小儿定喘口服液联合甲泼尼龙治疗重症支气管哮喘的临床研究

Clinical study on Xiao'er Dingchuan Oral Liquid combined with methylprednisolone in treatment of severe bronchial asthma

目的探讨小儿定喘口服液联合甲泼尼龙治疗重症支气管哮喘的临床疗效。方法选取2015年2月—2016年2月在西电集团医院呼吸内科接受治疗的小儿重症支气管哮喘患者86例,随机分成对照组和治疗组,每组各43例。对照组患儿静脉滴注注射用甲泼尼龙琥珀酸钠,1 mg/kg加入到5%葡萄糖溶液250 m L中,1次/d。治疗组在对照组的基础上口服小儿定喘口服液,3-6岁患儿10 m L/次,7-10岁患儿15 m L/次,10岁以上患儿20 m L/次,均为3次/d。所有患儿均连续治疗2周。比较两组临床疗效、肺功能变化、动脉血气指标、临床症状和体征消失时间以及肿瘤坏死因子α（TNF-α）、白介素-8（IL-8）和免疫球蛋白E（Ig E）表达水平。结果治疗后,对照组和治疗组总有效率分别为81.40%和95.35%,两组比较差异有统计学意义（P〈0.05）。治疗后,两组一秒用力呼气容积（FEV1）、最大呼气流量（PEF）、用力肺活量（FVC）和FEV1/FVC均较同组治疗前显著升高,同组比较差异具有统计学意义（P〈0.05）;且治疗组这些观察指标显著高于对照组,两组比较差异具有统计学意义（P〈0.05）。治疗后,两组氧分压（p O2）和血氧饱和度（Sp O2）升高,二氧化碳分压（p CO2）较治疗前下降,同组治疗前后差异具有统计学意义（P〈0.05）;且治疗组这些观察指标显著优于对照组,两组比较差异具有统计学意义（P〈0.05）。治疗后,治疗组患儿喘憋消失时间和肺部哮鸣音消失时间短于对照组,两组比较差异具有统计学意义（P〈0.05）。治疗后,两组患儿TNF-α、IL-8和Ig E表达水平均下降,同组治疗前后差异具有统计学意义（P〈0.05）;且治疗组这些观察指标水平低于对照组,两组比较差异具有统计学意义（P〈0.05）。结论小儿定喘口服液联合甲泼尼龙治疗重症支气管哮喘的疗效显著,可有效改善患儿肺功能及降低血清炎性因子水平,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacies of Xiao＇er Dingchuan Oral Liquid combined with methylprednisolone in treatment of severe bronchial asthma. Methods Children（86 cases） with severe bronchial asthma in Department of Respiratory, Xi＇an XD Group Hospital from February 2015 to February 2016 were randomly divided into control and treatment groups, and each group had 43 cases. Patients in the control group were iv administered with Methylprednisolone Sodium Succinate for injection, 1 mg/kg added into 5% glucose solution 250 m L, once daily. Patients in the treatment group were po administered with Xiao＇er Dingchuan Oral Liquid on the basis of the control group, 10 m L/time for 3 — 6 years old children, 15 m L/time for 7 — 10 years old children, 20 m L/time for children over 10 years old, three times daily. The patients in two groups were treated for 2 weeks. After treatment, the efficacy was evaluated, and pulmonary function changes, arterial blood gas indexes, disappeared time of clinical symptoms and signs, tumor necrosis factor α（TNF-α）, interleukin-8（IL-8）, and immunoglobulin E（Ig E） in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 81.40% and 95.35%, respectively, and there were differences between two groups（P〈0.05）. After treatment, FEV1, PEF, FVC, and FEV1/FVC in two groups were significantly increased, and the difference was statistically significant in the same group（P〈0.05）. And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups（P〈0.05）. After treatment, p O2 and Sp O2 in two groups were significantly increased, and p CO2 was decreased, and the difference was statistically significant in the same group（P〈0.05）. And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups（P〈0.05）. After treatment, disappeared time of shortness of breath and wheezing of children in treatment group were shorter than those in the control group, with significant difference between two groups（P〈0.05）. After treatment, TNF-α, IL-8, and Ig E in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And the decreased degree of the observational indexes in the treatment group was better than those in the control group, with significant difference between two groups（P〈0.05）. Conclusion Xiao＇er Dingchuan Oral Liquid combined with methylprednisolone has a significant clinical efficacy in treatment of severe bronchial asthma, can significantly improve lung function, and reduce inflammatory factors level in serum, which has a certain clinical application value.