脾氨肽口服液治疗变应性鼻炎的疗效及对T淋巴细胞亚群免疫平衡的影响

冯波; 张伟炜; 郑启; 何勇

doi:10.16766/j.cnki.issn.1674-4152.002230

脾氨肽口服液治疗变应性鼻炎的疗效及对T淋巴细胞亚群免疫平衡的影响

doi: 10.16766/j.cnki.issn.1674-4152.002230

宁波大学医学院附属医院耳鼻咽喉科，浙江宁波 315020

基金项目:

浙江省医药卫生科技计划项目 2020KY874

详细信息

通讯作者:
冯波, E-mail: fl11700@163.com

中图分类号: R765.21
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- 被引次数: 0
出版历程
- 收稿日期: 2020-05-18
- 网络出版日期: 2022-03-02

The therapeutic effect of Spleen Aminopeptide Oral Solution on allergic rhinitis and immune balance of T lymphocyte subsets

Department of Otolaryngology, Affiliated Hospital of Ningbo University Medical College, Ningbo, Zhejiang 315020, China

摘要

摘要: 目的探究脾氨肽口服液用于变应性鼻炎治疗的临床效果，并分析其对患者血清T淋巴细胞亚群的影响。方法选取2018年4月—2019年5月宁波大学医学院附属医院收治的变应性鼻炎患者93例，采用随机数字表法分为脾氨肽组(46例)与常规组(47例)，对比2组临床疗效、T淋巴细胞亚群、免疫功能及生活质量。结果脾氨肽组总有效率高于常规组(P=0.031)；治疗后，脾氨肽组CD3⁺[(70.33±6.89)%]、CD4⁺[(39.28±4.31)%]及CD4⁺/CD8⁺(1.64±0.39)均高于常规组[(59.46±7.26)%、(36.04±4.76)%、1.35±0.43，均P＜0.001]，CD8⁺[(24.12±2.38)%]低于常规组[(26.34±2.11)%，P＜0.001]；治疗后脾氨肽组血清白介素-2[(75.52±10.48)pg/mL]、γ-干扰素[(85.56±6.24)pg/mL]高于常规组[(69.27±8.53)pg/mL、(68.81±7.07)pg/mL]，白介素-4[(115.58±34.45)pg/mL]、白介素-5[(625.64±114.28)pg/mL]水平低于常规组[(168.37±40.22)pg/mL、(837.57±117.49)pg/mL，均P＜0.001]；治疗后脾氨肽组鼻结膜炎生活质量评分低于常规组(P＜0.001)。结论脾氨肽口服液可提高变应性鼻炎疗效，发挥免疫调节作用，减轻机体变态反应与临床症状。
- 脾氨肽口服液 /
- 变应性鼻炎 /
- T淋巴细胞亚群 /
- 免疫功能
Abstract: Objective To explore the therapeutic effect of Spleen Aminopeptide Oral Solution on allergic rhinitis and immune balance of T lymphocyte subsets. Methods A total of 93 patients with allergic rhinitis admitted to our hospital were randomly divided into Spleen Aminopeptide group (n=46) and regular group (n=47) according to the random number table method. The clinical efficacy, T lymphocyte subsets, immune function and quality of life of the two groups were compared. Results The total effective rate of the Spleen Aminopeptide group which was higher than that of the regular group (P=0.031). After treatment, the CD3⁺ [(70.33±6.89)%]、CD4⁺ [(39.28±4.31)%] and CD4⁺/CD8⁺ (1.64±0.39) in the Spleen Aminopeptide group were higher than those in the regular group [(59.46±7.26)%、(36.04±4.76)%、1.35±0.43, all P < 0.001], and the CD8⁺[(24.12±2.38)%] was lower than that in the regular group [(26.34±2.11)%, P < 0.001]. After treatment, the levels of serum interleukin-2 [(75.52±10.48) pg/mL] and interferon-γ [(85.56±6.24) pg/mL] in the Spleen Aminopeptide group were higher than those in the regular group [(69.27±8.53) pg/mL, (68.81±7.07) pg/mL], the levels of serum interleukin-4 [(115.58±34.45) pg/mL] and serum interleukin-5 [(625.64±114.28) pg/mL] were lower than those in the regular group [(168.37±40.22) pg/mL, (837.57±117.49) pg/mL, all P < 0.001]. After treatment, the rhinoconjunctivitis quality of life questionnaire (RQLQ) score of the Spleen Aminopeptide group was lower than that of the regular group (P < 0.001). Conclusion Spleen Aminopeptide Oral Solution can improve the curative effect of allergic rhinitis, play the role of immune regulation, reduce the body allergy and clinical symptoms.
- Spleen Aminopeptide Oral Solution /
- Allergic rhinitis /
- T lymphocyte subsets /
- Immune function

