槐杞黄颗粒联合孟鲁司特治疗儿童咳嗽变异性哮喘疗效观察

Clinical Observation of Huaiqihuang Granules Combined with Montelukast for Child Cough Variant Asthma

目的:观察槐杞黄颗粒联合孟鲁司特治疗儿童咳嗽变异性哮喘(CVA)的临床疗效及对血清辅助性T细胞17(Th17)水平的影响。方法:将100例CVA患者按随机数字表法分为2组,对照组50例采用孟鲁司特治疗,研究组50例采用槐杞黄颗粒联合孟鲁司特治疗,疗程均为1月,观察比较2组患儿治疗前后临床症状、肺功能[第1秒用力呼气容积(VFEV_1)、VFEV_1与用力肺活量(FVC)的比值(VFV_1/FVC)、血清Th17、CD^+4CD^+25调节性T细胞(CD^+4CD^+25HighTreg)水平的差异,以及2组临床疗效和不良反应情况。结果:总有效率研究组为96.0%,对照组为80.0%,2组比较,差异有统计学意义(P<0.05)。治疗后,研究组患儿咳嗽痰响消失时间、干湿性啰音消失时间、体温复常时间及住院时间均明显短于对照组,差异有统计学意义(P<0.05)。治疗后,2组患者VFEV_1、VFV_1/FVC值均较治疗前升高(P<0.05);且研究组VFEV_1、VFV_1/FVC值升高较对照组更显著(P<0.05)。治疗后,2组患者Th17值较治疗前降低(P<0.05),CD^+4CD^+25HighTreg值均较治疗前升高(P<0.05);且研究组上述指标改善较对照组更显著(P<0.05)。不良反应发生率研究组为2.0%,对照组为4.0%,2组比较,差异无统计学意义(P>0.05)。随访6月,复发率研究组为6.0%,对照组为24.0%,2组比较,差异有统计学意义(P<0.05)。结论:槐杞黄颗粒联合孟鲁司特治疗儿童CVA效果显著,可显著改善患儿肺功能和免疫功能,且复发率低。

Objective:To observe the clinical effect of Huaiqihuang granules combined with montelukast for child cough variant asthma(CVA) and the effect on level of helper T cell 17 (Th17) in serum. Methods:Divided 100 cases of patients with CVA into two groups randomly according to random number table,50 cases in each group. The control group was treated with montelukast,and the study group was given Huaiqihuang granules combined with montelukast. The course of treatment was both one month. Observed and compared the differences of the clinical symptoms,lung function [forced expiratory volume in 1 second (VFEV1),ratio of VFEV1 to forced vital capacity(FVC) (VFV1/FVC),Th17 in serum,and levels of CD4+CD25+ regulatory T cells of children in the two groups before and after treatment as well as the clinical effect and adverse reactions in the two groups. Results:The total effective rate was 96.0% in the study group and 80.0% in the control group, compared the two groups, difference being significant (P<0.05). After treatment,the disappearance time of cough and phlegm,disappearance time of dry and wet rales,recovery time of body temperature and hospitalization time of children in the study group were all shorter than those in the control group,difference being significant(P < 0.05). After treatment, the values of VFEV1 and VFV1/FVC in the two groups were increased when compared with those before treatment(P<0.05);the increase of VFEV1 and VFV1/FVC values in the study group was more significant than that in the control group (P<0.05). After treatment,the values of Th17 in the two groups were decreased when compared with those before treatment(P<0.05); the values of CD4+CD25+HighTreg were increased when compared with those before treatment (P<0.05); the improvement of the indexes mentioned above in the study group was more obvious than that in the control group (P<0.05). The incidence of adverse reactions was 2.0% in the study group and 4.0% in the control group, and there was no significant difference being found in the comparison of the two groups(P>0.05). During the follow-up of 6 months,the recurrence rate was 6.0% in the study group and 24.0% in the control group,compared the two groups,difference being significant(P<0.05). Conclusion:The application of Huaiqihuang granules combined with montelukast has significant effect in treating child CVA. It can evidently improve lung function and immune function in children and has a low recurrence rate.