Clinical Efficacy Analysis Of Standardized Subcutaneous Immunotherapy Combined With Salmetroticasone Powder Inhalant In Moderate Childhood Asthma

Objectives1.A randomized,controlled trial was conducted to objectively evaluate the clinical efficacy of standardized subcutaneous immunotherapy combined with salmetroticasone powder inhalant in the treatment of children with moderate asthma,and to clarify its advantages in the treatment of children with moderate asthma.2.To explore the mechanism of immunotherapy through cytokine level and provide a reliable treatment plan for clinical follow-up treatment.MethodsA total of 160 children aged 5-12 years who were diagnosed with moderate childhood asthma and whose allergen was dust mites in my hospital from April 2018 to March 2021 were selected.A randomized,controlled trial was conducted and divided into control group(80 cases,treated with salmetroticasone powder inhalant)and treatment group(80 cases,Standardized subcutaneous immunotherapy combined with salmetroticasone powder inhalant).Before and 12,24 and 36 months after treatment regular follow-up of the number of asthma attacks,immunoinflammatory response[interleukin 4(IL-4),expiratory NO(FeNO)],effective efficacy of asthma control,adverse reactions,before and after treatment assessment of childhood asthma control test(C-ACT)score and estimated percentage of first-second expiratory flow rate to expected value(FEV1 accounts for%of expected value)and peak expiratory flow rate as a percentage of the expected value(PEF accounts for%of expected value)to evaluate lung function,Two groups were compared with the number of asthma attacks,immune inflammatory response[interleukin 4(IL-4),expiratory nitric oxide(FeNO)],asthma control efficacy,adverse reactions,and disease conditions and pulmonary function indicators before and 12,24,and 36 months after treatment.Data was analyzed by SPSS 24.0;mean ± standard deviation[(x ± s)]for measurement data meeting normal distribution,group design t-test or rank sum test,one-way repeated measures ANOVA was used for the comparison of different time periods;count data were represented as cases(percentage)[n(%)],and by rank sum test or χ2 test.Results1.Number of asthma attacks:compared with before treatment,the number of attacks decreased significantly after 36 months of treatment(P<0.05),and the number of attacks in the treatment group was lower than that in the control group(P<0.01).2.Immunoinflammatory response:in treatment group and control group,IL-4 and FeNO were lower than before treatment,and IL-4 and FeNO in treatment group were lower than those in the control group(P<0.05).3.Therapeutic effect of asthma control:52 cases of obvious effect,26 cases of effective,2 cases of ineffective,control effective rate of 97.50%,46 cases of obvious effect,24 cases of effective,10 cases of ineffective,control effective rate of 87.50%,in treatment group control,effective rate is higher than in control group(P<0.05).4.Adverse reactions:In the treatment group,there were 4 local rash,2 dizziness/headache,0 cases of dyspnea,and the adverse reaction rate was 7.5%.In the control group,4 local rash,1 dizziness/headache,and 0 cases of dyspnea,the adverse reaction rate was 6.75%between the two groups(P>0.05).5.Patient’s condition:In the treatment group and in control group,the C-ACT scores were higher at 12,24 and 36 months after treatment than before treatment,and the C-ACT scores in the treatment group were higher at 12,24 and 36 months after treatment than in the control group(P<0.05).6.Lung function index:after treatment,at 12,24 and 36 months,in two group,FEV1 accounts for%of expected value and PEF accounts for%of expected value were higher than before,and at 12,24 and 36 months after treatment,FEV1 accounts for%of expected value and PEF accounts for%of expected value in treatment group were higher than those in control group(P<0.05).Conclusions1.Salmetroticasone combined with standardized subcutaneous immunotherapy for children with asthma whose allergen is dust mites has better clinical efficacy,and can improve clinical symptoms,immune inflammatory response,serum immunological indicators,disease condition and lung function more effectively.2.The mechanism of salmetroticasone combined with standardized subcutaneous immunotherapy may be related to the improvement of immune inflammatory response;3.On the basis of salmetroticasonet,combined with subcutaneous immunotherapy did not significantly increase adverse reactions in children.