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Objective To study the effects of dust mite immunotherapy on the hormonal dosage, specific immunoglobulins G4(sIgG4)level and pulmonary function in asthmatic children.Methods One hundred and twenty-four cases of asthmatic children were randomly divided into specific immunotherapy treatment(SIT) group (62 cases, treated with the dust mite immunotherapy) and inhaled corticosteroids (ICS) group (62 cases, treated with ICS). The changes of clinical symptoms, serum sIgG4 level, pulmonary function and ICS dosage before and after treatment were compared between two groups. Results After treatment for 12,18,and 24 months, the scores of childhood asthma control test(C-ACT) in SIT group were significantly higher than those in ICS group:(23.84 ± 1.15)scores vs.(22.75 ± 1.08) scores, (24.29 ± 1.27)scores vs.(23.17 ± 1.22)scores, (24.83 ± 1.40)scores vs.(23.88 ± 1.34)scores, there were significant differences (P<0.05). After treatment for 12, 24 months, the level of serum sIgG4 in SIT group were significantly higher than those in ICS group:(308.75 ± 102.96) μg/L vs. (239.64 ± 79.35) μg/L, (542.28 ± 113.37) μg/L vs. (243.65 ± 80.21) μg/L, there were significant differences (P<0.05). After treatment for 12, 24 months, the levels of percentage of forced expiratory volume in 1 second (FEV1%), percentage of maximal expiratory flow rate (PEF%) in SIT group were significantly higher than those in ICS group: FEV1%:(95.82 ± 7.64)% vs. (92.79 ± 8.52)%, (99.52 ± 8.17)% vs.(95.89 ± 7.53)%;PEF%:(95.78 ± 5.85)% vs.(93.54 ± 6.18)%,(99.77 ± 5.69)% vs. (97.61 ± 5.56)%, there were significant differences (P<0.05). After treatment for 12, 24 months, the scores of daytime asthma symptoms scale (DAS) and nocturnal asthma symptoms scale (NAS) in SIT group were significantly lower than those in ICS group:DAS:(1.75 ± 0.54)scores vs.(1.96 ± 0.60)scores, (0.84 ± 0.27) scores vs. (1.19 ± 0.38) scores;NAS: (0.75 ± 0.27) scores vs.(0.92 ± 0.30) scores, (0.55 ± 0.18)scores vs.(0.81 ± 0.24)scores, there were significant differences(P<0.05).After treatment for 12, 24 months, the dosage in SIT group was significantly lower than those in ICS group:(172.08±16.73)μg/d vs.(194.63 ± 14.17)μg/d,(138.09 ± 16.23)μg/d vs.(163.15 ± 15.38)μg/d, there were significant differences(P<0.05).Conclusions Dust mite immunotherapy can effectively improve the clinical symptoms and pulmonary function in children with dust mite allergy asthma and reduce the ICS dosage, it may be related to the increase of protective antibody sIgG4 in children.
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Objective To investigate the changes of airway function in different stages of asthma and its detection value.Methods One hundred and twenty children with acute exacerbation of asthma were selected as acute exacerbation group. The children were treated with routine asthma for 1 month. After that, children went into chronic duration (chronic duration group). The pulmonary function was measured in acute exacerbation group and chronic duration group,and the indexes were compared with those of 60 healthy children(healthy control group). Results The pulmonary function indexes of large airway forced vital capacity(FVC),peak expiratory flow(PEF),forced expired volume in 1 second(FEV1) and FEV1/FVC in acute exacerbation group were significantly lower than those in healthy control group and chronic duration group:(1.398 ± 0.518)L vs.(1.942 ± 0.557)and(1.851 ± 0.453)L,(2.701 ± 0.901) L/s vs.(4.102 ± 0.971)and(3.840 ± 1.001)L/s,(1.201 ± 0.316)L vs.(1.841 ± 0.499)and(1.690 ± 0.401) L, (86.337 ± 8.769)% vs. (96.589 ± 4.069)% and (94.317 ± 6.311)%, and there were statistical differences (P<0.05). The FEV1/FVC in chronic duration group was significantly lower than that in healthy control group,and there was statistical difference(P<0.05).There were no statistical differences in FVC, PEF and FEV1between chronic duration group and healthy control group (P>0.05). The pulmonary function indexes of small air channel forced expired flow at 25% of FVE (FEF25%), forced expired flow at 50% FVE (FEF50%), forced expired flow at 75% of FVE (FEF75%) and maximal midexpiratory flow (MMEF) in acute exacerbation group were significantly lower than those in healthy control group and chronic duration group:(2.187 ± 0.866)L/s vs.(3.869 ± 0.891)and(3.489 ± 0.947)L/s, (1.291 ± 0.549)L/s vs.(2.871 ± 0.584)and(2.599 ± 0.701)L/s,(0.596 ± 0.231)L/s vs.(1.412 ± 0.461) and(1.191 ± 0.571)L/s,(1.087 ± 0.496)L/s vs.(2.507 ± 0.629)and(2.259 ± 0.584)L/s,the indexes in chronic duration group were significantly lower than those in healthy control group, and there were statistical differences (P<0.05). Conclusions The lung function is abnormal in asthma children with acute exacerbation.After entering the chronic duration,the lung function appears to be improved,and the large airway function indexes return to normal. The small airway function indexes do not recover completely.Therefore,the detection of small airway function has great value in the diagnosis,severity and treatment of asthmatic children.
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Objective To evaluate the efficacy of tinnitus retraining therapy (TRT) on anxiety , depression , and symptoms of sleep disorders in patients with chronic subjective tinnitus. Methods Eighty patients with chronic subjective tinnitus visiting The Affiliated Hospital of Hangzhou Normal University from January 2016 to December 2017 were recruited ,and were divided into an observation group and a control group through computer generated random numbers. Patients in the control group were given drug treatment only ,while those in the observation group received TRT in addition to drug treatment. Clinical efficacy was evaluated using Tinnitus Handicap Inventory (THI) , Pittsburgh Sleep Quality Index (PSQI) ,Hamilton Depression Scale (SDS) ,and Hamilton Anxiety Scale (SAS ) for both groups. Results Patients in the observation group were associated with significantly lower scores of THI ,PSQI ,SAS and SDS ,compared with those in the control group 3 months after treatment (each P＜0.05). Furthermore ,the effectiveness rate was markedly higher (82.5% or 33 cases vs. 55.0% or 22 cases ,χ2＝7.040 ,P＜0.01) in the observation group than in the control group 6 months after treatment. Conclusion Tinnitus retraining therapy combined with conventional therapy can help to reduce the severity of tinnitus handicap ,ameliorate negative emotions such as anxiety and depression ,and improve sleep quality in patients with chronic subjective tinnitus.