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表 1 2组变应性鼻炎患者临床疗效比较[例(%)]

组别	例数	显效	有效	无效	总有效
脾氨肽组	46	29(63.04)	13(28.26)	4(8.70)	42(91.30)
常规组	47	21(44.68)	14(29.79)	12(25.53)	35(74.47)
统计量			2.115^a		4.626^b
P值			0.034		0.031
注：^a为Z值，^b为χ²值。

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表 2 2组变应性鼻炎患者T淋巴细胞亚群比较(x±s)

组别	例数	CD3⁺(%)		CD4⁺(%)		CD8⁺(%)		CD4⁺/CD8⁺
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
脾氨肽组	46	50.32±5.74	70.33±6.89^a	31.28±5.03	39.28±4.31^a	29.53±3.61	24.12±2.38^a	1.06±0.28	1.64±0.39^a
常规组	47	49.53±6.35	59.46±7.26^a	30.66±4.72	36.04±4.76^a	29.87±3.44	26.34±2.11^a	1.10±0.31	1.35±0.43^a
t值		0.629	7.403	0.613	8.524	0.465	4.762	0.653	3.404
P值		0.531	< 0.001	0.541	< 0.001	0.643	< 0.001	0.516	0.001
注：与治疗前比较，^aP＜0.05。

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表 3 2组变应性鼻炎患者免疫功能相关指标比较(x±s，pg/mL)

组别	例数	IL-2		INF-γ		IL-4		IL-5
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
脾氨肽组	46	68.42±8.53	75.52±10.48^a	67.49±8.06	85.56±6.24^a	271.46±51.78	115.58±34.45^a	976.73±132.25	625.64±114.28^a
常规组	47	67.83±9.36	69.27±8.53	66.73±7.61	68.81±7.07	275.39±47.63	168.37±40.22^a	981.46±128.42	837.57±117.49^a
t值		0.318	3.157	0.468	12.104	0.381	6.791	0.175	8.815
P值		0.752	0.002	0.641	< 0.001	0.704	< 0.001	0.861	< 0.001
注：与治疗前比较，^aP＜0.05。

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表 4 2组变应性鼻炎患者生活质量评分比较(x±s，分)

组别	例数	治疗前	治疗后	t值	P值
脾氨肽组	46	78.65±19.83	28.53±11.76	14.744	< 0.001
常规组	47	76.49±21.32	37.17±14.48	10.459	< 0.001
t值		0.506	3.155
P值		0.614	0.002

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参考文献(20)

