小五味子汤、布地奈德联合推拿治疗感染后慢性咳嗽患儿的临床疗效

Clinical Efficacy of Xiaowuweizi Decoction and Budesonide Combined with Massage on Children with Chronic Cough after Infection

目的探讨小五味子汤、布地奈德联合推拿治疗感染后慢性咳嗽患儿的临床疗效。方法选取2017年1月—2019年12月接受治疗的感染后慢性咳嗽(风邪伏肺证)患儿92例,随机分为两组,每组46例。对照组给予布地奈德联合推拿手法治疗,在此基础上,观察组加以小五味子汤治疗,连续用药10 d,记录患儿治疗前后症状积分、症状消失时间、临床疗效、血清免疫球蛋白水平[免疫球蛋白(lg G) G、免疫球蛋白G(lg E)、免疫球蛋白G(lg M)]、血清T淋巴细胞亚群水平(CD3^+、CD4^+、CD8^+、CD4^+/CD8^+)和痰上清液炎性因子水平[肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-4、IL-8]水平,并记录两组患儿用药不良反应发生情况。结果与对照组相比,观察组咳嗽症状积分、风邪伏肺证积分均显著降低(P<0.05),症状消失时间显著缩短(P<0.05);观察组治疗后总有效率较对照组显著提高(P<0.05);观察组治疗后血清CD4^+、CD3^+、CD4^+/CD8^+、lg G、lg E、Lg M水平均显著高于对照组(P<0.05),CD8^+显著低于对照组(P<0.05);观察组治疗后痰上清液TNF-α、IL-4和IL-8水平均显著低于对照组(P<0.05);两组均未见肝肾功能损伤等明显不良反应。结论小五味子汤、布地奈德联合推拿手法治疗感染后慢性咳嗽患儿疗效满意,相对于布地奈德联合推拿手法治疗而言,可显著提高临床疗效、调节患儿免疫功能、降低气道炎症反应,缩短治疗时间。

Objective To explore the clinical efficacy of Xiaowuweizi decoction and budesonide combined with massage in treating children with chronic cough after infection.Methods 92 children with chronic cough(Wind-Induced Lung Syndrome) after infection in our hospital from January 2017 to December 2019 were randomly divided into two groups,each with 46 cases.The control group was given budesonide combined with massage Manipulative therapy.On this basis,the observation group was treated with Xiaowuweizi decoction for 10 days.Record the child’ s symptom score before and after treatment,clinical symptoms,clinical efficacy,serum immunoglobulin levels[immunoglobulin(lg G) G,immunoglobulin G(lg E),immunoglobulin G(lg M) ],serum T lymphocytes Subpopulation levels(CD3^+,CD4^+,CD8^+,CD4^+/CD8^+) and sputum supernatant inflammatory factor levels[tumor necrosis factor-α(TNF-a),interleukin(IL)-4,IL-8]levels,the incidence of adverse drug reactions in the two groups of children was recorded.Results Compared with the control group,the cough symptom score and Fengxiefufei syndrome score of the observation group were significantly reduced(P<0.05),and the time to disappear symptoms was significantly shortened(P<0.05).The total effective rate of treatment in observation group was significantly higher than that in control group(97.83% vs 84.78%),P<0.05.Serum CD4^+,CD3^+,CD4^+/CD8^+,lg G,lg E,and lg M levels in the observation group were significantly higher than those in the control group(P<0.05),and CD8^+were significantly lower than those in the control group(P<0.05);The levels of sputum supernatant TNF-a,IL-4 and IL-8 in the observation group were significantly lower than those in the control group(P<0.05).No obvious adverse reactions such as liver and kidney damage were seen in both groups.Conclusion The combination of Xiaowuweizi decoction and budesonide combined with massage therapy in the treatment of children with cough after chronic infection is satisfactory.Compared with budesonide combined with massage therapy,it can significantly improve the clinical efficacy,adjust the immune function of children,and reduce airway inflammation Shorten the treatment time.