孟鲁司特钠联合寒喘祖帕颗粒及呼吸操治疗成人咳嗽变异性哮喘风寒袭肺证的临床观察

Clinical observation of montelukast sodium combined with Hanchuan Zupa Granules and respiratory exercise for treating cough variant asthma with wind-cold attacking lung syndrome in adults

目的:研究孟鲁司特钠联合寒喘祖帕颗粒及呼吸操治疗成人咳嗽变异性哮喘(cough variant asthma,CVA)风寒袭肺证的疗效。方法:将本院2018年3月至2020年1月诊治的84例CVA风寒袭肺证患者按照信封法随机分为联合组与对照组,每组各42例,对照组接受孟鲁司特钠治疗,联合组在此基础上加用寒喘祖帕颗粒及呼吸操,观察两组患者总有效率、中医症状积分、血清炎症指标肿瘤坏死因子α(TNF-α)、巨噬细胞炎性蛋白-1α(MIP-1α)、白介素-6(IL-6),肺功能指标用力肺活量(FVC)、第1秒用力呼气量(FEV1)、峰值呼气流速(PEF)治疗前后水平的差异。结果:联合组治疗总有效率为88.10%,对照组69.05%,两组比较差异有统计学意义(P<0.05);两组患者治疗后咳嗽、憋闷积分较治疗前均降低,联合组低于对照组(P<0.05);两组患者治疗后血清TNF-α、MIP-1α、IL-6水平较治疗前均下降,且联合组各指标均比对照组低(P<0.05);两组患者治疗后FVC、FEV1、PEF与治疗前相比均上升,联合组各指标均比对照组高(P<0.05)。结论:呼吸操联合孟鲁司特钠及寒喘祖帕颗粒对于CVA风寒袭肺证患者疗效较好,能有效改善患者咳嗽症状及炎症反应,提高肺功能。

Objective:To study the curative effect of montelukast sodium combined with Hanchuan Zupa Granules and respiratory exercise in the treatment of cough variant asthma(CVA)with wind-cold attacking lung syndrome in adults.Methods:84 patients with CVA and wind-cold attacking lung syndrome who were diagnosed and treated in the hospital between March 2018 and January 2020 were randomly divided into combined group and control group,42 cases in each group.The control group was treated with montelukast sodium,and the combined group was treated with Hanchuan Zupa Granules and respiratory exercise based on the treatment of control group.The total response rates of the two groups were observed.Meanwhile,TCM symptom score,serum inflammatory factors[tumor necrosis factorα(TNF-α),macrophage inflammatory protein-1α(MIP-1α),interleukin-6(IL-6)]and lung function[forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),peak expiratory flow(PEF)]of the 2 groups were compared before and after treatment.Results:The total response rate of the combined group was 88.10%,significantly higher than 69.05%of the control group(P<0.05).After treatment,cough and depression scores of the 2 groups were significantly reduced,and the above scores of combined group were significantly lower than those of the control group(P<0.05).Serum TNF-α,MIP-1αand IL-6 levels in the 2 groups were significantly reduced,which were significantly lower in the combined group than the control group(P<0.05).FVC,FEV1 and PEF were significantly increased,and the above indexes in the combined group were significantly higher than those of the control group(P<0.05).Conclusion:Hanchuan Zupa Granules combined with respiratory exercise and montelukast sodium is effective in treatment of CVA with wind-cold attacking lung syndrome in adults,which can effectively alleviate the patients’cough symptoms and inflammation,and improve lung function.