哮喘儿童免疫功能变化及槐杞黄干预研究

发布时间：2018-07-13 14:15

【摘要】：目的:了解哮喘缓解期儿童免疫功能状态,通过应用中药淮杞黄90天后观察哮喘患儿ACT量表、肺功能、一氧化氮和上呼吸道感染次数变化,以期探讨中药槐杞黄对哮喘儿童免疫功能的影响。方法:我们对中国大连市儿童医院呼吸科的哮喘儿童进行了15个月的前瞻性研究。研究在2014年6月至2015年8月之间进行。我们将随机选取的137例患者分为两组;第一组(治疗组)包括97例接受中药槐杞黄规律治疗的患者,第二组(对照组)包括40例仅仅接受标准治疗的患者。所有的患者均在入院的当天和接受上述治疗的90天后接受ACT(哮喘控制测试)、FENO(呼气一氧化氮检测)、上呼吸道感染次数(URTI)以及FEV1测试。我们使用SPSS22.0软件分析数据。结果:1.哮喘患儿平均年龄为5.25岁(n=137,S.D=1.790)。其中89例(64.96%)为男孩;48例(35.04%)为女孩。按照年龄分组,4-6岁的患儿占82.48%,7-13岁患儿占17.52%。2.在纳入标准并进行免疫功能测试的40例患者中,65%存在免疫功能低下和异常免疫功能结果,其中以细胞免疫异常和体液免疫异常混合为主占42%,其次为体液免疫异占31%,单纯细胞免疫异常最少占4%。3.在符合纳入标准的137例哮喘缓解期患儿中,达到哮喘控制良好水平共72例,治疗组有47例,对照组25例。达到哮喘控制不良水平共65例,治疗组有50例,对照组15例。治疗组与对照组治疗后ACT评分均有改善,p0.05,差异有统计学意义。其中哮喘控制不良患儿中治疗组哮喘控制水平优于对照组,p0.01,差异有统计学意义。4.在符合纳入标准的137例哮喘缓解期患儿中,做肺功能检查患儿共35例,治疗组20例,对照组15例。治疗组与对照组治疗后FEV1评分均有改善,p0.05,差异有统计学意义。两组间比较,p0.05,无显着性差异,结果无统计学意义。5.在符合纳入标准的137例哮喘缓解期患儿中,患上呼吸道感染共60例,其中治疗组30例,对照组30例。应用HQH后治疗后两组URTI均较前减少,p0.05,显著差异;治疗组与对照组相比,治疗组URTI明显降低,p0.05,显著差异,有统计学意义。6.在符合纳入标准的137例哮喘缓解期患儿中,做Fe NO患儿共40例,治疗组20例,对照组20例。应用HQH后治疗组FENO明显降低,p0.05,显著差异,有统计学意义;对照组FENO无明显降低,p0.05,无显著差异,结果没有统计学意义。结论:1.哮喘缓解期患儿4/5为学龄前期,男孩多于女孩。2.哮喘缓解期患儿中约有超过3/5的患者免疫功能存在着免疫功能紊乱,以体液免疫与细胞免疫混合免疫异常为主。3.哮喘缓解期患儿系统吸入表面糖皮质激素治疗,可以有效提高FEV1和哮喘控制水平。哮喘缓解期患儿哮喘控制测试水平未达到良好控制,应用HQH可以辅助提高哮喘控制水平。4.哮喘患儿在系统吸入表面糖皮质激素治疗基础上,应用免疫调节剂中药淮杞黄,观察3个月,槐杞黄有利于降低气道炎症水平,减少上呼吸道感染次数。
[Abstract]:Objective: to investigate the immune function of children in remission period of asthma and observe the changes of ACT, pulmonary function, nitric oxide and the times of upper respiratory tract infection in children with asthma after 90 days of application of Huai Qi Huang. The aim of this study was to investigate the effect of Huai Qi Huang on the immune function of asthmatic children. Methods: a prospective 15-month study of asthmatic children in respiratory department of Dalian Children's Hospital was conducted. The study was conducted between June 2014 and August 2015. We randomly divided 137 patients into two groups: the first group (treatment group) consisted of 97 patients who received the regular treatment of Sophora chinensis and the second group (control group) consisted of 40 patients who received standard treatment only. All patients were treated with ACT (Asthma Control Test) FENO (Expiratory nitric oxide), Upper Respiratory tract infection (URTI), and FEV1 tests on the day of admission and 90 days after the above treatment. We use SPSS 2. 0 software to analyze data. The result is 1: 1. The average age of asthmatic children was 5.25 years old (NX 137 S.D 1.790). Among them, 89 cases (64.96%) were boys and 48 cases (35.04%) were girls. Children aged 4 to 6 years old accounted for 82. 48% of children aged 7 to 13 years old, accounting for 17. 52%. 2. Of the 40 patients who were included in the criteria and tested for immune function, 65% had hypoimmune function and abnormal immune function. The mixture of cellular immune abnormality and humoral immune abnormality accounted for 42% of the total, followed by humoral immune abnormality accounting for 31%, and simple cellular immune abnormality at least 4. 3%. Among 137 asthmatic remission children who met the inclusion criteria, 72 cases reached the level of good asthma control, 47 cases in the treatment group and 25 cases in the control group. There were 65 cases with poor control of asthma, 50 cases in the treatment group and 15 cases in the control group. The ACT scores of the treatment group and the control group were improved after treatment (P 0.05), and the difference was statistically significant. The asthma control level in the treatment group was better than that in the control group (P 0.01), and the difference was statistically significant. There were 35 children with lung function, 20 patients in the treatment group and 15 patients in the control group. FEV 1 scores in the treatment group and the control group were improved (P 0.05), and the difference was statistically significant. There was no significant difference between the two groups (P 0.05), and there was no significant difference between the two groups. There were 60 cases of upper respiratory tract infection in 137 asthmatic remission children, including 30 cases in the treatment group and 30 cases in the control group. After treatment with HQH, the URTI of the two groups was significantly lower than that of the former group (P 0.05), while that of the treatment group was significantly lower than that of the control group (P 0.05). Of 137 asthmatic remission children who met the inclusion criteria, 40 were treated with FeNO, 20 in the treatment group and 20 in the control group. After HQH, FENO in the treatment group was significantly lower than that in the control group, and there was no significant difference in FENO between the control group and the control group. Conclusion 1. Four out of five children with asthma in remission were pre-school, with more boys than girls. More than 3 / 5 of the children in remission stage of asthma have immune function disorder, mainly humoral immunity and cellular immunity. Inhaled surface glucocorticoid therapy can effectively improve FEV 1 and asthma control in asthmatic remission children. The asthma control test level in children with asthma in remission stage was not well controlled, and HQH could help to improve asthma control level. 4. On the basis of systemic inhalation of surface glucocorticoid, Huai Qi Huang, an immunomodulator, was used in asthmatic children. For 3 months, Huai Qi Huang was beneficial to reduce the level of airway inflammation and reduce the number of upper respiratory tract infection.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.6

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