加味玉屏风汤联合妥洛特罗贴剂对小儿咳嗽变异性哮喘的影响

The Effects of Modified Yupingfeng Tang Combined with Tulobuterol Patches on Children with Cough-variant Asthma

目的:观察加味玉屏风汤联合妥洛特罗贴剂治疗小儿咳嗽变异性哮喘(cough-variant asthma,CVA)的疗效及对细胞免疫因子的影响。方法:将咳嗽变异性哮喘患儿60例按照随机数字表法分为对照组、观察组各30例,两组患儿均予止咳、抗感染和解痉平喘等常规治疗,并给予孟鲁司特钠和妥洛特罗贴剂治疗。观察组在此基础上给予加味玉屏风汤治疗,比较两组临床疗效、临床症状以及治疗前后肺功能指标和细胞免疫因子水平情况。结果:总有效率观察组为96.7%(29/30),高于对照组的90.0%(27/30)(P<0.05);观察组患者咳嗽缓解时间,咳嗽消失时间及平均住院时间均短于对照组(P<0.05);两组治疗后最大呼气峰流速(peak expiratory fowl rate,PEF)、用力肺活量(forced vital capacity,FVC)和第一秒用力呼气量(forced expi-ratory volume in one second,FEV1)高于治疗前(P<0.05),且观察组高于对照组(P<0.05);两组治疗后干扰素γ(interferon-γ,INF-γ)和INF-γ/IL-4高于治疗前,白细胞介素4(interleukin4,IL-4)水平低于治疗前(P<0.05),治疗后观察组INF-γ水平和INF-γ/IL-4高于对照组,IL-4低于对照组(P<0.05);INF-γ与PEF、FVC和FEV1均呈正相关(P<0.05),IL-4与PEF、FVC和FEV1均呈负相关(P<0.05)。结论:加味玉屏风汤联合孟鲁司特钠及妥洛特罗贴剂,可有效缩短CVA小儿临床症状改善时间,改善肺功能,调节免疫功能。

Objective:To observe clinical effects of modified Yupingfeng Tang joined with tulobuterol patches in the treatment for cough-variant asthma(CVA)and its effects on cellular immune factors.Methods:Sixty children were divided into the control group and the observation group according to random number table method,30 cases each group,both groups accepted conventional therapy of stopping cough,fighting against infection,relieveing spasm and asthma,and others,and they were given montelukast sodium chewable tablets and tulobuterol patches.The observation group took modified Yupingfeng Tang based on conventional therapy,to compare curative effects,clinical symptoms,the incidexes of pulmonary function before and after treating and the levels of cellular immune factors between both groups.Results:Total effective rate of the observation group was 96.7%(29/30),higher than 90.0%(27/30)of the control group(P<0.05);the observation group was shorter than the control group in cough remission time,cough disappearing time,average hospitalization time(P<0.05);PEF,FVC and FEV1 of both groups after treating were higher than these before treating(P<0.05),and the observation group was higher than the control group(P<0.05);INF-γand INF-γ/IL-4 of both groups after treating were higher than these before treating,while the levels of IL-4 were lower than these before treating(P<0.05),after treating the observation group was higher than the control group in the levels of INF-γand INF-γ/IL-4,lower than the control group in IL-4(P<0.05);INF-γwas positively related to PEF,FVC and FEV1(P<0.05),IL-4 was negatively related to PEF,FVC and FEV1(P<0.05).Conclusion:Modified Yupingfeng Tang joined with montelukast sodium chewable tablets,tulobuterol patches in the treatment for CVA could effectively shorten the improvement time of clinical symtoms,ameliorate pulmonary function and regulate immunologic function.