射干麻黄汤加减联合脾多肽注射液对小儿咳嗽变异性哮喘的免疫功能影响及临床疗效观察

Effect of Shegan Mahuang Decoction plus or minus combined with spleen polypeptide injection on immune function of children with cough variant asthma and its clinical effect

目的探讨射干麻黄汤加减联合脾多肽注射液对小儿咳嗽变异性哮喘的免疫功能影响及临床治疗效果。方法黑龙江中医药大学附属第一医院2015年2月至2016年12月收治小儿咳嗽变异性哮喘64例,按随机数字表法分成两组。对照组32例,采取中医辨证射干麻黄汤加减,煎至150～200 mL,分2次服;观察组32例,采用射干麻黄汤加减联合脾多肽注射液治疗(每日1次静脉滴注脾多肽注射液1支)。7 d为一个疗程,治疗前后分别采用流式细胞术检测观察组及对照组的外周血T淋巴细胞群,并在一个疗程结束后评定疗效。结果观察组32例,临床治愈15例,显效10例,有效4例,无效3例,总体有效率90.6%;对照组32例,临床治愈10例,显效9例,有效6例,无效7例,总体有效率78.1%。两组均未发现不良反应。与治疗前相比,两组在治疗后的外周血T淋巴细胞亚群CD3^+T和CD4^+T细胞亚群均上升(P=0.000),CD8^+T及Treg(调节T细胞)亚群均下降(P=0.000);观察组的外周血T淋巴细胞亚群较对照组改变差异有统计学意义(P=0.000)。治疗前观察组和对照组的血清免疫球蛋白水平(IgM、IgG和IgA)差异无统计学意义。治疗后,观察组的血清免疫球蛋白水平(IgM、IgG)较治疗前升高(P=0.000),且高于对照组(P=0.003,P=0.000)。结论射干麻黄汤加减联合脾多肽注射液应用于小儿CVA疗效显著,副作用小,且能显著改善病儿免疫功能,值得临床推广。

Objective To explore the clinical effect of association of Shegan Mahuang Decoction with the spleen polypeptide injection for the children with cough variant asthma on the immune function.Methods Sixty-four cases of infantile cough variant asthma of children were enrolled in the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from February 2015 to December 2016.Patients were randomly assigned into two groups according to the random number table method.Control group(32 cases)was treated with traditional Chinese medicine(TCM)syndrome differentiation and dried Shegan Mahuang Decoction,fried to 150~200 mL,and divided into 2 times,while observation group(32 cases)was treated with the Shegan Mahuang Decoction combined with spleen polypeptide injection therapy(one intravenous infusion of spleen once a day).7 days for a period of treatment,peripheral blood T lymphocytes of control group and observation group before and after treatment were observed by flow cytometry,and the curative effect was assessed at the end of a period of treatment.Results 32 cases of observation group,among them,15 cases got cure,10 cases had marked effect,4 cases were effective,3 had no effect,the total effective rate was 90.6%;32 cases of control group,among them,10 cases of clinical cure,9 cases were markedly effective,6 cases effective,7 had no effect,the total effective rate was 78.1%.No adverse reactions were found in the two groups.Compared with before treatment,CD3+T and CD4+T cell subsets of peripheral blood T lymphocytes in both groups increased after treatment(P=0.000),while CD8+T and Treg(regulating T cells)subsets decreased(P=0.000).Peripheral blood T lymphocyte subsets in the observation group were significantly different from those in the control group(P=0.000).There was no significant difference in serum IgM,IgG and IgA levels between the observation group and the control group before treatment.After treatment,serum IgM and IgG levels in the observation group were higher than those before treatment(all P=0.000),and higher than those in the control group(P=0.003,P=0.000).Conclusions Shegan Mahuang Decoction combined with the spleen polypeptide injection is effective in children with cough variant asthma with lower side effects,and can significantly improve the immune function of children,which is worthy of clinical promotion.