Introduction

Bronchial asthma combined with allergic rhinitis drives persistent allergic‑airway inflammatory cascade, characterised by recurrent respiratory symptoms, immune dysregulation and progressive impairment of children’s quality of life. Despite abundant clinical practice, the immune‑inflammatory mechanisms underlying this comorbid disease and the optimal combined medication strategies remain to be further clarified.

Aim

To evaluate the effects of mometasone furoate combined with either montelukast sodium or loratadine on symptom relief, inflammatory cytokines, and T lymphocyte subpopulations in children with bronchial asthma and allergic rhinitis.

Material and methods

A total of 120 children with bronchial asthma and allergic rhinitis, admitted to our hospital from June 2022 to June 2023, were randomly divided into three groups: Group A (mometasone furoate, n = 40), Group B (mometasone furoate plus loratadine, n = 40), and Group C (mometasone furoate plus montelukast sodium, n = 40). Symptom scores, clinical efficacy, inflammatory cytokine levels, T lymphocyte subgroups, and adverse reactions were compared across the three groups.

Results

Post-treatment, Asthma Control Test (ACT) scores, nasal congestion, sneezing, and rhinorrhea improved in all groups. Group C showed greater improvements in ACT scores, nasal congestion, sneezing, and rhinorrhea compared to Groups A and B (p < 0.05), with Group B showing better results than Group A (p < 0.05). The total effective rate in Group C (97.50%) was higher than in Group B (80.00%) and Group A (70.00%) (p < 0.05). Serum levels of interleukin-17 (IL-17), interleukin-33 (IL-33), and transforming growth factor-b (TGF-b) significantly decreased across all groups, with Group C showing the greatest reductions, followed by Group B and then Group A (p < 0.05). CD3+, CD4+, and the CD4+/CD8+ ratio increased, while CD8+ levels decreased in all groups after treatment (p < 0.05). Group C demonstrated the most pronounced improvements in these immune markers compared to Groups A and B, with Group B performing better than Group A (p < 0.05). Adverse reaction rates were 5.00% in Group A, 10.00% in Group B, and 7.50% in Group C, with no statistically significant differences among the groups (p > 0.05).

Conclusions

Mometasone furoate combined with either montelukast sodium or loratadine effectively improves symptoms, reduces inflammatory cytokine levels, and balances T lymphocyte subpopulations in children with bronchial asthma and allergic rhinitis. The combination of mometasone furoate and montelukast sodium showed superior efficacy.