痰热清注射液结合西医常规疗法治疗小儿毛细支气管炎临床研究

The effect ofTanreqing injection combined with conventional western medicine therapy on children with bronchioliti

目的：评价痰热清注射液结合西医常规疗法治疗小儿毛细支气管炎的临床疗效。方法将符合入选标准的毛细支气管炎患儿116例按随机数字表法分为2组各58例。对照组采用持续低流量吸氧，沙丁胺醇气雾剂平喘，合并细菌感染时抗感染等常规治疗。观察组在对照组基础上加用痰热清注射液。均治疗7 d。采用流式细胞仪检测辅助性T细胞（Th17）和调节性T细胞（Treg），采用ELISA法检测IL-17和IL-10水平，评价临床疗效。结果与对照组治疗后比较，观察组Th17细胞[（5.91±0.83）%比（7.23±1.25）%，t＝2.346]明显降低（P＜0.05）、Treg细胞[（7.32±1.24）%比（5.32±1.03）%，t＝2.352]明显升高（P＜0.05）；观察组IL-17[（14.62±3.24）ng/ml比（22.52±5.14）ng/ml，t＝2.412]水平明显降低（P＜0.05）、IL-10[（15.84±2.23）ng/ml 比（11.72±2.12）ng/ml，t＝2.365]水平明显升高（P＜0.05）。对照组退热时间、咳嗽、喘憋、肺部啰音消失和住院时间均明显长于观察组（t值分别为2.264、2.437、3.406、2.258、2.352， P值分别为0.048、0.032、0.034、0.046、0.042）。对照组总有效率为79.3%（46/58），观察组为94.8%（55/58），2组比较差异有统计学意义（χ2＝2.327，P＝0.041）。结论痰热清注射液可调节毛细支气管炎患儿体内的Th17/Treg细胞平衡，疗效优于西医常规疗法。

Objective To detect the effect ofTanreqing injection combined with conventional western medicine therapy on children with bronchioliti.Methods A total of 116 children with bronchioliti were enrolled in this study. Children were randomly divided into the control group （n=58） andTanreqing injection observation group （n=58）. The control group received continued low flow oxygen, anti-infection treatment, and salbutamol aerosol to relieve asthma. The observation group receivedTanreqing injection based on the intervention of control group. Each group was treated for 7 d. The Th17 and Treg cells were detected by cytometry analysis and the expression of IL-17 and IL-10 were detected by ELISA analysis. The clinical effect of the two groups was compared.Results After treatment, compared with the control group, the Th17 cells （5.91% ± 0.83%vs. 7.23% ± 1.25%,t=2.346） and IL-17 （14.62 ± 3.24 ng/mlvs. 22.52 ± 5.14 ng/ml,t=2.412） decreased significantly, and the Treg cells （7.32% ± 1.24%vs. 5.32% ± 1.03%,t=2.352） and IL-10 （15.84 ± 2.23 ng/mlvs.11.72 ± 2.12 ng/ml,t=2.365） increased significantly in the observation group （P〈0.05）. The temperature recovery time （t=2.264,P=0.048）, disappearance time of coughing （t=2.437,P=3.406）, wheezing（t=2.258,P=2.352）, pulmonary rales （t=0.032,P=0.034） and hospital duration （t=0.046,P=0.042） in the control group were significantly higher than those in the observation group. The clinical effective rate （94.8%, 55/58） in observation group was higher than that （79.3%, 46/58） in control group （χ2=2.327,P=0.041）. ConclusionTanreqing injection can regulate Th17/Treg cell balance, and its curative effect is superior to conventional therapy in children with bronchiolitis.