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Step sequential therapy in patients with steroid-dependent asthma the Th1/Th2 affect the

Author: WenZhiHao
Tutor: CuiHongSheng
School: Beijing University of Traditional Chinese Medicine
Course: TCM Internal Medicine
Keywords: SDA Three-step sequential therapy Th1 Th2
CLC: R259
Type: Master's thesis
Year: 2006
Downloads: 77
Quote: 0
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Abstract


Glucocorticoid inhalation has been used as principal therapy for asthma with positive therapeutic efficiency and little adverse effect .However, there are some asthmatic patients who have to take steroid orally with a large dose for a long time to control the symptom, or asthma will recur or to be more serious. We can call this kind of asthma as steroid-dependent asthma which is often abbreviated to SDA. SDA belong to difficult asthma.At present , anti-immune preparations are mostly used as alternative therapy for SDA ,the therapeutic efficacy of which are not positive and with biggish adverse effect.On the other hand ,these medicine are difficult to be accepted for adverse effect .In the past few years,Traditional Chinese medicine(TCM)made a great step forward in treating SDA and shown it’s advantage.For moderning the research of SDA and developing the microcosmic syndrome,it is necessary to do deep research on the immanent physical basis of the syndrome of SDA.Objective:To open out the therapeutic efficacy mechanism of three-step sequential therapy by investigating the changes of ratio of Th1/Th2 of the patients with SDA during steroid withdrawl.Method:The patients in the trial were devided into two groups which were treatment group(n=20) and control group(n=20).The treatment group was treated by three-step sequential therapy while the control group was treated by inhaling steroid with dose of 300μg.The period of treatment was 12 to 14 weeks. Expression of IFN-γand IL - 4 in blood CD4+T cells ,which respectively indicate Th1% and Th2%, were carried out before and after the treatment .Results: After the treatment ,the expression of Th2 of the two groups were both degraded significantly (P<0.01, P<0.05), the expression of Th2 of the treatment group was lower than that of the control group with significance(P<0.01);The ratio of Th1/Th2 of the two groups were raised significantly after the treatment (P<0.01,P<0.01), the ratio of Th1/Th2 was higher than that of the control group with significance(P<0.01); After the treatment, the expression of Th1 of the two groups didn’t change and there was not significant difference between them; After the treatment,%FEV1/Pred、FEV1/FVC% of the two groups were both degraded significantly (P<0.01, P<0.01),the efficiency

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