| Part One Objective:To explore the application of capsaicin cough provocation test in children with asthma and chronic cough,Methods:1.Select 73 cases of children with asthma in remission stage,153 with chronic cough,include 33 cases of cough variant asthma(CVA), post infection cough(PIC) 23 cases, 76 cases of allergic rhinitis(AR) and22 of atopic cough(AC) between August 2015 to February 2016. The cough symptom scores were recorded, and tested with capsaicin, the concentration inducing two(C2) and five or more coughs(C5) was recorded, the lg C2 lg C5 was calculated as the cough reflex sensitivity.2. Follow-up of 48 cases of chronic cough children, which the AR 15 cases, CVA10 cases, PIC13 cases and AC10 cases. After treatment of cough alleviated or disappeared then ware tested with capsaicin and recorded C2 and C5.3 extraction in children with asthma in 35 cases, CVA 20 and AR 25 cases serum and determination of serum total Ig E(T Ig E), and test with capsaicin, exhaled nitric oxide(Fe NO), then analyze the data.Results: 1. lg C2 of normal control group, asthma in remission stage and chronic cough children had no significant difference, but lg C5 had a statistically significant difference between them, Cough symptom score of them had no significant difference. The mean lg C5 from PIC was significantly lower than the other groups, and the ranking was control group> asthma in remission stage > AR > CVA > AC > PIC.2. In the control group the lg C5 was more concentrated in 3.Athough the lg C5 PIC, AC CVA and asthma in remission stage was discrete, but the median was almost in 3.The lg C5 of PIC and AC discrete was similarity, but the median is not similar. This may suggested that outcome of the test in normal, asthma, chronic cough in children have overlap, so the diagnosis is not clear, it can help to understand the condition of cough.3. children with asthma in remission stage, AR and CVA showed that there was no significant difference between Fe NO, lg C5 and lg C2 in different T Ig E levels.4. 276 cases of children were tested with capsaicin, FEV1, PEF and PEF25-75 before and after the test was no significant decrease, only 1 case had nausea, but no one appeared wheezing, allergies, breathing difficulties and other serious symptom.Conclusion:Capsaicin provocation test can reflect the severity of cough, different diseases had different cough sensitivity, and capsaicin provocation test is safety in children.Part Two Objective:To observe the efficacy of short-medium term and low dose inhalation of corticosteroids of bronchial asthma and the effects on growth in children.Methods:A total of 64 children diagnosed with bronchial asthma between January 2014 and October 2014 were assigned to treatment and control group is 54.Comparisonsmain pulmonary function indicators, Growth velocity and Body mass index between the two groups were carried out before treatment and at 12,24 and 52 weeks after treatment.Results:At 12, 24 and 52 weeks after the treatment, the asthma group had significantly increased pulmonary function indicators(P<0.05); The GV and BMI showed no significant differences between the two groups at12, 24 and 52 weeks after treatment(P>0.05).Conclusion:Low dose ICS for one year reveals no apparent effect on the growth and development of children with asthma, while enhancing pulmonary function in those. |
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