Effect Of ICS Combined With Astragalus Granule On Inflammatory Cells And Mediators In Sputum Induced In Children With Asthma

Objective To observe the effect of inhaled corticosteroids(ICS)combined with Astragalus Granule on the level of inflammatory cells and inflammatory mediators in induced sputum of children with acute bronchial asthma and its clinical efficacy,and discuss the possible mechanism of influence to provide a certain basis for clinical treatment.Methods 60 cases of children with acute bronchial asthma admitted from December 2015 to December 2017 in our hospital were divided into two groups according to the random number table method.Group A: 30 cases were treated with nebulization and inhalation of ICS;Group B: 30 cases were treated with ICS atomization inhalation combined with Astragalus granule for oral treatment.Oxygen-driven inhalation of short-acting beta2 agonists(SABA)was used in both groups.The course of treatment was 10 days.20 cases of healthy physical examination children in the medical center of our hospital were selected as group C(healthy control group).The sputum smears were induced,and the sputum cells were counted and classified by Rayleigh staining in each group.Determination of expression level of IL-10,IL-13,IL-33 and IFN-gamma in sputum by enzyme linked immunosorbent assay(ELISA).Pulmonary ventilation function was monitored and compared before and after treatment.Results 1.Before treatment,There was no significant difference in the percentage of eosinophils,neutrophils,lymphocytes and monocytes in the sputum of A group and B group during the acute attack stage(P>0.05).The exception of lymphocyte was significantly higher than that in C group(P<0.01).2.After treatment for 10 d,the sputum eosinophils,neutrophils and monocytes in the two groups of A and B were significantly lower than those before treatment(P<0.01),And group B was significantly lower than group A(P<0.05).The percentage of lymphocytes in the total number of cells increased significantly,and the B group was significantly higher than that in the A group(P<0.05).There was no significant difference between the B group and the C group except eosinophil(P>0.05).3.There was no significant difference in the expression of IL-10,IL-13,IL-33 and IFN-gamma in the sputum induced by A and B two groups before treatment(P>0.05),but the level of IL-13 and IL-33 was higher than that of group C(P<0.01).The expression level of IL-10 and IFNgamma was significantly lower than that in group C(P<0.01).4.After treatment of 10 d,the expression level of IL-13 and IL-33 in A and B two groups were significantly lower than that before treatment(P<0.01),and group B was significantly lower than group A(P<0.05).The expression level of IL-10 and IFN-gamma in children was significantly higher than that before treatment(P<0.01),and group B was significantly higher than that in group A(P<0.05).There was no significant difference between group B and group C(P>0.05).5.There was no significant difference in FEV1 and FEV1% between the two groups before treatment(P>0.05).The indexes of lung function in the two groups after treatment were higher than those before treatment(P<0.05),and the improvement in group B was more significant than that in group A(P<0.05).Conclusion 1.the above inflammatory cells and mediators are overexpressed in the induced sputum in children with bronchial asthma,which can better reflect the chronic airway inflammation in children with bronchial asthma.2.nhaled glucocorticoid combined with Astragalus granule can significantly improve the expression level of inflammatory cells,media and pulmonary ventilation in sputum in children with bronchial asthma.3.the changes of the above inflammatory cells and mediators in the sputum can be used to judge the condition and guide the treatment.