玉屏风加味汤联合雾化吸入布地奈德治疗小儿咳嗽变异性哮喘临床观察

Clinical Effect of Using Huoxiang Chaihu Decoction Combined with Nebulized Budesonide in the Treatment of Cough Variant Asthma in Children

目的:探讨玉屏风加味汤联合雾化吸入布地奈德治疗小儿咳嗽变异性哮喘(CVA)的临床疗效。方法:选取2017年1月~2020年12月柳州市中医医院收治的CVA患儿100例,随机数字表法分为两组,对照组(n=50)接受雾化吸入布地奈德治疗,观察组(n=50)接受玉屏风加味汤联合雾化吸入布地奈德治疗治疗。对比两组患儿临床疗效和治疗前后中医症状积分、肺功能指标、气道重塑指标、外周血T淋巴细胞及不良反应发生情况。结果:观察组临床治疗总有效率明显高于对照组(P<0.05);治疗后观察组中医症状积分和气道壁厚度(T)、气道壁面积(WA)、气道总横截面积(AO)、气道腔面积(AI)及外周血CD8^(+)百分比明显低于对照组,儿童呼吸和哮喘控制测试(TRACK)和第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC、呼气流量峰值(PEF)及外周血CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)明显高于对照组(P<0.05);两组患儿不良反应发生率对比无差异(P>0.05)。结论:玉屏风加味汤联合雾化吸入布地奈德治疗小儿CVA疗效确切,可有效延缓或逆转气道重塑,改善免疫功能和肺功能,且安全性高,值得临床推广。

Objective:To explore the clinical efficacy of using Huoxiang Chaihu Decoction combined with Nebulized Budesonide in the treatment of cough variant asthma(CVA)in children.Methods:100 CVA children from January 2017 to December 2020 in Liuzhou Hospital of traditional Chinese Medicine were selected.The controlled group(n=50)received Nebulized Budesonide.The observation group(n=50)received Huoxiang Chaihu Decoction combined with Nebulized Budesonide.The clinical efficacy and TCM symptom scores,lung function indicators,airway remodeling indicators,peripheral blood T lymphocytes and adverse reactions before and after treatment were compared between the two groups.Results:The total effective rate of clinical treatment in the observation group was significantly higher than that in the controlled group(P<0.05).After treatment,the TCM symptom score,airway wall thickness(T),airway wall area(WA),total airway cross-sectional area(AO),airway cavity area(AI),and the percentage of CD8^(+)in peripheral blood in the observation group were significantly lower than those in the controlled group,Test for Respiratory and Asthma Control in Kids(TRACK)and the first second forced expiratory volume(FEV_(1)),forced vital capacity(FVC),FEV_(1)/FVC,peak expiratory flow(PEF)and peripheral blood CD3^(+),CD4^(+),CD4^(+)/CD8^(+)were obvious higher than the controlled group(P<0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Huoxiang Chaihu Decoction combined with nebulized inhalation of Budesonide has a definite effect in the treatment of pediatric CVA.It can effectively delay or reverse airway remodeling,improve immune function and lung function,and has high safety.It is worthy of clinical promotion.