疏肝平喘方治疗小儿咳嗽变异性哮喘的临床研究

Clinical Study on Shugan Pingchuan Decoction in the Treatment of Infantile Cough Variant Asthma

目的观察疏肝平喘方治疗小儿咳嗽变异性哮喘(CVA)肝气犯肺证的临床疗效。方法将88例咳嗽变异性哮喘肝气犯肺证患儿随机分为2组,治疗组与对照组各44例,治疗组以疏肝平喘方颗粒剂口服,对照组以顺尔宁口服,2组均治疗2周,比较治疗前后2组咳嗽症状、中医证候积分、外周血嗜酸性粒细胞(EOS)百分比、血清总免疫球蛋白E(总IgE)、血清白介素-6(IL-6)。结果 2组疗效比较,治疗组优于对照组(P<0.05)。2组治疗后日间咳嗽程度、夜间咳嗽程度均较治疗前有所改善(P<0.05~0.01),治疗后2组差异无统计学意义(P>0.05)。2组治疗后主要证候积分,次要证候积分、证候积分较治疗前有所改善(P<0.05~0.01),2组次要证候积分、证候总积分比较有显著性差异(P<0.05~0.01),治疗组优于对照组。对照组气促、咳痰、鼻涕、喷嚏、睡眠较治疗前有所改善,差异有统计学意义(P<0.05~0.01),治疗组气促、咳痰、鼻涕、喷嚏、睡眠、食欲、大便较治疗前有所改善,差异有统计学意义(P<0.01),治疗组对咳痰、鼻涕、喷嚏、食欲、大便症状的改善上优于对照组(P<0.01)。2组治疗后EOS百分比、总IgE、IL-6均较治疗前有所改善(P<0.01),2组间EOS百分比具有显著性差异(P<0.01)。结论疏肝平喘方对小儿CVA具有良好的临床疗效,能够减轻咳嗽症状,改善中医证候,抑制气道炎症,其机制值得进一步研究。

OBJECTIVE To observe the clinical effect of Shugan Pingchuan decoction in the treatment of infantile cough variant asthma （CVA）. METHODS 88 children with CVA were randomly divided into the treatment group and the control group, and 44 cases in each group. The treatment was intervened by orally taking Shugan Pingchuan granules, and the control group was intervened by orally taking Singulair. Both groups were treated for two weeks. Cough symptoms, TCM syndrome scores, peripheral blood eosinophils （EOS） percentages, serum total immunoglobulin E （total IgE） and Serum interleukin-6 （IL-6） in two groups were compared before and after treatment. RESULTS The curative effects of the treatment group was better than that of the control group （ P 〈 0.05 ）. Daytime and night coughing degrees in both groups were better after treatment than those of the pre treatment, but there was no significant difference between the 2 groups after treatment （ P 〉0.05）. Main syndrome scores, secondary syndrome scores and total syndrome scores of both group were improved after treatment compared with those of the pre treatment （ P 〈 0.05 ）. There were significant differences between secondary syndrome scores of 2 groups. The differences of total syndrome scores in two groups were statistically significant （ P 〈 0.05 ）, and the treatment group was better than the control group. Shortness of breath, expectoration, runny nose, sneezing and sleep in the control group were improved compared with those of the pre treatment, the differences were statistically significant （ P 〈 0.05 ）. Shortness of breath, expectoration, runny nose, sneezing, sleep, appetite and defecation in the treatment were improved compared with those of the pre treatment, the differences were statistically significant （ P 〈 0.05 , P 〈0.01）. The improvements of expectoration, runny nose, sneezing, appetite and defecation of the treatment group were better than those of the control group （ P 〈 0.05 , P 〈0.01）. Comparing with the pre treatment, EOS%, total IgE and IL-6 in both groups were all improved after the treatment （ P 〈 0.01 ）, and the EOS% differences between two groups were statistically significant （ P 〈 0.01 ）. CONCLUSION Shugan Pingchuan decoction has satisfactory clinical effect for infantile CVA, which can relieve cough symptoms, improve TCM syndrome and inhibit airway inflammation. And its mechanism is worthy of further study.