关键词:

支气管哮喘, 儿童, 沙丁胺醇, 肺部康复训练, 炎症因子, 肺功能

Abstract:

Objective　To analyze the effect of lung rehabilitation training on the airway inflammatory factors and lung function in children with severe acute bronchial asthma treated with salbutamol, so as to provide therapeutic basis for clinical treatment of severe acute bronchial asthma. Methods　A prospective study was conducted on 102 children with acute attack of severe bronchial asthma who were admitted to the Third Affiliated Hospital of Zhengzhou University from September 2021 to February 2023, and the children were divided into two groups (a reference group and a treatment group) by the random number table method, with 51 cases in each group. In the reference group, there were 32 boys and 19 girls, the age was 5-12 (7.32±1.85) years old, the course of disease was 2-18 (12.30±1.28) months, and the body weight was 12-27 (21.65±2.08) kg. In the treatment group, there were 28 boys and 23 girls, the age was 6-13 (7.94±1.16) years old, the course of disease was 2-17 (11.89±2.31) months, and the body weight was 11-28 (22.32±2.17) kg. After admission, both groups were given anti-infection treatment with budesonide, the reference group was treated with salbutamol, and the treatment group was treated with salbutamol combined with pulmonary rehabilitation training. The treatment cycle of both groups was 1 month. The clinical effects, disappearance time of clinical symptoms (dyspnea, cough, wheezing, wheezing rales, and moist rales), and levels of inflammatory factors [interleukin-4 (IL-4), IL-18, IL-1β, and eosinophils (EOS)] and lung function [forced expiratory flow at 50% (FEF50%), peak expiratory flow (PEF), forced expiratory volume in the first second (FEV₁), and forced vital capacity (FVC)] before and 1 month after treatment of the two groups were compared. t and χ² tests were applied. Results　The total effective rate of the treatment group was higher than that of the reference group [96.08% (49/51) vs. 82.35% (42/51)] (χ²=4.993, P<0.05). Compared with those in the reference group [(5.23±1.03) d, (4.32±1.30) d, (2.36±0.26) d, (6.22±1.63) d, and (5.89±1.07) d], the duration of dyspnea, cough, wheezing, wheezing rales, and moist rales in the treatment group [(2.25±0.69) d, (2.03±0.85) d, (2.23±0.32) d, (5.63±1.10) d, (3.62±1.04) d] were shorter, with statistically significant differences (t=17.166, 10.529, 2.252, 2.143, and 10.864, all P<0.05). After 1 month of treatment, the levels of serum IL-4, IL-18, IL-1β, and EOS in the treatment group were lower than those in the reference group [(25.30±3.96) ng/L vs. (28.30±3.47) ng/L, (92.03±7.36) ng/L vs. (100.65±8.66) ng/L, (2.03±0.26) ng/L vs. (2.89±0.32) ng/L, (1.06±0.39)% vs. (2.84±0.52)%], with statistically significant differences (t=4.069, 5.417, 14.896, and 19.557, all P<0.05). After 1 month of treatment, the levels of FEF50%, PEF, FEV1, and FVC in the treatment group were higher than those in the reference group, with statistically significant differences (all P<0.05). Conclusion　Lung rehabilitation training can improve the clinical effect, shorten the disappearance time of clinical symptoms such as dyspnea and cough, alleviate the airway inflammation, promote the recovery of lung function, and accelerate the recovery in children with severe bronchial asthma treated with salbutamol in acute stage.

Key words:

Bronchial asthma, Children, Salbutamol, Pulmonary rehabilitation training, Inflammatory factors, Pulmonary function