The Clinical Research On The Level Of Urine Leukotriene E₄ In The Children With Cough Variant Asthma Attack (Cold-heat Complication) And The Effect Of Chinese Medicine Therapy

Objective: To observe the levels of urine leukotricnes E4 (LTE4) in the cases with cough variant asthma (CVA) (Cold-heat complication) at onset and after the Chinese medicine therapy, explore the relation with leukotrienes to the pathogenesis for CVA and the mechanism of Chinese decoction of Shukeheji on CVA, and find a new way to treat the patients suffered from CVA.Methods: According to the criterion for diagnosis, 60 children with CVA at attack stage were randomly divided into 2 groups. Among 60 cases, 30 cases treated with the Chinese decoction of Shukeheji were in the treatment group, another 30 cases put on Ventolin and Ketotifen were in the control group. The clinical symptoms and signs, pulmonary function (PEF), and the levels of urine LTE4 were respectively tested before and after the therapy. 30 healthy children were used as the normal control group. 30 asthmatic cases were taken as the asthma group. The levels of urine LTE4 were also determined in these two groups. The urine samples were tested for LTE4 by ELISA.Results: 1. The levels of urine LTE4 in both the CVA group and asthma group were markedly higher than that in the normal group (P<0.01). The level of urine LTE4 in the asthma group was higher than that in the CVA group (P<0.01). 2. Even after treatment, the levels of urine LTE4 in both treatment and control groups were still higher than that in the normal group (P<0.01). 3.In the treatment group, the level of urine LTE4 was obviously reduced after therapy (P<0.01), while the levels of urine LTE4 was not significantly decreased in the control group (P>0.05). There was quite difference between these two groups (P<0.01). 4. After therapy, much improvements of PEF were seen in the treatment group and the control group (P<0.01), but there was no difference between two groups (P>0.05). 5. The clinical effective rate did not show any significant difference between treatment and control groups. 6. The time of disappearing symptom was quite difference between the control group and the treatment group (P<0.01).Conclusion: 1. The level of urine in the children with CVA ( Cold-heat complication ) obviously higher than that in the heath children, while lower then that in the asthmatic children (Cold-heat complication). Leukotrienes, one of the inflammatory factors, is possibly contributed to the development of the airway inflammation in CVA, but the severity of the inflammation was lower than that of asthma. The results indicated that the level of urine LTF4 maybe used as a diagnostic index for judging how much severity of CVA is. 2. The clinical improvements were satisfied in both treatment and control groups. Although no evidence showed Chinese medicine was more effective for CVA, the level of urine LTE4 in the treatment was remarkably decreased compared with that in the control group. Chinese decoction of Shukeheji may interfere with the synthesis of leukotrienes or influence upon leukotrienes receptors and then prohibit releasing of the inflammatory factors such as leukotrienes, which is relevant to the control of airway inflammation and prevention of airway remodeling.