定喘汤联合孟鲁司特钠对小儿咳嗽变异性哮喘(风热袭肺证)患儿中医证候积分、呼气高峰流量及血清ECP浓度的影响

Effects of Dingchuan Decoction combined with montelukast sodium on the TCM syndrome score,peak expiratory flow and serum ECP concentration in children with cough variant asthma(wind-heat invading lung syndrome)

目的:探讨定喘汤联合孟鲁司特钠对小儿咳嗽变异性哮喘(CVA)(风热袭肺证)患儿中医证候积分、呼气高峰流量及血清嗜酸性阳离子蛋白(ECP)浓度的影响。方法:选取2019年3月~2021年3月本院收治的CVA(风热袭肺证)患儿86例,随机数字表法分2组,对照组(n=43)口服孟鲁司特钠,研究组(n=43)在对照组基础上内服定喘汤。比较两组疗效、中医证候积分、肺功能指标、T淋巴细胞亚群,同时检测血清ECP、免疫球蛋白E(IgE)水平。结果:研究组总有效率高于对照组(P<0.05);治疗后两组主要症状(咳嗽次数/程度/时间)评分、次要症状(咽痛(红)/咯痰/流涕)评分均小于治疗前(P<0.05),且研究组主要症状(咳嗽次数/程度/时间)评分、次要症状(咽痛(红)/咯痰/流涕)评分均小于对照组(P<0.05);治疗后两组用力呼气容积(FEV_(1))、呼气高峰流量(PEF)、FEV_(1)/用力肺活量(FVC)均大于治疗前(P<0.05),且研究组FEV_(1)、PEF、FEV_(1)/FVC均大于对照组(P<0.05);治疗后两组血清ECP、IgE水平均低于治疗前(P<0.05),且研究组血清ECP、IgE水平均低于对照组(P<0.05);治疗后两组CD3^(+)、CD4^(+)/CD8^(+)均大于治疗前(P<0.05),CD8^(+)均小于治疗前(P<0.05),且研究组CD3^(+)、CD4^(+)/CD8^(+)均大于对照组(P<0.05),CD8^(+)均小于对照组(P<0.05)。结论:定喘汤联合孟鲁司特钠治疗小儿CVA(风热袭肺证)能有效提高疗效,减轻症状,改善肺功能与细胞免疫功能,调节血清ECP、IgE水平。

Objective:To investigate the effects of combining montelukast sodium with Dingchuan Decoction on the TCM syndrome score,peak expiratory flow,and serum eosinophilic cationic protein(ECP)concentration in children with cough variant asthma(CVA)(wind-heat attacking lung syndrome).Methods:A total of 86 children with CVA(wind-heat attacking lung syndrome)were admitted to the hospital from March 2019 to March 2021 and were divided into two groups using a random number table method.The control group(n=43)received oral montelukast sodium,while the study group(n=43)received internal Dingchuan Decoction in addition to the control group.The efficacy,TCM syndrome score,lung function index,and T lymphocyte subpopulation were compared between the two groups,and serum ECP and immunoglobulin E(IgE)levels were also measured.Results:The overall effective rate of the study group was higher than that of the control group(P<0.05).The scores of major symptoms(number/degree/time of cough)and minor symptoms(sore throat(red)/sputum/runny nose)in both groups after treatment were significantly lower than those before treatment(P<0.05),and the scores of major symptoms(number/degree/time of cough)and minor symptoms(sore throat(red)/sputum/runny nose)in the study group were significantly lower than those in the control group(P<0.05).After treatment,the exertional expiratory volume(FEV1),peak expiratory flow rate(PEF),and FEV1/exertional spirometry(FVC)were significantly higher in both groups than before treatment(P<0.05),and FEV1,PEF,and FEV1/FVC were significantly higher in the study group than in the control group(P<0.05).After treatment,serum ECP and IgE levels were significantly lower in both groups than before treatment(P<0.05),and the study group had significantly lower serum ECP and IgE levels than the control group(P<0.05).After treatment,serum ECP and IgE levels in both groups were significantly lower than those before treatment(P<0.05),and serum ECP and IgE levels in the study group were significantly lower than those in the control group(P<0.05).After treatment,CD3+,CD4+/CD8+in both groups were significantly greater than those before treatment(P<0.05),and CD8+in the study group were significantly greater than those in the control group(P<0.05),and CD8+in both groups were significantly lower than those in the control group(P<0.05).Conclusion:The combination of Dingchuan Decoctionwith montelukast sodium in the treatment of paediatric CVA(wind-heat attacking lung syndrome)can effectively improve efficacy,reduce symptoms,improve lung function and cellular immune function,and regulate serum ECP and IgE levels.