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目的评估益生菌联合布地奈德对支气管哮喘患儿外周血Th1/Th2平衡的调节作用及其治疗儿童支气管哮喘的临床疗效。方法采用随机、开放、平行对照研究方法,将45例患儿分为对照组(布地奈德吸入剂组)22例和观察组(布地奈德吸入剂+益生菌联合治疗组)23例,通过检测血浆Ig E水平,血浆Th1细胞相关因子[γ-干扰素(IFN-γ)]和Th2细胞相关因子[白细胞介素(IL-4)]表达水平,观察临床症状评分、生活质量评分、临床疗效和不良事件发生情况,评估其临床效果和安全性。结果两组药物治疗都可改善患儿的临床症状,但观察组改善更明显;治疗前两组患儿的CD+3、CD+4、CD+8百分比,CD+4/CD+8比值,Ig E、Th1、Th2及Th1/Th2与IL-4、IFN-γ,生活质量评分,症状评分水平比较差异未见统计学意义(P>0.05);治疗后观察组的CD+4/CD+8比值,Th1、Th2及Th1/Th2与IL-4、IFN-γ,生活质量评分,症状评分水平改善情况明显优于对照组,组间比较差异均有统计学意义(P<0.05)。结论布地奈德吸入治疗和益生菌+布地奈德吸入剂联合治疗儿童支气管哮喘都具有良好的疗效和安全性,但益生菌+布地奈德吸入剂联合治疗方法疗效更好,能有效改善患儿Th1/Th2免疫失衡,值得在临床上推广应用。
Objective To evaluate the regulatory effect of probiotics combined with budesonide on Th1 / Th2 balance in peripheral blood of children with bronchial asthma and its clinical efficacy in the treatment of children with bronchial asthma. Methods A total of 45 children were divided into control group (budesonide inhalation group) and observation group (budesonide inhalation + probiotics combined group) The level of plasma IgE, the level of plasma Th1-related cytokines (IFN-γ) and Th2 cell-related factor [interleukin (IL) -4) were measured to evaluate the clinical symptoms score, quality of life score Efficacy and adverse events, evaluate the clinical effect and safety. Results Both groups improved the clinical symptoms of children, but the improvement in the observation group was more obvious. Before the treatment, the percentage of CD + 3, CD + 4, CD + 8 and CD + 4 / CD + The levels of Ig E, Th1, Th2, Th1 / Th2 and IL-4, IFN-γ, quality of life score and symptom score had no significant difference (P> 0.05) 8 ratio, Th1, Th2 and Th1 / Th2 and IL-4, IFN-γ, quality of life scores and symptom scores were significantly improved compared with the control group, the difference was statistically significant (P <0.05). Conclusion Both budesonide inhalation and probiotics combined with budesonide inhalation have a good curative effect and safety in children with bronchial asthma, but the combined treatment of probiotics and budesonide inhalation is more effective and can effectively improve children with bronchial asthma Th1 / Th2 immune imbalance, it is worth to promote the clinical application.