Objective To explore the effects of bacterial lysate capsules combined with probiotics on Notch signaling pathway indicators, intestinal microbiota, and clinical efficacy in children with allergic asthma (AA). Methods A total of 99 children with AA were selected as research subjects and randomly divided into the Broncho-Vaxom group, probiotic group, or combined group, with 33 cases in each group. On the basis of conventional anti-inflammatory and anti-asthmatic therapies, the three groups were treated with bacterial lysate capsules, Bifidobacterium quadruple live tablets, and bacterial lysate capsules combined with Bifidobacterium quadruple live tablets, respectively, all for 3 consecutive months. The Notch signaling pathway indicators, immunological indicators (interferon-γ [IFN-γ], interleukin-4 [IL-4], and total immunoglobulin E [tIgE]), counts of intestinal microbiota colonies, and asthma symptom score before and after treatment; the asthma control level after 3 months of treatment; and incidence of adverse reactions during treatment were compared among the three groups. Results Before treatment, there was no statistically significant difference in the baseline indicators among the three groups (all P>0.05). At 1 month and 3 months after treatment initiation, the relative expression levels of NOTCH1 mRNA and NOTCH4 mRNA, serum levels of IL-4 and tIgE, and daytime and nighttime symptom scores in the three groups showed a trend of the combined group's < the Broncho-Vaxom group's < the probiotic group's (all P<0.05); the serum IFN-γ level in the three groups showed a trend of the combined group's > the Broncho-Vaxom group's > the probiotic group's (all P<0.05). At 3 months after treatment initiation, there was a statistically significant overall difference in the total effective rate of asthma control among the three groups (P<0.05), and the total effective rate of asthma control in the combined group was higher than that in the probiotic group (P<0.05); the counts of intestinal Bifidobacteria and Lactobacilli in the three groups showed a trend of the combined group's > the probiotic group's > the Broncho-Vaxom group's (all P<0.05). There was no statistically significant difference in the total incidence of adverse reactions among the three groups during treatment (P>0.05). Conclusion The combined use of bacterial lysate capsules and probiotics demonstrates superior efficacy over monotherapy in treating pediatric AA, potentially mediated by synergistic downregulation of Notch signaling pathway activity, correction of Th1/Th2 immune imbalance, and improvement in gut microbiota colonization, significantly enhancing clinical outcomes without increasing adverse reactions.

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