滋阴清热补肺益肾法治疗咳嗽变异性哮喘的临床研究

Clinical study on treating cough variant asthma with Ziyin Qingre Bufei Yishen therapy in TCM

目的:观察滋阴清热、补肺益肾法治疗咳嗽变异性哮喘的临床疗效,并探讨其作用机制。方法:将70例符合研究标准的咳嗽变异性哮喘患者随机分为两组,治疗组、对照组各34例(两组各脱落1例)。治疗组给予滋阴清热补肺益肾法组方的汤剂,对照组给予茶碱缓释胶囊治疗,100mg,口服,每12小时1次。两组均以4周为一个疗程。分别在治疗前后观察患者咳嗽、咽痒、咯痰、气急等症状变化,同时检测两组患者治疗前后外周血中IFN-γ、IL-4的含量,比较治疗前后的变化。结果:治疗4周后疗效比较:治疗组与对照组有效率分别为85.3%和70.6%,两组间差异具有统计学意义(P<0.05)。治疗组治疗后外周血IFN-γ水平升高(P<0.05),IL-4水平降低(P<0.05),与对照组比较差异具有统计学意义(P<0.05)。结论:采用滋阴清热、补肺益肾法治疗CVA可明显减轻患者临床症状,其机制可能与提高患者IFN-γ水平,降低IL-4水平有关。

Objective： To observe the clinical effect of Ziyin Qingre, Bufei Yishen therapy in treatment of cough variant asthma （CAV） and explore its mechanism. Methods： 70 CVA patients were randomly divided into control group and treatment group, the 34 patients （1 dropped out） in the treatment group were treated with Chinese herbs of Ziyin Qingre, Bufei Yishen therapy, and the 34 patients （1 dropped out） in the control group were treated with theophylline sustained-release capsules, 100mg, 1 time per 12 hours, a course of treatment for 4 weeks. The symptoms change of cough, throat itching, expectoration and shortness of breath were observed in patients before and after the treatment. At the same time, the changes of peripheral blood of IFN-γ, IL-4 were detected before and after the treatment in both groups. Results： Four weeks after taking the medicine, the TCM syndrome total effective rates was 85.3% in treatment group and 70.6% in control group （P〈0.05）. After treatment, the level of IFN-γ in serum was significantly higher than before treatment in the treatment group （P〈0.01）; The level of IL-4 in serum was significantly lower than that before treatment in the two groups （P〈0.05）. After treatment, the level of IFN-γ, IL-4 in serum were significantly different between the two groups （P〈0.05）. Conclusions： The treatment of CVA with Ziyin Qingre, Bufei Yishen therapy can relieve the clinical symptoms obviously. The mechanism of this therapy in curing CVA was related with increasing IFN-γ, and decreasing IL-4 level.