[1]	李伟, 江晶. 安庆地区变应性鼻炎变应原调查分析[J]. 中国中西医结合耳鼻咽喉科杂志, 2020, 28(1): 29-32. https://www.cnki.com.cn/Article/CJFDTOTAL-XYJH202001007.htm
[2]	刘婷, 任秀敏, 郝东阳, 等. 变应性鼻炎患者白细胞介素23和白细胞介素27对调节性T细胞/辅助性T细胞17细胞平衡的调控作用[J]. 中国耳鼻咽喉头颈外科, 2018, 25(6): 315-319. https://www.cnki.com.cn/Article/CJFDTOTAL-EBYT201806009.htm
[3]	丁敏, 潘家华. 儿童变应性鼻炎诊疗进展[J]. 中华全科医学, 2018, 16(12): 1958-1959. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201812002.htm
[4]	YONEKURA S, OKAMOTO Y, SAKURAI D, et al. An analysis of factors related to the effect of sublingual immunotherapy on Japanese cedar pollen induced allergic rhinitis[J]. Allergol Int, 2018, 67(2): 201-208. doi: 10.1016/j.alit.2017.07.005
[5]	时春明, 马秀慧, 金宝, 等. 脾氨肽辅治小儿支气管哮喘疗效及对肺功能和免疫功能的影响[J]. 解放军预防医学杂志, 2018, 36(5): 643-646. https://www.cnki.com.cn/Article/CJFDTOTAL-JYYX201805025.htm
[6]	中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 变应性鼻炎诊断和治疗指南(2015年, 天津)[J]. 中华耳鼻咽喉头颈外科杂志, 2016, 51(1): 6-24. doi: 10.3760/cma.j.issn.1673-0860.2016.01.004
[7]	JUNIPER E F, GUYATT G H, DOLOVICH J. Assessment of quality of life in adolescents with allergic rhinoconjunctivitis: Development and testing of a questionnaire for clinical trials[J]. J Allergy Clin Immunol Pract, 1994, 93(2): 413-423. doi: 10.1016/0091-6749(94)90349-2
[8]	中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉科分会. 变应性鼻炎的诊治原则和推荐方案(2004年, 兰州)[J]. 中华耳鼻咽喉头颈外科杂志, 2005, 40(3): 166-167. doi: 10.3760/j.issn:1673-0860.2005.03.003
[9]	葛文栋, 谭路, 陶泽璋, 等. 鼻喷型过敏原阻隔剂联合口服抗组胺药对尘螨过敏型变应性鼻炎患者的疗效评估[J]. 临床耳鼻咽喉头颈外科杂志, 2018, 32(1): 33-36. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH201801007.htm
[10]	宋柠颖, 吴琦, 刘锋. 不同剂型抗组胺药联合治疗常年性变应性鼻炎的短期疗效分析[J]. 成都医学院学报, 2018, 13(1): 37-40. doi: 10.3969/j.issn.1674-2257.2018.01.008
[11]	李娟, 程杰, 何艳. 鼻腔冲洗联合糠酸莫米松鼻喷雾剂治疗变应性鼻炎的疗效观察[J]. 重庆医学, 2016, 45(25): 3506-3507, 3513. doi: 10.3969/j.issn.1671-8348.2016.25.017
[12]	程冯丽, 祁雪萍, 赵长青, 等. 内源性糖皮质激素对小鼠变应性鼻炎免疫反应的影响[J]. 中华耳鼻咽喉头颈外科杂志, 2018, 53(10): 757-764. doi: 10.3760/cma.j.issn.1673-0860.2018.10.008
[13]	顾俊, 郭建林, 严华. 特异性免疫治疗对变应性鼻炎患者免疫平衡及炎症状态的影响[J]. 河北医药, 2020, 42(6): 896-899. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYZ202006024.htm
[14]	熊斯怡, 杨洋, 阮昊, 等. 变应性鼻炎免疫治疗的研究进展[J]. 免疫学杂志, 2018, 34(1): 86-92. https://www.cnki.com.cn/Article/CJFDTOTAL-MYXZ201801015.htm
[15]	COX L S. Sublingual Immunotherapy for Allergic Rhinitis: Is 2-Year Treatment Sufficient for Long-term Benefit?[J]. JAMA, 2017, 317(6): 591-593. doi: 10.1001/jama.2017.0128
[16]	王颖. 过敏性鼻炎-哮喘综合征168例临床分析[J]. 山西医药杂志, 2016, 45(23): 2804-2806. https://www.cnki.com.cn/Article/CJFDTOTAL-SXYY201623035.htm
[17]	张丽, 郝现伟, 王云茹, 等. 经面罩吸入糖皮质激素联合脾氨肽治疗过敏性鼻炎-哮喘综合征患儿的临床疗效分析[J]. 中国妇幼保健, 2018, 33(1): 102-104. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201801037.htm
[18]	田艳勋, 郝现伟, 刘丽敏, 等. 糖皮质激素联合脾氨肽治疗儿童过敏性鼻炎-哮喘综合征的研究[J]. 检验医学与临床, 2018, 15(10): 1477-1480. doi: 10.3969/j.issn.1672-9455.2018.10.033
[19]	王薇, 李玉雪, 胡民. 脾氨肽联合维生素A、E治疗反复性呼吸道感染患儿的临床效果及其对免疫功能的影响[J]. 临床误诊误治, 2019, 32(3): 21-24. doi: 10.3969/j.issn.1002-3429.2019.03.006
[20]	ASARIA M, DHAMI S, REE R V, et al. Health economic analysis of allergen immunotherapy (AIT) for the management of allergic rhinitis, asthma, food allergy and venom allergy: A systematic overview[J]. Allergy, 2017, 73(2): 269-283.