Objective: To evaluate the efficacy of dermatophagoides farinae drops combined with fluticasone propionate inhalation aerosol in the treatment of acute attack of asthma complicated with allergic rhinitis in children and its effects on serum tissue inhibitor of metalloproteinase-1 (TIMP-1)

nerve growth factor (NGF) and Toll like receptor 2 (TLR2) in sputum. Methods: Totally 123 children with acute attack of asthma complicated with allergic rhinitis admitted into our hospital from Mar. 2018 to Nov. 2020 were extracted to be divided into 61 cases in the observation group and 62 cases in the control group via the random number table. The control group was given dermatophagoides farinae drops on the basis of conventional treatment

while the observation group received dermatophagoides farinae drops combined with fluticasone propionate inhalation aerosol on the basis of conventional treatment. The severity of allergic rhinitis and asthma were scored before treatment and after treatment of 12 weeks. Immunoturbidimetry was used to detect immunoglobulin M (IgM)

immunoglobulin G (IgG)

immunoglobulin A (IGA) and serum C-reactive protein (CRP) before treatment and after treatment of 12 weeks. Flow cytometry was used to detect CD3+

CD4+

CD8+

and calculate CD4+/CD8+. Serum levels of interleukin-8 (IL-8)

tumor necrosis factor (TNF)-α

TIMP-1

TLR2 and NGF were detected by enzyme linked immunosorbent assay (ELISA). The forced expiratory volume in one second (FEV1)

peak expiratory flow rate (PEF)

25% forced expiratory flow rate (PEF25)

50% forced expiratory flow rate (PEF50) and 75% forced expiratory flow rate (PEF75) were measured by pulmonary function analyzer. And the incidence of adverse drug reactions of two groups was observed. Results: After treatment of 12 weeks

the severity score of allergic rhinitis and asthma in the observation group were lower than those in the control group (P<0.05). After treatment of 12 weeks

the levels of IgM

IgG

IgA

CD3+

CD4+ and CD4+/CD8+ in the observation group were higher than those in the control group (P<0.05)

the levels of CD8+ were lower than those in the control group (P<0.05). After treatment of 12 weeks

the levels of CRP

IL-8 and TNF-α in the observation group were lower than those in control group (P<0.05)

and the levels of FEV1

PEF

PEF25

PEF50 and PEF75 were higher than those in the control group (P<0.05). After 12 weeks of treatment

the serum levels of TIMP-1 in the observation group were lower than those in the control group (P<0.05)

the sputum levels of TLR2 were higher than those in the control group

and the levels of NGF were lower than those in the control group (P<0.05). There was no significant difference in the incidence of adverse drug reactions between two groups (c2=1.03

P>0.05). Conclusion: Dermatophagoides farinae drops combined with fluticasone propionate inhalation aerosol can effectively improve the clinical efficacy of children with acute attack of asthma complicated with allergic rhinitis

improve the immune function

inhibit the inflammatory reaction

improve the lung function

decrease the levels of TIMP-1 and NGF

inhibit the airway remodeling

increase the levels of TLR2

regulate the inflammatory and neurogenic factors

with lower incidence of adverse drug reactions and higher safety.