寒喘祖帕颗粒联合甲泼尼龙治疗儿童顽固喘憋性肺炎的临床研究

Clinical study on Hanchuanpazu Granules combined with methylprednisolone in treatment of persistent asthmatic pneumonia in children

目的探讨寒喘祖帕颗粒联合注射用甲泼尼龙琥珀酸钠治疗儿童顽固喘憋性肺炎的临床效果。方法选取2016年4月—2017年6月深圳市龙岗中心医院儿科收治的82例顽固喘憋性肺炎患儿,根据随机分组法将所有患儿分为对照组和治疗组,每组各41例。对照组静脉滴注注射用甲泼尼龙琥珀酸钠,1.5 mg/kg,3次/d。治疗组在对照组治疗的基础上口服寒喘祖帕颗粒,2 g/次,2次/d。两组患儿均连续治疗6 d。比较两组患儿的临床疗效,同时比较治疗前后两组患儿的临床症状改善情况、血气指标和炎性指标。结果治疗后,对照组和治疗组的总有效率分别为75.6%、92.7%,两组总有效率比较差异具有统计学意义(P<0.05)。治疗组气喘缓解时间、咳嗽消失时间、喘鸣音消失时间和平均住院时间均显著短于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组氧分压(pO_2)明显升高,二氧化碳分压(pCO_2)明显降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组血气指标明显优于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组血清TNF-α、IL-13、IL-1β水平均明显下降,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组炎性指标水平明显低于对照组,两组比较差异有统计学意义(P<0.05)。结论寒喘祖帕颗粒联合注射用甲泼尼龙琥珀酸钠治疗儿童顽固喘憋性肺炎具有较好临床疗效,可有效改善临床症状和血气指标,降低炎症状态,具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Hanchuanpazu Granules combined with Methylprednisolone Sodium Succinate for injection in treatment of persistent asthmatic pneumonia in children. Methods Children（82 cases） with persistent asthmatic pneumonia in Shenzhen Longgang Central Hospital from April 2016 to June 2017 were randomly divided into control group（41 cases） and treatment group（41 cases）. Children in the control group were iv administered with Methylprednisolone Sodium Succinate for injection, 1.5 mg/kg, 3 times daily. Children in the treatment group were po administered with Hanchuanpazu Granules on the basis of the control group, 2 g/time, twice daily. Patients in two groups were treated for 6 d. After treatment, the clinical efficacies were evaluated, and clinical symptom improvement, blood gas index, and inflammatory index in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 75.6% and 92.7%, respectively, and there was difference between two groups（P〈0.05）. After treatment, the remission time of asthma, the time of cough disappearance, the time of wheezing disappearance, and the average hospital stay in the treatment group were significantly shorter than those in the control group, with significant difference between two groups（P〈0.05）. After treatment, pO_2 in two groups were significantly increased, but pCO_2 in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And the blood gas 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, the levels of TNF-α, IL-13, and IL-1β in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And the inflammatory indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups（P〈0.05）. Conclusion Hanchuanpazu Granules combined with Methylprednisolone Sodium Succinate for injection has clinical curative effect in treatment of persistent asthmatic pneumonia in children, can improve clinical symptom and blood gas index, decrease the levels of inflammatory factor, which has a certain clinical application value.