注射用母牛分枝杆菌对支气管哮喘病人的辅助治疗作用

目的:探讨注射用母牛分枝杆菌对支气管哮喘病人的辅助治疗作用。方法:初次诊断的轻度持续或中度持续支气管哮喘病人34例,随机分为2组。观察组19例,予沙美特罗替卡松(50／250μg,吸入,bid)联合母牛分枝杆菌22．5μg,im,q 10 d。对照组15例,除不用母牛分枝杆菌外,余同观察组。疗程均为3 mo,治疗前后观察血清细胞因子和肺功能水平。结果:2组治疗后白细胞介素4(IL-4)、白细胞介素5(IL-5)、免疫球蛋白E(IgE)下降,干扰素γ(IFN-γ)上升,但仅观察组中IL-5下降(46±s 13)ng·L~(-1)]和IgE下降(86±43)IU·L~(-1)]变化有非常显著意义(P＜0．01)。2组用力肺活量和第1秒用力呼气量变化无显著差异(P＞0．05)。观察组治疗后每日最大呼气流量有所上升,治疗mo 2、3与对照组比较,差异非常显著(P＜0．01)。结论:注射用母牛分枝杆菌可促进Th 1型细胞因子分泌,抑制Th 2型细胞因子分泌,调节Th 1／Th 2平衡;并可能在一定程度上减轻气道阻力,对支气管哮喘病人具有明显辅助治疗作用。

Assisted therapeutic effect of Mycobacterium vaccae on asthma patients

AIM:To explore the assisted therapeutic effect of Mycobacterium vaccae(M.vaccae)on asthmatic patients.METHODS:Thirty-four asthmatic patients in mild or moderate persistent state were randomly enrolled into two groups:observation group(n=19)and control group(n=15).The patients in observation group inhaled salmeterol xinafoate and flulieasone propionate(50/250μg,bid)and intramuscular injection of M.vaccae(22.5μg,q 10 d)The patients in control group only used salmetrol xinafoate and flulieasone propionate.The levels of IFN-γ,IL-4,IL-5,IgE in serum and lung function were determined before and after the treatment with a course of 3 months for both groups.RESULTS:After the drug intervention in two groups,the level of IFN-γincreased and those of IL-4,IL-5 and IgE decreased.In observation group,the levels of IL-5 deceased(46±s 13)ng·L~(-1)(P＜0.01)and IgE deceased(86±43)IU·L~(-1)(P＜0.01). There were no significant different in levels of FVC and FEV_1 of lung function changes between two groups(P＞0.05).In observation group,the levels of PEF in 2nd and 3rd month increased than those in 1 st month,with significant difference compared to those in control group at the same time(P＜0.01).CONCLUSION :M.vaccae can provide assisted therapeutic effect on asthmatic patients,with contribution of the secretion of Thl cytokines, restraining the secretion of Th2 cytokines significantly,regulating the balance of Thl/Th2 and simultaneously to some extent lowing down the air way resistance.