Clinical Research Of Inhaling Budesonide On Treating Reversible Airway Hyperreactivity Disease

BackgroundThe essence of bronchial asthma is an airway chronical inflammatory disease referred to cells (for instance,eosinophile granulocyte, mast cell, T cell, neutrophile granulocyte, airway cellula epithelialis) and celelular component. This chronical inflammation induce increase of airway hyperresponsiveness. Commonly, it represented the reversible limition of airflow, which was extensive and changeful, aroused the symptoms of paroxysmal pant, short of breath cough. The symptom of asthma often outbreaks and was aggravated at night or in the early morning, which of most patients can be relieved with or without treatment. The outbreak of asthma is affected by both genetic factor and environment factor. In recent years, accompany with improving of living environment of human being,attack rate and death rate of asthma raise year by year. World Health Organization define asthma as a treatment disease for life. At present it is generally considered that glucocorticosteroid is the most valid medicine which can control and prevent asthmatic attack.However, glucocorticosteroid which is given through intravenous injection or peros usually ineluctably has a lot of side effect.In order to reduce the side effect of glucocorticosteroid,inhaled glucocorticosteroid was advanced after 50's in 20 centuries.Inhaled glucocorticosteroid can reached to arget organ quickly, and it is the best medicine method of bronchial asthma. In 1972 ICS has been applicated in clinical, but it has not been extensively applied.Inhaled budesonide was go on the market in 1981, which gives the new desire to the asthma.Being the new generation of the inhaled glucocorticosteroid, its high performance and safety make it excel others as a crane among chickens at this treatment of the realm. The ICS has become the forefront medicine of asthma treatment currently and been recommended as the capital anti-inflammatory agent to cure light-midrange asthmatic attack, and it is also the first choosen therapy in《global asthma managementand prevention strategy》to prevent and cure chronic asthma. Inhaled budesonide has already been extensively applied by the clinical medical workers. The safety problem of applied over a long period of time,the curative effect of glucocorticosteroid, and the mechanism that glucocorticosteroid treat the asthma is valued by people more and more.PurposeInvestgate the effect of inhaling budesonide in treating asthma through determining lung function,eosinophile granulocyte count, the T cell subgroup and the IL-3, and reclamate new pathway of the treatment of asthma.MethodThe sample who is hospitalizated in our hospital and diagnosed identifily as a midrange asthma impatient was selected.The thirty-two samples were divided into 2 groups at random,control group and treatment group, there were 16 samples for each. The control group uses conventional therapy contain antibiotics, aminophylline; at this foundation the treatment group add inhaled treatment which contain budesonide 0.5 mg and 0.9% isotonic Na chloride 3ml, twice in a day. The time of therapy is two weeks in the two groups. Determine lung function, the T cell subgroup, IL-3 and acidophilia granulocyte count before and after treatment, contrasting the amend whether or not have difference in statistics.Result1. The level of IL-3 was heighten before treatment and after treatment the level was decreased, but still higher then health adult.In the two group there was significantly statistical difference between the level before and after treatment (P<0.05), the level in the treatment group was significantly higher than that in the control group(P<0.05). 2. After treatment, the lung function is improved obviously ,and the treatment group was obvious higher than that in the control (P<0.05). 3. There is disproportion of leukomonocyte subgroup in asthma patients,before treatment CD4 /CD8,percentage of NK was higher,but after treatment the counting is decreased. The descending of the treatment group is more obvious in two groups (P<0.05)4. Eosinophile granulocyte count is increased in the acute episode time of asthma.The eosinophile granulocyte count after treatment was significantly lower than prior (P<0.05). The eosinophile granulocyte count in the treatment group has statistical significance compared with the control group(P<0.05). Conclusion1. The bronchial asthma is a kind of immunity relativity disease,there is change of leukomonocyte subgroup in asthma patients.CD4 T cell hyperfunction, CD8 T cell quantity decrease and insufficiency of function,and the NK cell amount and activity increase.After treatment the leukomonocyte subgroup can recover normally. 2. Eosinophile granulocyte count is considered as the main inflammation cell of asthma.It was increased regardless of period of onset or paracmasis in the asthma.The result has reflected that the airway inflammation didn't disappear completely after treatment,and the patients still need continue to cure. 3. IL-3 which is recognized as the key factor of EOS existence,can delay the procedure of apoptosis with IL-5, GM-CSF, and promote the occurrence and the development of asthma. 4. Inhaled glucocorticosteroid can control and prevention acute episode of asthma from a series of link.It should be payed attention by all clinical doctor, and be recommended to use actively.