使用罗伊氏乳杆菌作为辅助治疗儿童新诊断哮喘在菲律宾三级医院

J. Villanueva, Agnes M. Gonzalez-Andaya
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引用次数: 0

摘要

原理:益生菌是对宿主有益的活微生物,包括减轻过敏性疾病症状。特别是罗伊氏乳杆菌被证明可以减轻过敏性气道,当用作治疗儿童哮喘的辅助药物时,与安慰剂相比,可以降低呼出的一氧化氮和白细胞介素水平。然而,关于罗伊氏乳杆菌作为治疗过敏性疾病,特别是过敏性气道疾病的辅助药物的重要性,目前的信息不足。目的:本研究的目的是确定罗伊氏乳杆菌作为辅助药物控制新诊断的儿童哮喘的疗效。方法和人群:在这项分析性、实验性、前瞻性、随机对照试验中,从圣托马斯大学医院门诊部招募了44名6-18岁的哮喘患者,研究期为3个月。基线临床评估包括皮肤点刺试验、肺量测定和儿童哮喘控制试验。哮喘的严重程度和控制水平分别基于国家哮喘教育和预防计划的专家小组3 (EPR-3)和2018年全球哮喘指南倡议。患者随机分组,其中一半患者每日1次给予罗伊氏乳杆菌26.5 mg/咀嚼片(至少1亿菌落形成单位),连续30天,另一半患者不给予。在干预开始时、干预后1个月、2个月和3个月分别进行肺活量测定和C-ACT测试作为基线。将实验组患者的结果与对照组患者的结果进行比较。结果:罗伊氏乳杆菌组患者FEV1显著高于对照组(p = 0.045)。两组FVC中位数随时间变化差异有统计学意义(p = 0.007),其中罗伊氏乳杆菌组FVC显著高于对照组。罗伊氏乳杆菌组和对照组患者的ACT评分有统计学上的显著改善,特别是在治疗2个月和3个月时。在多致敏患者中,罗伊氏乳杆菌与对照组相比,FEV1、FEF25-75和FVC均有显著改善。结论:在新诊断的哮喘患儿中,使用罗伊氏乳杆菌辅助治疗可显著改善肺功能和控制哮喘症状。关键词:罗伊氏乳杆菌;益生菌;哮喘
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The Use of Lactobacillus reuteri as an Adjunct in the Treatment of Children with Newly Diagnosed Asthma in a Tertiary Hospital in the Philippines
Rationale: Probiotics are live microorganisms that exert beneficial effects on the host, including a reduction of allergic disease symptoms. Lactobacillus reuteri in particular was shown to attenuate the allergic airway, and when used as an adjunct in the treatment of asthma in children, resulted in decreased fractional exhaled nitric oxide and interleukin levels when compared to placebo. However, insufficient information is available regarding the significance of L. reuteri as an adjunct in the treatment of allergic disorders, particularly in allergic airway disease. Objectives: The objective of the study was to determine the efficacy of L. reuteri as an adjunct for the control of newly diagnosed asthma in children. Methodology and Population: In this analytical, experimental, prospective, randomized controlled trial, 44 asthmatic patients aged 6–18 years were recruited from the University of Santo Tomas Hospital outpatient department, for a study period of three months. Baseline clinical assessment included skin prick test to aeroallergens, spirometry, and Childhood Asthma Control Test. Asthma severity and level of control was based on the National Asthma Education and Prevention Program’s Expert Panel 3 (EPR-3) and the Global Initiative for Asthma Guidelines 2018, respectively. Patients were randomized and half of them received L. reuteri 26.5 mg/chewable tab (at least 100 million colony forming units) once daily for 30 days, while the other half did not. Spirometry and C-ACT test were conducted at the start of intervention as baseline, after one month, two months, and three months post intervention. The results of patients from the experimental group were compared to results of patients in the control group. Results: The FEV1 of patients in the L. reuteri group was significantly higher than those in the control group (p = 0.045). The median FVC of the two groups significantly differed from each other through time (p = 0.007), with the L. reuteri group having significantly higher FVC than the control group. There were statistically significant improvements in ACT scores between patients in the L. reuteri and control groups, particularly at two months and three months of treatment. Among polysensitized patients, there were significant improvements in the FEV1, FEF25–75, and FVC between the L. reuteri and control group. Conclusion: The use of L. reuteri as an adjunct was associated with significant lung function improvement and asthma symptom control amongst newly diagnosed asthmatic children. Key Words: Lactobacillus reuteri, Probiotics, Asthma, Children
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