布地奈德联合孟鲁司特钠治疗支气管哮喘的有效性和安全性及对肺功能的影响

为了探讨布地奈德联合孟鲁司特钠治疗支气管哮喘的有效性和安全性及对肺功能的影响,并探讨IL-23/IL-17轴在发病过程中的作用,本研究首先通过卵清蛋白(ovalbumin,OVA)给药诱导支气管哮喘大鼠实验模型,对大鼠分别应用布地奈德、孟鲁司特钠、布地奈德+孟鲁司特钠治疗,采用RT-PCR和免疫组化染色检查大鼠肺组织中IL-23和IL-17的表达。然后,将80例支气管哮喘患儿随机分为观察组和对照组,每组40例,观察组采用布地奈德联合孟鲁司特钠治疗,对照组采用布地奈德治疗,两组均治疗1周。比较两组治疗后的疗效、肺功能指标(呼吸频率,潮气量,达峰时间比(TPEF/VE)和达峰容积比(VPEF/VE))和炎症因子(IL-1β,IL-6,IL-17,IL-23和TNF-α)水平。研究显示,哮喘模型大鼠肺组织病变严重且IL-17和IL-23均为高表达(p<0.05)。布地奈德联合孟鲁司特钠对肺组织病理的改善效果更明显,且极大地抑制了IL-23/IL-17轴的激活。支气管哮喘患儿治疗后,观察组的有效率(95.00%)显著高于对照组(82.50%)。观察组的呼吸频率显著低于对照组,而潮气量、达峰时间比和达峰容积比均显著高于对照组(p<0.05)。观察组患儿的炎症因子水平均显著低于对照组(p<0.05)。本研究表明,在治疗支气管哮喘患儿过程中,布地奈德联合孟鲁司特钠通过抑制IL-23/IL-17轴的激活来抑制炎症因子的表达,从而改善了患者的肺功能并提高了治疗效果。

Efficacy and Safety of Budesonide Combined with Montelukast Sodium in the Treatment of Bronchial Asthma and Its Effect on Lung Function

To investigate the effectiveness and safety of budesonide combined with montelukast sodium in the treatment of bronchial asthma and its effect on lung function,and to explore the role of the IL-23/IL-17 axis in the pathogenesis,first,an experimental model of bronchial asthma was induced by ovalbumin(OVA)administration.Rats were treated with budesonide,montelukast sodium,budesonide+montelukast sodium,RT-PCR and immunohistochemical staining was used to examine the expression of IL-23 and IL-17 in rat lung tissue.Then,80 children with bronchial asthma were randomly divided into observation group and control group,40 cases in each group.The observation group was treated with budesonide and montelukast sodium,and the control group was treated with budesonide.Both groups were treated with 1 week.The efficacy,lung function indicators(respiratory frequency,tidal volume,peak time ratio(TPEF/VE)and peak volume ratio(VPEF/VE))and inflammatory factors(IL-1β,IL-6,IL-17,IL-23 and TNF-α)levels were compared.Studies showed that the lung tissue of asthma rats was severely diseased and both IL-17 and IL-23 were highly expressed(p<0.05).In addition,budesonide combined with montelukast sodium have a more significant effect on lung tissue pathology,and greatly inhibited the activation of the IL-23/IL-17 axis.After treatment of children with bronchial asthma,the effective rate in the observation group(95.00%)was significantly higher than that in the control group(82.50%).The respiratory frequency of the observation group was significantly lower than that of the control group,while the tidal volume,peak time ratio,and peak volume ratio were significantly higher than the control group(p<0.05).The levels of inflammatory factors in the observation group were significantly lower than those in the control group(p<0.05).This study shows that in the treatment of children with bronchial asthma,budesonide combined with montelukast sodium inhibits the expression of inflammatory factors by inhibiting the activation of the IL-23/IL-17 axis,thereby improving the patient’s lung function and improving the effect of treatment.