孟鲁司特联合噻托溴铵对支气管哮喘缓解期患者的影响

魏胜全, 薛华, 王惠霞, 贾汝臻

魏胜全, 薛华, 王惠霞, 贾汝臻. 孟鲁司特联合噻托溴铵对支气管哮喘缓解期患者的影响[J]. 实用临床医药杂志, 2020, 24(14): 48-52. DOI: 10.7619/jcmp.202014013
引用本文: 魏胜全, 薛华, 王惠霞, 贾汝臻. 孟鲁司特联合噻托溴铵对支气管哮喘缓解期患者的影响[J]. 实用临床医药杂志, 2020, 24(14): 48-52. DOI: 10.7619/jcmp.202014013
WEI Shengquan, XUE Hua, WANG Huixia, JIA Ruzhen. Effect of montelukast combined with tiotropium bromide in bronchial asthma patients in remission stage[J]. Journal of Clinical Medicine in Practice, 2020, 24(14): 48-52. DOI: 10.7619/jcmp.202014013
Citation: WEI Shengquan, XUE Hua, WANG Huixia, JIA Ruzhen. Effect of montelukast combined with tiotropium bromide in bronchial asthma patients in remission stage[J]. Journal of Clinical Medicine in Practice, 2020, 24(14): 48-52. DOI: 10.7619/jcmp.202014013

孟鲁司特联合噻托溴铵对支气管哮喘缓解期患者的影响

基金项目: 

陕西省卫生厅科研项目(2014JM04023)

详细信息
    通讯作者:

    魏胜全,E-mail:chensj781@163.com

  • 中图分类号: R562.2

Effect of montelukast combined with tiotropium bromide in bronchial asthma patients in remission stage

  • 摘要: 目的 探讨孟鲁司特联合噻托溴铵对支气管哮喘缓解期患者诱导痰中炎症介质、T细胞亚群水平和黏附因子水平的影响。 方法 选取支气管哮喘缓解期患儿96例,采用随机数字表将96例患儿分为观察组和对照组,每组48例。对照组给予噻托溴铵治疗,观察组给予孟鲁司特联合噻托溴铵治疗, 2组均连续治疗3个月。比较2组治疗前后肺功能指标,诱导痰中炎性因子、T细胞亚群和黏附因子水平变化及治疗中不良反应。 结果 治疗后,观察组第1秒用力呼气容积(FEV1)、用力肺活量(FVC)和最大用力呼吸峰流量占预计值百分比(PEF%)均显著高于对照组(P<0.05); 观察组诱导痰中白细胞介素-6(IL-6)、白细胞介素-8(IL-8)和肿瘤坏死因子(TNF-α)水平显著低于对照组(P<0.05); 诱导痰中Th1、CD8+CD28-、CD4+CD25+ 水平显著高于对照组, Th2、Th17水平显著低于对照组(P<0.05); 观察组诱导痰中细胞间黏附分子-1(ICAM-1)、血管黏附分子-1(VCAM-1)、CD44水平显著低于对照组(P<0.05)。2组不良反应发生率差异无统计学意义(P>0.05)。 结论 孟鲁司特联合噻托溴铵治疗支气管哮喘缓解期患者,能有效减轻气道局部炎症、黏附性,调节免疫功能。
    Abstract: Objective To explore the effects of montelukast combined with tiotropium bromide on the levels of inflammatory mediators, T cell subsets and adhesion factors in induced sputum of patients with bronchial asthma during remission. Methods A total of 96 children patients with bronchial asthma during remission period were selected. According to random number table method, 96 children patients were divided into observation group and control group, with 48 cases in each group. Control group was treated with tiotropium bromide, and observation group was given montelukast combined with tiotropium bromide, and the two groups were continuously treated for 3 months. The levels of lung function indexes and inflammatory factors, T cell subsets and adhesion factors in induced sputum before and after treatment, and adverse reactions during treatment were compared between the two groups. Results After treatment, the forced expiratory volume in 1 second(FEV1), forced vital capacity(FVC)and percentage of maximum forced respiratory peak flow in predicted value(PEF%)in the observation group were significantly higher than those in the control group(P<0.05); the levels of interleukin-6(IL-6)、interleukin-8(IL-8)and tumor necrosis factor(TNF-α)in the observation group were significantly lower than those in the control group(P<0.05); the Th1,CD8+CD28- and CD4+CD25+ in induced sputum were significantly higher than those in the control group, while the Th2 and Th17 were significantly lower than those in the control group(P<0.05); the levels of intercellular adhesion molecule-1(ICAM-1), vascular cell adhesion molecule-1(VCAM-1)and CD44 in - induced sputum in the observation group were significantly lower than those in control group(P<0.05). There was no statistically significant difference in the incidence rate of adverse reactions between the two groups(P>0.05). Conclusion Montelukast combined with tiotropium bromide in the treatment of patients with bronchial asthma during remission can effectively recieve local airway inflammation and adhesion, and regulate immune function.
  • 文华. 孟鲁司特治疗对支气管哮喘患者肺功能及Th1、Treg平衡的调节作用[J]. 现代中西医结合杂志, 2017, 26(11): 1219-1221.
    张瑶, 任洛, 高钰, 等. 246例支气管哮喘急性发作住院患儿呼吸道病原学及临床特征分析[J]. 临床儿科杂志, 2018, 36(11): 60-64.
    李涛, 李丽华, 白雪明. 孟鲁司特钠联合运动处方在儿童哮喘防治中的临床研究[J]. 临床肺科杂志, 2015, 20(6): 1099-1101.
    高焕焕, 王庞, 孙耕耘, 等. 噻托溴铵联合用药治疗老年支气管哮喘的临床疗效观察[J]. 安徽医药, 2017, 21(5): 921-924.
    中华医学会儿科学分会呼吸学组. 儿童支气管哮喘诊断与防治指南(2016年版)[J]. 中华儿科杂志, 2016, 54(3): 167-181.

