐四七, 居霞, 王胜斌, 陈永权. 咪达唑仑口服溶液比右美托咪定喷鼻更有效缓解儿童术前焦虑[J]. 中国临床药理学与治疗学, 2023, 28(6): 666-670.
[2]	朱丽, 魏兵, 廖世峨, 张超, 郑晓宇, 刘亚军. 药物代谢酶细胞色素P450单核苷酸多态性影响哮喘儿童吸入皮质醇激素疗效研究[J]. 中国临床药理学与治疗学, 2023, 28(5): 536-543.
[3]	张志英, 靳秀红, 张小宁, 张向峰, 罗青林, 张松林. TBX21和ADCY9多态性在儿童哮喘发生发展中的临床研究[J]. 中国临床药理学与治疗学, 2023, 28(4): 407-412.
[4]	李晨豪, 喻喜华, 闫文浩, 柴宇霞, 李燕燕, 李锟, 李泽运. 儿童癫痫与维生素D相关性研究进展[J]. 中国临床药理学与治疗学, 2023, 28(11): 1299-1306.
[5]	赵子文, 范方田, 蒋志君. 诱导性支气管相关淋巴组织（iBALT）形成与相关肺疾病的研究[J]. 中国临床药理学与治疗学, 2022, 27(3): 353-360.
[6]	李佳佳, 陈蒙蒙, 王睿娴, 黄梦朦, 李军, 上官王宁. 阿芬太尼对扁桃体腺样体切除患儿气管插管效果的随机双盲研究[J]. 中国临床药理学与治疗学, 2022, 27(2): 184-189.
[7]	章权, 石仕元, 韩贵和. 1,25二羟维生素D3在脊柱结核治疗中的免疫调节作用[J]. 中国临床药理学与治疗学, 2021, 26(7): 787-793.
[8]	王媛媛, 洪钰, 张磊, 殷方雄, 雷婷, 朱熙. 儿科人血白蛋白药物利用评价标准的建立与应用[J]. 中国临床药理学与治疗学, 2021, 26(6): 653-661.
[9]	宣妙燕, 徐震. 小儿川崎病肠道菌群变化与特异性转录因子RORγt、FOXP3、T淋巴细胞亚群水平的关联性#br#[J]. 中国临床药理学与治疗学, 2021, 26(2): 154-160.
[10]	李静, 马丽娟, 袁圆, 王捷, 郁长治, 赵军. 吸入性糖皮质激素布地奈德相关基因多态性与哮喘疗效的关系[J]. 中国临床药理学与治疗学, 2021, 26(11): 1250-1258.
[11]	茹彩旺, 袁天明, 杨兵芬, 吴福根, 林应荣, 莫妙军. 亚胺培南-西司他丁钠联合免疫球蛋白对婴儿脓毒症并发弥散性血管内凝血的疗效[J]. 中国临床药理学与治疗学, 2020, 25(5): 559-565.
[12]	潘露萍，石武杰，沈志鹏. 依托泊苷联合卡铂用于复发性髓母细胞瘤患儿的疗效与安全性[J]. 中国临床药理学与治疗学, 2020, 25(2): 189-195.
[13]	张磊. 基于网络药理学的郁金治疗哮喘的作用机制研究[J]. 中国临床药理学与治疗学, 2020, 25(1): 61-67.
[14]	卜璋于，吴黎明，俞小虹，刘珏，邓琳. 柴胡解毒汤治疗尖锐湿疣的疗效观察和机制探讨[J]. 中国临床药理学与治疗学, 2019, 24(6): 681-686.
[15]	孙凯凯，黄春红，王云云，吴炜，陈智. HBV感染者外周血T淋巴细胞表面共刺激分子和T淋巴细胞亚群的检测及临床意义[J]. 中国临床药理学与治疗学, 2019, 24(3): 241-247.