加味射干麻黄汤对小儿咳嗽变异性哮喘细胞因子的影响

Effect of Modified Shegan Mahuang Decoction on Cytokines in Children Patients with Cough and Variant Asthma

目的研究加味射干麻黄汤对小儿咳嗽变异性哮喘外周血中细胞因子如肿瘤坏死因子-α(TNF-α)、白细胞介素(interleukin,IL)-10、IL-13的影响。方法154例患儿分为两组,并设健康组45例。治疗组79例采用加味射干麻黄汤,每天1剂水煎分2次口服;对照组75例采用孟用鲁司特,2～5岁4mg,6～14岁5mg,每天1次口服,两组均用药4周。检测两组治疗前后血清TNF-α、IL-10及IL-13含量。结果治疗前血清TNF-α(ng/L)、IL-13(ng/L)含量治疗组(2510±1500、60.76±23.67)及对照组(2890±1410、61.56±20.37)较健康组(709±280、39.49±3.09)明显增高(P<0.01);IL-10(ng/L)治疗及对照组(1546±1434、1823±1314)明显低于健康组(7123±2641,P<0.01)。治疗后治疗组TNF-α、IL-13分别为960±420、43.67±12.37,较治疗前明显降低(P<0.01);IL-10(6834±2216)较治疗前明显提高(P<0.01);与对照组TNF-α、IL-13(2610±1220、50.56±19.56)及IL-10(2529±1223)水平比较,差异均有统计学意义(P<0.01)。临床疗效:治疗组总有效率86.07%,明显优于对照组(42.67%,P<0.01)。结论加味射干麻黄汤可提高临床治疗小儿咳嗽变异性哮喘的疗效,并可调节患儿血清TNF-α、IL-10、IL-13水平。

Objective To study the influence of modified Shegan Mahuang Decoction （SGMH） on cyto- kines such as tumor necrosis factor-α （TNF-α）, interlikin（ IL）-10 and IL-13 in children suffered from cough and variant asthma （C＆VA）. Methods One hundred and fifty-four children with C＆VA were randomly assigned to two groups： 79 in the treatment group were medicated orally with SGMH one dose per day taking in twice; 75 in the control group were medicated with Montelukast once a day in dose of 4 mg for children aged from 2 to 5 years and 5 mg for those from 6 to 14 years, the medication for all was given 4 weeks. Serum contents of cytokines, including TNF-α, IL-10 and IL-13, in patients were measured before and after treatment. Besides, serum contents of these cytokines in 45 healthy children were measured for control. Results Serum levels of TNF-α and IL- 3 in the treatment group were 2510±1500 ng/L and 60.76 ±23.67 ng/L, and in the control group, 2890 ±1410 ng/L and 61.56 ±20.37 ng/L, respectively, all were significantly higher than those of healthy （709 ±280 ng/L and 39.49 ±3.09 rig/L, P〈0.01 ） ; but level of IL-10 was significant lower in the two patient groups than that in control （1546 ±1434 ng/L and 1823 ±1314 ng/L vs7123 ±2641 ng/L, P〈0.01）. After treatment, the levels of TNF-cc and IL-13 decreased and IL-10 increased significantly in the treatment group, and showed significant dif- ferent to those in the control group respectively （960 ±420 ng/L, 43.67 ±12.37 ng/L and 6834 ±2216 ng/L vs 2610 ±1220 ng/L, 50.56 ±19.56 ng/L and 2529 ±1223 ng/L, P〈0.01 ）. Clinical efficacy between groups also showed that the total effective rate in the treatment group was significantly better （86.07% vs 42.67%, P 〈 0.01 ）. Conclusion SGMH can regulate the serum levels of TNF-α IL-10 and IL-13, and shows evident clinical effect in treating children＇s C＆VA.