目的 探討核酪口服溶液聯(lián)合丙酸氟替卡松治療小兒支氣管哮喘的臨床療效。方法 選取2018年6月—2021年8月鄭州陽城醫(yī)院兒科門診收治的90例支氣管哮喘患兒，所有患兒按照隨機(jī)數(shù)字表法分為對照組和治療組，每組各45例。對照組經(jīng)鼻腔吸入丙酸氟替卡松吸入氣霧劑，50～100µg/次，2次/d。治療組在對照組基礎(chǔ)上口服核酪口服溶液，5 mL/次，2次/d。兩組觀察其連續(xù)用藥7 d。比較兩組臨床效果和癥狀好轉(zhuǎn)時(shí)間，比較兩組治療前后免疫功能指標(biāo)、血清炎癥因子水平和不良反應(yīng)。結(jié)果 治療后，治療組總有效率97.78%，顯著高于對照組的84.44%（P＜0.05）。治療后，治療組出現(xiàn)咳嗽、喘息、胸悶、呼吸困難好轉(zhuǎn)時(shí)間均明顯短于對照組（P＜0.05）。治療后，兩組血清免疫球蛋白A（IgA）、血清免疫球蛋白G（IgG）、血清免疫球蛋白E（IgE）均顯著高于同組治療前（P＜0.05）；治療后，治療組免疫功能指標(biāo)改善優(yōu)于對照組（P＜0.05）。治療后，兩組血清白細(xì)胞介素-1β（IL-1β）、白細(xì)胞介素-6（IL-6）、腫瘤壞死因子α（TNF-α）水平均顯著降低，而白細(xì)胞介素-2（IL-2）水平顯著升高（P＜0.05）；治療后，治療組血清炎癥因子水平改善優(yōu)于對照組（P＜0.05）。治療組不良反應(yīng)發(fā)生率8.89%，顯著低于對照組的17.78%（P＜0.05）。結(jié)論 核酪口服溶液聯(lián)合丙酸氟替卡松治療支氣管哮喘患兒具有較好的臨床療效，可明顯改善患兒免疫功能，降低氣道炎癥反應(yīng)，值得臨床推廣。

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

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃(聯(lián)合共建)項(xiàng)目(LHGJ20190102)