Clinical Research Of Combination Of Montelukast And Pidotimod In The Treatment Of Bronchiolitis

Background and objectiveAs the incidence of infantile bronchial asthma increased all over the world, it is not only a kind of chronic diseases which harm children’s physical and mental health, but also become a worldwide problem,because of the lower quality of life and the heavy burden of the family. A number of studies have confirmed that infants with asthmatic diseases have close correlation in children with bronchial asthma,no matter from the point of view of immunology and etiology.Treating infants and young children with asthmatic disease, shorten the course of the disease, regulating immunity in children asthmatic diseases,which is becoming more and more important to medical workers. This article will focus on infants and young children with bronchiolitis in-depth study,which is the most common type of asthmatic disease.Bronchiolitis is also called the "wheezing-pneumonia," which is the most common illness in infants and young children under 2 years-old and it is a common inflammation of lower respiratory tract. Bronchiolitis commonly led to acidosis, respiratory failure and heart failure. The typically symptoms and signs of bronchiolitis is wheezing,tachypea,and respiratory distress. Bronchiolitis is the most common respiratory illness occurred in small airway, it can cause contraction of the smooth muscle of the airway, increased mucus secretion, especially the eosinophilic inflammation cell clustering result in small airway obstruction. In addition, the auxiliary type T cells subgroup imbalance is the key of the occurrence and progress of airway hyperresponsiveness(AHR), which is also the key factors for the development of asthma. Although the etiology of bronchiolitis is relatively clear, the incidence of it is increasing in recent years as the air pollution is aggravating. It is easy to break out repeatedly, and it is lack specific drugs. How to shorten the course of the disease, improving immune function of children, preventing the happening of the bronchiolitis is the key in this study.Although bronchodilators and corticosteroids may attenuate airway obstruction, their use remains controversial and empiric, and patients should be assessed individually to determine responsivessness.The sustainable of airway hyperresponsiveness turned it to be bronchial asthma. This research aimed at shortening the course of bronchiolitis, regulating on immune function, improving the respiratory the airway hyperresponsiveness. Materials and MethodsAccording to the diagnostic criteria for bronchiolitis as defined by Zhu Fu Tang Practical Pediatrics 8th Edition[3], 90 children with infant bronchiolitis from Jan 2014 to Nov 2015 were chosen as the subjects for study and randomly divided into Montelukast group(A group) 、Montelukast combined with Pidotimod group(B group) and a control group,with 30 cases in each group.These children including 52 males and 38 females, aged 4 months to 2 years, excluding foreign body aspiration, bronchial / vascular congenital malformations, primary immunodeficiency disease, miliary tuberculosis, whooping cough, the tumor oppression to the surrounding tissue of airway or the severe cases with respiratory failure, heart failure.The control group received routine treatment such as anti-virus and symptomatic treatment. In addition to routine treatment,the A group received Montelukast respectively for 3 months.The B group received Montelukast and Pidotimod respectively for 3 months besides routine treatment. The clinical efficacy of 3 groups was compared by the level of immunoglobulin A, immunoglobulin E and T lymphocyte subsets.Results1.The recovery rate of children in A group and B group was higher than the control group during hospitalization.2. After treatment for 3 months,the level of immunoglobulin A in B group was significantly higher than those before treatment and other groups(P < 0.05).3.After treatment for 3 months,CD3+, CD4+, CD4+/CD8+ in B group was significantly higher than before treatment and other groups.And CD8+ in B group of was significantly lower than before treatment and other groups. There were statistically significant differences in T lymphocyte subsets between A group and B group(P < 0.05).4.There were no statistically significant differences in the three groups in the level of immunoglobulin E after treatment for 3 months(P>0.05). ConclusionsMontelukast has higer curative effect on children with asthmatic disease and Pidotimod can improve immunity.It is worthy of popularization.