酪酸梭菌活菌散对支气管哮喘患儿辅助性T细胞17、调节性T细胞及其相关细胞因子和肠道菌群的影响

目的 探讨酪酸梭菌活菌散对支气管哮喘患儿辅助性T细胞17(Th17细胞)、调节性T细胞(Tr细胞)及其相关细胞因子和肠道菌群的影响。方法 选择2018年3月至2020年6月新乡医学院第三附属医院收治的97例支气管哮喘患儿为研究对象，根据治疗方法将患儿分为观察组(n=49)和对照组(n=48)。对照组患儿给予吸入用布地奈德混悬液、吸入用异丙托溴铵溶液和孟鲁司特钠颗粒治疗；在对照组治疗基础上，观察者组患儿给予酪酸梭菌活菌散治疗，2组患儿均治疗2个月。应用流式细胞仪检测2组患儿治疗前后Th17细胞和Tr细胞水平，并计算Th17细胞与Tr细胞的比值(Th17/Tr);采用酶联免疫吸附试验检测2组患儿治疗前后血清中白细胞介素-17(IL-17)、白细胞介素-10(IL-10)水平。使用儿童肺功能仪检测2组患儿治疗前后第1秒用力呼气容积(FEV₁)、FEV₁/用力肺活量(FVC)、呼气流量峰值(PEF)日变异率；分别于治疗前后收集并培养2组患儿新鲜粪便，观察肠道菌群分布情况。治疗期间观察2组患儿不良反应发生情况，治疗后评估患儿临床疗效；所有患儿治疗后随访...

Effect of Clostridium butyricum powder on helper T cell 17,regulatory T cells and their related cytokines and intestinal flora in children with bronchial asthma

Objective　To investigate the effect of Clostridium butyricum powder on helper T cell 17 (Th17 cell),regulatory T cell (Tr cell) and their related cytokines and intestinal flora in children with bronchial asthma.Methods　A total of 97 children with bronchial asthma admitted to the Third Affiliated Hospital of Xinxiang Medical University from March 2018 to June 2020 were selected as the study subjects,and the children were divided into observation group (n=49) and control group (n=48) according to the treatment methods.The children in the control group were treated with budesonide suspension for inhalation,ipratropium bromide solution for inhalation and montelukast sodium oral granules.On the basis of the treatment in the control group,the children in the observation group were treated with Clostridium butyricum powder.The children in both groups were treated for two months.The levels of Th17 cells and Tr cells of children in the two groups were detected by flow cytometry before and after treatment,and the ratio of Th17 cells to Tr cells (Th17/Tr) was calculated.The levels of serum interleukin-17 (IL-17) and interleukin-10 (IL-10) of children in the two groups were detected by enzyme-linked immunosorbent assay.The forced expiratory volume in the first second (FEV₁),FEV₁/forced vital capacity (FVC) and daily variation rate of peak expiratory flow (PEF) of children in the two groups were measured by pulmonary function tester before and after treatment.The fresh feces of children in the two groups were collected and cultured before and after treatment to observe the distribution of intestinal flora.The adverse reactions of children in the two groups were observed during the treatment,and the clinical efficacy was evaluated after treatment.All children were followed up for two months after treatment,and the number of acute asthma attacks per month was recorded.Results　There was no significant difference in Th17/Tr and serum IL-17,IL-10 levels of Children between the two groups before treatment (P>0.05).Compared with before treatment,the levels of Th17/Tr and serum IL-17 of children in the two groups decreased significantly after treatment,and the level of serum IL-10 increased significantly (P<0.05).After treatment,the levels of Th17/Tr and serum IL-17 of children in the observation group were significantly lower than those in the control group,and the level of serum IL-10 was significantly higher than that in the control group (P<0.05).There was no significant difference in the FEV₁,FEV₁/FVC and the daily variation rate of PEF of children between the two groups before treatment (P>0.05).Compared with before treatment,the FEV₁ and FEV₁/FVC of children in the two groups increased significantly,and the daily variation rate of PEF decreased significantly after treatment (P<0.05).After treatment,the FEV₁ and FEV₁/FVC of children in the observation group were significantly higher than those in the control group,and the daily variation rate of PEF was significantly lower than that in the control group (P<0.05).There was no significant difference in the number of colonies of Clostridium butyricum,Escherichia coli and Enterococcus faecalis in the feces of children between the two groups before treatment (P>0.05).There was no significant difference in the number of colonies of Lactobacillus,Clostridium butyricum,Escherichia coli and Enterococcus faecalis in the feces of children in the control group before and after treatment (P>0.05).Compared with before treatment,the number of colonies of Lactobacillus and Clostridium butyricum in the feces of children in the observation group increased significantly after treatment,while the number of colonies of Escherichia coli decreased significantly (P<0.05).There was no significant difference in the number of Enterococcus faecalis colonies in the feces of children in the observation group before and after treatment (P>0.05).After treatment,the number of colonies of Lactobacillus and Clostridium butyricum in the feces of children in the observation group was significantly higher than that in the control group,and the number of colonies of Escherichia coli was significantly lower than that in the control group (P<0.05).There was no significant difference in the number of Enterococcus faecalis colonies in the feces between the two groups after treatment (P>0.05).The total effective rate of children in the observation group and the control group was 95.91% (47/49) and 81.25% (39/48),respectively.The total effective rate of children in the observation group was significantly higher than that in the control group(χ²=5.189,P<0.05).The number of acute asthma attacks per month in the observation group and the control group was 0.42±0.24 and 0.84±0.33,respectively.The number of acute asthma attacks per month of children in the observation group was significantly lower than that in the control group (P<0.05).There was no obvious adverse reaction of children in the both groups during treatment.Conclusion　Clostridium butyricum powder can effectively improve the immune function,inhibit inflammatory reaction,regulate the balance of intestinal flora,and improve the lung function and clinical symptoms in children with bronchial asthma.