滋阴清嗓汤对咳嗽变异性哮喘发作期患儿IgE、IL-4、IL-5水平的影响及安全性分析

Effect of Ziyin Qingsang Decoction on levels of IgE,IL-4 and IL-5 in CVA Children at Onset Stage and Its Safety Analysis

目的:探究滋阴清嗓汤对咳嗽变异性哮喘(CVA)发作期患儿免疫球蛋白E(IgE)、白细胞介素-4(IL-4)、白细胞介素-5(IL-5)的影响及安全性。方法:选取2018年1月—2019年6月在河南省儿童医院东三街院区呼吸科一病区住院治疗的170例CVA患儿,随机分为中医联合组(85例)和西医常规组(85例)。所有患儿均给予西医常规治疗,中医联合组加用滋阴清嗓汤。两组均连续治疗14 d后,观察并比较两组的疗效、症状改善时间、临床主要症状积分、外周血单个核细胞(PBMC)内IL-4、IL-5、血清IgE水平、呼出气一氧化氮(FeNO)及肺功能指标水平。结果:中医联合组患儿痊愈率为80.00%(68/85),显著高于西医常规组痊愈率61.18%(52/85)(P<0.05)。中医联合组患儿症状改善时间(咳嗽减轻、咳嗽消退、夜咳停止的时间)均显著短于西医常规组(P<0.05)。治疗后,两组患儿咳嗽、咽痛、喉痒评分均显著下降,且中医联合组显著低于西医常规组(P<0.05)。治疗后,两组患儿PBMC内IL-4、IL-5及血清IgE水平均显著下降,且中医联合组均显著低于西医常规组(P<0.05)。治疗后,两组患者FeNO和1 s用力呼气容积(FEV1)均显著下降(P<0.05),呼气峰流速(PEF)均显著升高(P<0.05),组间比较,中医联合组均显著优于西医常规组(P<0.05)。两组患者在治疗期间均未发生明显不良反应和不良事件。结论:滋阴清嗓汤对CVA发作期患儿具有良好的疗效,可发挥较好的滋阴清热、止咳平喘、改善慢性炎症作用,有效改善其临床症状,安全性高,值得推广。

Objective:To explore the effect and safety of Ziyin Qingsang Decoction on the levels of immunoglobulin E(IgE),interleukin-4(IL-4)and interleukin-5(IL-5)in children with cough variant asthma(CVA)at the onset stage,and to analyze the safety of the therapy.Methods:170 children who met the inclusion criteria were randomly divided into the control group(n=85)and observation group(n=85).The control group was treated with conventional western medication;on which basis,the observation group was also treated with Ziyin Qingsang Decoction.After consecutive 14 days of treatment,the curative effect,time of symptom improvement,clinical main symptom scores,the levels of IL-4,IL-5 in peripheral blood mononuclear cells(PBMC),as well as serum IgE,fractional exhaled nitric oxide(FeNO)and pulmonary function index were observed and compared in the two groups.Results:The cure rate of the observation group was 80.00%(68/85),which was significantly higher than 61.18%(52/85)of the control group(P<0.05).The time of symptom improvement,such as cough relief,cough regression and night cough cessation,came earlier in the observation group compared to that in the control group(P<0.05).After the treatment,the scores of cough,sore throat and throat itching decreased in the two groups,and the decreases in the observation group were more significant(P<0.05).The levels of IL-4,IL-5 in PBMC and serum IgE also decreased in the two groups after the treatment,and the improvements of the observation group were more significant(P<0.05).FeNO and 1 s forced expiratory volume(FEV1)were lower and peak expiratory flow rate(PEF)was higher in the two groups after the treatment(P<0.05),of which the changes of the observation group were more obvious(P<0.05).No obvious adverse reactions and adverse events occurred in the two groups during the treatment.Conclusion:Ziyin Qingsang Decoction has a good curative effect on children with CVA attack.It can play a better role in nourishing yin,clearing heat,relieving cough and asthma,improving chronic inflammation and effectively improving its clinical symptoms.The therapy has a high safety,which is worthy of promotion.