    LAJQI N, ILAZI A, KASTRATI B, et al. Comparison of glucocorticoid(budesonide)and antileukotriene(montelukast)effect in patients with bronchial asthma determined with body plethysmography[J]. Acta Inform Med, 2015, 23(6): 347-351.

    郑贵浪, 吴家兴. 孟鲁司特治疗儿童支气管哮喘的临床疗效及肺功能和细胞因子变化研究[J]. 中国全科医学, 2015,18(12): 1387-1389

    , 1395.

    ALVARADO-GONZALEZ A, ARCE I. Tiotropium bromide in chronic obstructive pulmonary disease and bronchial asthma[J]. J Clin Med Res, 2015, 7(11): 831-839.

    李玉磊, 刘莉敏, 张瑞芳, 等. 噻托溴铵在重度支气管哮喘患者中的疗效分析[J]. 临床肺科杂志, 2017, 22(8): 1397-1399.
    李凯歌, 盛亚琳. 孟鲁司特联合噻托溴铵治疗支气管哮喘96例[J]. 陕西医学杂志, 2016, 45(3): 358-359.

    KANG H W, OH H J, PARK H Y, et al. Endobronchial amyloidosis mimicking bronchial asthma: a case report and review of the literature[J]. Open Med(Wars), 2016, 11(1): 174-177.

    刘晓冬. 三步序贯法对老年SDA患者诱导痰和BALF相关指标的影响[J]. 西南国防医药, 2017, 27(11): 1156-1159.
    张惠芬, 李俊华. Toll样受体4在儿童哮喘发作中的作用及对IL-6、IL-8、TNF-α表达的影响[J]. 临床和实验医学杂志, 2015, 14(6): 445-448.
    田祖慧, 左凤琼, 张魏. 哮喘患儿诱导痰中T细胞亚群和细胞因子的变化及意义[J]. 海南医学院学报, 2016, 22(1): 72-74

    , 78.

    田戈, 姜敏, 王晶, 等. 支气管哮喘患者外周血TH1、TH2、TH17及Treg细胞相关细胞因子的表达及意义[J]. 临床检验杂志, 2016, 34(10): 780-781.

    JIN F, XIE Y C, ZHANG M S, et al. Ligustrazine corrects Th1/Th2 and Treg/Th17 imbalance in a mouse asthma model[J]. Int Immunopharmacol, 2014, 21(1): 76-81.

    MUKHOPADHYAY S, MALIK P, ARORA S K, et al. Intercellular adhesion molecule-1 as a drug target in asthma and rhinitis[J]. Respirology, 2014, 19(4): 508-513.

    李院玲, 陈荣, 张芙蓉, 等. 舒利迭对比氟替卡松联合孟鲁司特对哮喘患者肺功能与临床症状的影响[J]. 实用临床医药杂志, 2019, 23(20): 25-27

    , 31.

    闫翠萍, 高婵娟. 孟鲁司特联合吸入沙美特罗替卡松治疗支气管哮喘的临床效果[J]. 科学养生, 2019, 22(12): 85-85.
    刘云. 布地奈德福莫特罗联合孟鲁司特钠治疗支气管哮喘的有效性观察[J]. 中国社区医师, 2019, 35(33): 24-24

    , 28.

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  • 收稿日期:  2020-03-20

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