扶正固本通络法治疗儿童支气管哮喘缓解期肺气亏虚证的临床疗效及对患儿肺通气功能、血清炎症因子、 T淋巴细胞亚群的影响

Clinical efficacy of Fuzheng Guben Tongluo method on children with bronchial asthma in remission stage of lung qi deficiency syndrome and its effect on pulmonary ventilation function, serum inflammatory factors and T lymphocyte subsets

目的观察扶正固本通络法治疗儿童支气管哮喘(以下简称哮喘)缓解期肺气亏虚证的临床疗效,以及对患儿肺通气功能、血清炎症因子、T淋巴细胞亚群的影响。方法将108例哮喘缓解期肺气亏虚证患儿按随机数字法分为2组。对照组54例予布地奈德福莫特罗粉吸入剂治疗;治疗组54例在对照组基础上加用扶正固本通络中药治疗。2组均治疗6个月后统计疗效,比较2组治疗前后肺通气功能指标[包括用力呼出25%肺活量时呼气流量(FEF25)、FEF50、FEF75及最大呼气中期流量(MMEF)]、血清炎症因子[包括肿瘤坏死因子α(TNF-α)、白细胞介素(IL)6及IL-4]及T淋巴细胞亚群(包括CD3^+、CD4^+、CD8^+及CD4^+/CD8^+)水平变化情况。结果治疗组总有效率92.6%,对照组总有效率77.8%,治疗组疗效明显高于对照组(P<0.05);2组治疗后FEF25、FEF50、FEF75及MMEF水平与本组治疗前比较均明显增加(P<0.05),且治疗组治疗后均高于对照组(P<0.05);2组治疗后TNF-α、IL-6及IL-4水平与本组治疗前比较均明显降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05);治疗组治疗后CD3^+、CD4^+、CD4^+/CD8^+水平与本组治疗前比较均明显升高(P<0.05),CD8+水平明显降低,且与对照组治疗后比较差异均有统计学意义(P<0.05),对照组治疗前后CD3^+、CD4^+、CD8^+、CD4^+/CD8^+水平变化比较差异无统计学意义(P>0.05)。结论扶正固本通络法治疗儿童哮喘缓解期肺气亏虚证疗效确切,可明显提高临床疗效,改善肺通气功能,降低炎症因子水平,抑制炎性反应,调节T淋巴细胞亚群比例,提高免疫功能。

Objective To observe the clinical efficacy of Fuzheng Guben Tongluo therapy on children with bronchial asthma(hereinafter referred to as asthma) in remission stage of lung qi deficiency syndrome and its effect on pulmonary ventilation function, serum inflammatory factors and T lymphocyte subsets. Methods 108 children with asthma in remission stage of lung qi deficiency syndrome were randomly divided into two groups according to the random number table method. 54 cases in control group were treated by budesonide formoterol powder inhalation. 54 cases in treatment group were treated by traditional Chinese medicine of Fuzheng Guben Tongluo on the basis of the control group. The curative effect was evaluated after 6 months of treatment in both groups. The changes of pulmonary ventilation function [ including exhalatory flow(FEF25), FEF50, FEF75 and maximum mid-expiratory flow(MMEF) during forced expiration of 25% vital capacity ], serum inflammatory factors [ including tumor necrosis factor-α(TNF-α), interleukin-6 and IL-4 ] and T lymphocyte subsets [ including CD3^+, CD4^+, CD8^+ and CD4^+/CD8^+] were compared between the two groups before and after treatment. Results The total effective rate was 92.6% in treatment group and 77.8 % in control group. The clinical curative effect of the treatment group was significantly higher than that of the control group(P<0.05). After treatment, the levels of FEF25, FEF50, FEF75 and MMEF in both groups were significantly increased(P<0.05), and the levels of pulmonary ventilation function in the treatment group were higher than those in the control group(P<0.05). After treatment, the levels of TNF-α, IL-6 and IL-4 in both groups were significantly lower than those before treatment(P<0.05), and the levels of serum inflammatory factors in the treatment group were lower than those in the control group(P<0.05). The levels of CD3^+, CD4^+, CD4^+/CD8^+ in the treatment group were significantly higher than those before treatment(P<0.05),the level of CD8+ was significantly decreased,there was significant difference between the two groups after treatment(P>0.05).There was no significant difference in the levels of CD3^+, CD4^+,CD8^+, CD4^+/CD8^+ in the control group before and after treatment(P>0.05). Conclusion Fuzheng Guben Tongluo method is effective in treating children asthma with lung qi deficiency syndrome in remission stage. It can obviously improve clinical efficacy, improve pulmonary ventilation function, reduce the level of inflammatory factors, inhibit inflammatory response, regulate the proportion of T lymphocyte subsets and improve immune function.