寒喘祖帕颗粒辅助治疗婴幼儿毛细支气管炎寒饮犯肺证80例临床观察

Clinical observation on 80 cases of infantile bronchiolitis with cold fluid invading lung syndrome treated by Hanchuan Zupa Keli(寒喘祖帕颗粒)as adjuvant therapy

目的观察寒喘祖帕颗粒辅助治疗婴幼儿毛细支气管炎寒饮犯肺证的临床疗效。方法选取平湖市第一人民医院儿科门诊和住院部2018年1月至2019年3月收治的160例毛细支气管炎寒饮犯肺证患儿作为研究对象,按照随机数字表法分为对照组和治疗组,各80例。对照组在常规物理降温、保证液体摄入量、保持呼吸道通畅、补充营养、镇静的基础上,予吸入用布地奈德混悬液1 mg+吸入用异丙托溴铵液0.25 mg+硫酸特布他林溶液2.5 mg+生理盐水2 mL雾化吸入,并口服孟鲁司特钠咀嚼片,治疗组在对照组治疗方法的基础上予寒喘祖帕颗粒口服,2组均以7 d为1个疗程,治疗1个疗程后观察2组的临床疗效、临床症状(咳嗽、气喘、肺部喘鸣音、呼吸困难)消失时间、治疗前后血清炎症因子水平的变化情况以及6个月后的复发情况。结果对照组总有效率为72.50%(58/80),治疗组为88.75%(71/80),2组比较,差异有统计学意义(P<0.05)。治疗组咳嗽、喘憋、肺部喘鸣音及呼吸困难消失时间显著短于对照组,2组比较,差异有统计学意义(P<0.05)。治疗前,2组血清肿瘤坏死因子-α(TNF-α)、白细胞介素-5(IL-5)、白细胞介素-6(IL-6)水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述指标水平均明显下降,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组下降更显著(P<0.05)。对照组复发19例(32.76%),治疗组复发11例(15.49%),2组比较,差异有统计学意义(P<0.05)。结论寒喘祖帕颗粒辅助治疗婴幼儿毛细支气管炎寒饮犯肺证,能明显改善患儿临床症状,减轻炎症反应,降低复发率,疗效显著,值得临床推广应用。

Objective To observe the clinical efficacy of Hanchuan Zupa Keli(寒喘祖帕颗粒) in adjuvant treatment of infantile bronchiolitis with cold fluid invading lung syndrome.Methods From January 2018 to March 2019, 160 cases of infantile bronchiolitis with cold fluid invading lung syndrome admitted into outpatient service and inpatient department of pediatric department in Pinghu The People’s Hospital were chosen as the research objects and divided into control group and treatment group according to random number table method,with 80 cases in each.On the basis of routine physical cooling,ensuring liquid intake,keeping respiratory tract unobstructed,replenishing nutrition and sedation,the control group was given aerosol inhalation with 1 mg of budesonide suspension for inhalation+0.25 mg of ipratropium bromide solution for inhalation+2.5 mg of terbutaline sulfate solution+ 2 mL of normal saline,and oral administration of montelukast sodium chewable tablets.Based on the therapeutic method of the control group,the treatment group was given oral administration of Hanchuan Zupa Keli.Seven days constituted 1 course of treatment for both groups,after 1 course of treatment,the clinical efficacy,the disappearance time of clinical symptoms(cough,asthma,wheeze of lung and dyspnea),changes of serum inflammatory factors before and after treatment,along with recurrence after 6 months of the 2 groups were compared.Results The total effective rate of the control group was 72.50%(58/80),that of the treatment group was 88.75%(71/80),and the difference between the 2 groups was statistically significant(P<0.05).The disappearance time of cough,asthma,wheeze of lung and dyspnea in the treatment group was significantly shorter than that in the control group,and the difference between the 2 groups was statistically significant(P<0.05).Before treatment, the difference was not statistically significant in the serum levels of tumor necrosis factor-α(TNF-α),interleukin-5(IL-5) and interleukin-6(IL-6) between the 2 groups(P>0.05),and they were comparable.After treatment,the above-mentioned index levels of the 2 groups all significantly decreased,and the difference was statistically significant compared with those in the same group before treatment(P<0.05),moreover,the treatment group decreased more significantly(P<0.05).There were 19 cases(32.76%) of recurrence in the control group and 11 cases(15.49%) in the treatment group, and the difference was statistically significant(P<0.05).Conclusion It can markedly alleviate the infantile clinical symptoms,reduce inflammatory reaction and decrease recurrence rate with marked efficacy to use Hanchuan Zupa Keli in adjuvant treatment of infantile bronchiolitis with cold fluid invading lung syndrome,which deserves clinical promotion and application.