滋阴清嗓汤联合布地奈德雾化混悬液治疗咳嗽变异性哮喘患儿临床研究

Clinical Study on Ziyin Qingsang Tang Combined with Budesonide Spray Suspension for Cough Variant Asthma in Children

目的:观察滋阴清嗓汤联合布地奈德雾化混悬液对咳嗽变异性哮喘(CVA)患儿肺功能指标、诱导痰嗜酸性粒细胞比例(EOS%)及睡眠质量的影响。方法:将96例CVA患儿采用随机数字表法分为对照组47例与治疗组49例。所有患儿治疗前均进行常规对症处理,如抗感染、补液、吸氧等,对照组给予布地奈德雾化混悬液治疗;治疗组在对照组的基础上给予滋阴清嗓汤治疗。观察比较2组1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)及呼气流速峰值(PEFR);血清白细胞介素-5(IL-5)、白细胞介素-10 (IL-10)、C-反应蛋白(CRP)及EOS%水平;咳嗽症状评分、匹兹堡睡眠质量指数(PSQI)评分。结果:治疗组总有效率为91.84%,对照组为72.34%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组血清FEV_(1)、FVC、PEFR水平均明显高于治疗前(P<0.05),且治疗组上述各项指标均高于对照组(P<0.05)。治疗后,2组患儿IL-5、CRP及EOS%水平均低于治疗前(P<0.05)、IL-10水平高于治疗前(P<0.05),且治疗组上述各项指标改善均优于对照组(P<0.05)。治疗后,2组患儿日间咳嗽、夜间咳嗽评分及PSQI评分均低于治疗前(P<0.05),且治疗组各项评分均低于对照组(P<0.05)。总不良反应发生率治疗组为8.16%,对照组为23.40%,2组比较,差异有统计学意义(P<0.05)。结论:滋阴清嗓汤联合布地奈德雾化混悬液治疗CVA,可有效恢复肺功能,改善气道炎症反应及睡眠质量,减少不良反应。

Objective:To observe the effect of Ziyin Qingsang tang combined with Budesonide spray suspension on indexes of the lung function, the proportion of eosinophils(EOS) in whole blood, and sleep quality in children with cough variant asthma(CVA). Methods:A total of 96 cases of CVA children were divided into the control group and the treatment group according to the number table method, 47 and 49 cases in each group respectively. Before treatment, all patients were given anti-infection, fluid replacement, oxygen inhalation, and other routine symptomatic treatments;the control group was given Budesonide spray suspension,and the treatment group was additionally given Ziyin Qingsang tang based on the treatment of the control group. Forced expiratory volume in the first second(FEV_(1)),forced vital capacity(FVC),and peak expiratory flow rate(PEFR) were observed and compared between the two groups. The levels of interleukin-5(IL-5),interleukin-10(IL-10),C-reactive protein(CRP) in serum,and the proportion of eosinophils in induced sputum(EOS%) were observed and compared between the two groups. The scores of cough symptom and the scores of Pittsburgh Sleep Quality Index(PSQI) were observed and compared between the two groups. Results:The total effective rate was 91.84% in the treatment group,and 72.34% in the control group,the difference being significant(P<0.05). After treatment,the levels of FEV_(1),FVC,and PEFR in serum in the two groups were significantly higher than those before treatment(P<0.05),and each index above in the treatment group was higher than that in the control group(P<0.05). After treatment,the levels of IL-5 and CRP as well as EOS% in the two groups were lower than those before treatment(P<0.05),and the IL-10 level was higher(P<0.05);the improvement of each index above in the treatment group was better than that in the control group(P<0.05).After treatment,the scores of daytime cough,nighttime cough,and PSQI in the two groups were lower than those before treatment(P<0.05);each score above in the treatment group was lower than that in the control group(P<0.05). The total incidence of adverse reactions was 8.16% in the treatment group,and 23.40% in the control group,the difference being significant(P<0.05). Conclusion:In the treatment of CVA, the therapy of Ziyin Qingsang tang combined with Budesonide spray suspension can effectively recover the lung function,improve inflammatory response of airway and sleep quality,and reduce adverse reactions.