高级检索

口服益生菌辅助治疗对过敏性哮喘儿童辅助性T细胞1/辅助性T细胞2失衡、肠道菌群、肺功能的调节作用

Regulatory effect of oral probiotics adjuvant therapy on imbalance of helper T cell 1/helper T cell 2, intestinal flora and pulmonary function in children with allergic asthma

    摘要
  • 摘要:
    目的 探讨口服益生菌辅助治疗对过敏性哮喘儿童辅助性T细胞1(Th1)/辅助性T细胞2(Th2)失衡、肠道菌群、肺功能的调节作用及临床疗效。
    方法 回顾性分析122例过敏性哮喘患儿的临床资料，依据治疗方案的不同将患儿分为对照组60例及观察组62例。对照组采用常规治疗联合布地奈德方案，观察组在对照组基础上加用口服益生菌辅助治疗。比较2组患儿的哮喘控制效果儿童哮喘控制测试(C-ACT)评分、肠道菌群(大肠杆菌、双歧杆菌、乳酸杆菌)、肺功能相关指标呼气流速峰值占预测值百分比(PEF%pred)、呼出气一氧化氮(FeNO)、第1秒用力呼气容积占预测值百分比(FEV1%pred)、呼吸力学参数呼吸功(WOB)、气道阻力(Raw)、气道峰压(PIP)、肺动态顺应性(Cdyn)、痰黏附分子整合素α4β1、血管细胞黏附分子-1(VCAM-1)、细胞间黏附分子-1(ICAM-1)水平、Th1/Th2细胞因子相关指标白细胞介素-4(IL-4)、γ干扰素(IFN-γ)、IFN-γ与IL-4比值(IFN-γ/IL-4)、Th1与Th2比值(Th1/Th2)水平、症状消失时间、临床疗效和不良反应发生率。
    结果 治疗后，观察组C-ACT评分、临床总有效率、IFN-γ/IL-4、Th1/Th2和乳酸杆菌、双歧杆菌、PEF%pred、FEV1%pred、Cdyn、IFN-γ水平均高于对照组，不良反应发生率和大肠杆菌、FeNO、Raw、WOB、PIP、整合素α4β1、VCAM-1、ICAM-1、IL-4水平均低于对照组，症状消失时间短于对照组，差异有统计学意义(P < 0.05)。Naranjo量表总得分为3分，提示药物不良反应与益生菌使用的因果关系为“可能有关”。
    结论 口服益生菌辅助治疗可调节儿童过敏性哮喘引起的Th1/Th2失衡，改善过敏性哮喘患儿的临床疗效、肺功能、呼吸力学参数、肠道菌群结构及痰黏附分子水平。

     

    Abstract:
    Objective To explore the regulatory effect of oral probiotics as adjuvant therapy on the imbalance of helper T cell 1 (Th1)/helper T cell 2 (Th2), intestinal flora and lung function in children with allergic asthma and its clinical efficacy.
    Methods A retrospective analysis was conducted in the clinical data of 122 children with allergic asthma. According to different treatment regimens, the children were divided into control group (n=60) and observation group (n=62). The control group received conventional treatment combined with budesonide, while the observation group received oral probiotics as adjunctive therapy in addition to the treatment in the control group. The asthma control effectsChildhood Asthma Control Test (C-ACT) score, intestinal flora (Escherichia coli, Bifidobacterium, Lactobacillus), relevant lung function indicatorspeak expiratory flow as a percentage of predicted value (PEF%pred), fractional exhaled nitric oxide (FeNO), forced expiratory volume in one second as a percentage of predicted value (FEV1%pred), respiratory mechanics parameterswork of breathing (WOB), airway resistance (Raw), peak inspiratory pressure (PIP), dynamic lung compliance (Cdyn), levels of sputum adhesion molecules integrin α4β1, vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), levels of Th1/Th2 cytokine-related indicatorsinterleukin-4 (IL-4), interferon-γ (IFN-γ), the ratio of IFN-γ to IL-4 (IFN-γ/IL-4), the ratio of Th1 to Th2 (Th1/Th2), symptom disappearance time, clinical efficacy, and the incidence of adverse reactions were compared between the two groups.
    Results After treatment, the observation group demonstrated significantly higher C-ACT scores, overall clinical response rates, IFN-γ/IL-4 and Th1/Th2 ratios, along with elevated levels of Lactobacillus, Bifidobacterium, PEF%pred, FEV1%pred, Cdyn and IFN-γ compared to the control group (P < 0.05). Conversely, adverse reaction rates, and levels of Escherichia coli, FeNO, Raw, WOB, PIP, integrin α4β1, VCAM-1, ICAM-1 and IL-4 were significantly lower in the observation group (P < 0.05). Symptom resolution time was also shorter in the observation group (P < 0.05). The total Naranjo scale score was 3, indicating a "possible" causal relationship between adverse drug reactions and probiotic use.
    Conclusion Oral probiotics as adjunctive therapy can effectively regulate Th1/Th2 imbalance induced by allergic asthma in children, improve clinical outcomes, pulmonary function, respiratory mechanics, intestinal microbiota composition, and sputum adhesion molecule levels.

     

    • HTML全文
    • 参考文献(25)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回