布地奈德气雾剂联合清热平喘汤对热哮证患儿实验室指标的影响

Effects of budesonide aerosol combined with Qingre Pingchuan Tang(清热平喘汤) on laboratory indexes of children with heat asthma syndrome

目的观察布地奈德气雾剂联合清热平喘汤对热哮证患儿血清炎症因子、肺功能和免疫功能指标的影响。方法选取2016年11月至2018年11月丽水市中医院儿科住院部82例热哮证患儿,按照随机数字表法分为对照组和治疗组,各41例。对照组吸入布地奈德气雾剂,治疗组在对照组治疗方法的基础上联合清热平喘汤口服治疗。2组均连续治疗4周后统计比较:1)免疫功能指标嗜酸性粒细胞(EOS)数目,CD+8、CD+4 T淋巴细胞数;2)炎症因子人内皮素(ET-1)、肿瘤坏死因子-α(TNF-α)、白细胞介素-10 (IL-10)、白细胞介素-4(IL-4);3)骨密度(BMD)和24 h尿游离皮质醇(24 h-UFC);4)肺功能第1秒用力呼气量(FEV1)和最大呼气峰流速(PEF)。结果治疗组总有效率为97.56%(40/41),显著高于对照组的80.49%(33/41),差异有统计学意义(P<0.05)。治疗前,2组ET-1、TNF-α、IL-10、IL-4水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述指标值与同组治疗前比较均显著降低/升高(P<0.05),且治疗组降幅/升幅更显著(P<0.05)。治疗前,2组EOS、CD+8、CD+4水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述指标值与同组治疗前比较均显著降低/升高(P<0.05),且治疗组降幅/升幅更显著(P<0.05)。治疗前,2组的体质量、BMD以及24 h-UFC水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述指标值与同组治疗前比较,差异无统计学意义(P>0.05)。结论布地奈德气雾剂联合清热平喘汤治疗热哮证患儿,不仅能够有效改善肺功能指标,还可减轻气道炎症、增强机体免疫功能,值得临床推广应用。

Objective To observe the effects of budesonide aerosol combined with Qingre Pingchuan Tang(清热平喘汤) on serum inflammatory factors,pulmonary function and immune function in children with heat asthma syndrome.Methods Eighty-two children with heat asthma syndrome in inpatient department of Lishui Hospital of Chinese Medicine from November 2016 to November 2018 were chosen and divided into control group and treatment group according to random number table method,with 41 cases in each.The control group was given budesonide aerosol,on this basis,the treatment group was combined with oral administration of Qingre Pingchuan Tang.We made statistical comparison after the 2 groups were both given consecutive treatment for 4 weeks:immune function index including the number of eosinophils(EOS),the number of T-lymphocytes CD+8,CD+4;2) inflammatory factors including human endothelin(ET-1),tumor necrosis factor-α(TNF-α),interleukin-10(IL-10),and interleukin-4(IL-4);3)bone mineral density(BMD) and 24 hours urinary free cortisol(24 h-UFC);4) pulmonary function including the forced expiratory volume in one second(FEV1) and peak expiratory flow(PEF).Results The total effective rate of the treatment group was 97.56%(40/41),which was significantly higher than 80.49%(33/41) of the control group,and the difference was statistically significant(P<0.05).Before treatment, the difference was not statistically significant in the levels of ET-1,TNF-α,IL-10 and IL-4 between the 2 groups(P>0.05),and they were comparable.After treatment,the above-mentioned indexes significantly decreased or increased compared with those in the same group before treatment(P<0.05),moreover,the treatment group decreased or increased more significantly(P<0.05).Before treatment,the difference was not statistically significant in the levels of body mass,BMD and 24 h-UFC between the 2 group(P>0.05),and they were comparable;after treatment,the difference was not statistically significant in the above-mentioned indexes compared with those in the same group before treatment(P>0.05).Conclusion It not only can effectively improve pulmonary function,but also can reduce airway inflammation and enhance the body immune function to use budesonide aerosol combined with Qingre Pingchuan Tang to treat children with heat asthma syndrome,which deserves clinical promotion and application.