中西医结合治疗小儿咳嗽变异性哮喘55例临床观察

Clinical Observation of Integrate Chinese and Western Medicine Therapy for Cough Variant Asthma in Children:A Study of 55 Cases

目的:观察中西医结合治疗小儿咳嗽变异性哮喘痰热阻肺证的临床疗效。方法:将110例咳嗽变异性哮喘痰热阻肺证患儿随机分为对照组和观察组各55例。所有患儿均予吸氧、平喘等基础治疗,对照组加用孟鲁司特,观察组在对照组治疗基础上联合小儿咳喘灵颗粒治疗,2组均治疗3月。观察2组治疗前后咳嗽、气喘积分及血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、用力肺活量(FVC)、1秒用力呼气量(FEV1)的变化,比较2组临床疗效和复发率。结果:治疗后,2组咳嗽、气喘积分均较治疗前降低(P<0.05),观察组的2项症状积分均低于对照组(P<0.05)。治疗后,2组TNF-α、IL-6水平均较治疗前降低(P<0.05),FVC、FEV1均较治疗前升高(P<0.05);观察组的TNF-α、IL-6水平均低于对照组(P<0.05),FVC、FEV1均高于对照组(P<0.05)。观察组总有效率90.91%,对照组总有效率74.55%,2组比较,差异有统计学意义(P<0.05)。对照组复发率23.81%,观察组复发率3.33%,2组比较,差异有统计学意义(P<0.05)。结论:在采用西药的基础上联合小儿咳喘灵颗粒治疗咳嗽变异性哮喘痰热阻肺证,能提高临床疗效,更有效地改善患儿的肺功能指标及控制炎症反应,降低复发率。

Objective：To observe the clinical effect of integrate Chinese and western medicine Therapy for children cough variant asthma with syndrome of retention of phlegm-heat in the lung.Methods：Selected 110 patients of cough variant asthma with syndrome of retention of phlegm-heat in the lung,and divided them into the control group and the observation group with 55 cases in each randomly.All patients were given the treatment of oxygen scavenging and antiasthmatic,the control group was given montelukast in addiction,and the observation group was given Xiaoer Kechuanling granules based on the treatment of the control group.Treatments of the two groups both lasted for three weeks.Observed changes of indexes of cough,asthma score,serum interleukin-6（IL-6）,tumor necrosis factor-α（TNF-α）,forced vital capacity（FVC）,forced expiratory volume in one second（FEV_1）.Compared clinical effect and recurrence rate of the two groups.Results：After treatment,cough and asthma symptom scores of the two groups were lower than those before treatment（P〈0.05）,and the scores of the two indexes of the observation group were both lower than those of the control group（P〈0.05）.After treatment,levels of TNF-α and IL-6 of the two groups were all lower than those before treatment（P〈0.05）,levels of FVC and FEV_1 of the two groups were all higher than those before treatment（P〈0.05）.Levels of TNF-α and IL-6 of the observation group were lower than those of the control group（P〈0.05）,and levels of FVC and FEV_1 of the observation group were higher than those of the control group（P〈0.05）.The total effective rate was 90.91%in the observation group and was 74.55%in the control group,the difference being significant（P〈0.05）.Follow up for six months,recurrence rate was 23.81%in the control group,and was 3.33%in the observation group,the difference being significant（P〈0.05）.Conclusion：Based on the treatment of western medicine,combined with Xiaoer Kechuanling granules can improve clinical effect and index of pulmonary function,control inflammatory and reduce recurrence rate in treating cough variant asthma with syndrome of retention of phlegm-heat in the lung.