麻龙平喘汤联合布地奈德治疗儿童咳嗽变异性哮喘疗效及对气道状态与肺功能的影响

Therapeutic Effect of Using Malong Pingchuan Decoction Combined with Budesonide in the Treatment of Children with Cough Variant Asthma and Its Effect on Airway Status and Lung Function

目的:观察分析麻龙平喘汤联合布地奈德治疗儿童咳嗽变异性哮喘(CVA)疗效及对气道状态与肺功能的影响。方法:选择我院2017年2月~2020年2月期间收治的88例CVA患儿作为研究对象,随机数字表法分为对照组与观察组。对照组采取布地奈德福莫特罗治疗,观察组在对照组基础上联合麻龙平喘汤治疗。试验过程中3例为脱落病例,1例为剔除病例,纳入分析84例(对照组与观察组各42例)。比较两组患儿临床疗效及治疗前后诱导痰中炎性介质水平、免疫功能及肺功能指标的变化情况。结果:治疗后观察组总有效率(97.62%)明显高于对照组(80.95%)(P<0.05);治疗后,观察组与对照组治疗前白细胞介素-8(IL-8)与嗜酸性粒细胞(EOS)水平显著降低,白细胞介素-10(IL-10)水平升高(P<0.05),且观察组治疗后IL-8、EOS水平低于对照组,IL-10水平明显高于对照组(P<0.05);治疗后,观察组CD_(4)^+、CD_(4)^+/CD_(8)^+水平低于对照组,CD_(8)^+水平明显高于对照组(P<0.05);治疗后,两组肺活量(FVC)、第1秒呼出气体容积(FEV1)、FEV1/FVC分别较治疗前升高,且观察组治疗后FVC、FEV1、FEV1/FVC水平均高于对照组(P<0.05)。结论:麻龙平喘汤联合布地奈德治疗CVA患儿临床疗效更佳,不但能明显降低患儿气道炎症水平,还可以调节其免疫功能,改善肺功能,值得推广。

Objective:To investigate the therapeutic effect of using Malong Pingchuan Decoction combined with Budesonide in the treatment of children with cough variant asthma and its effect on airway status and lung function.Methods:88 children with CVA treated in ouRhospital from February 2017 to February 2020 were selected as the study subjects,and randomized numbeRtable method was used to divide them into a controlled group and an observation group.The controlled group was treated with Budesonide Formoterol,while the observation group was treated with Marong Pingchuan Decoction on the basis of the controlled group.During the experiment,3 cases were exfoliated,1 case was excluded,84 cases were included in the analysis(42 cases in the controlled group and 42 cases in the observation group).The clinical efficacy and the changes of inflammatory mediators in induced sputum,immune function and lung function indexes before and afteRtreatment were compared between the two groups.Results:AfteRtreatment,the total effective rate of the observation group(97.62%)was significantly higheRthan that of the controlled group(80.95%)(P<0.05).AfteRtreatment,the levels of interleukin-8(IL-8)and eosinophil(EOS)in two groups were significantly decreased,and the levels of interleukin-10(IL-10)were increased(P<0.05),and the levels of IL-8 and EOS in the observation group were loweRthan those in the controlled group,and the levels of IL-10 were significantly higheRthan those in the controlled group(P<0.05).AfteRtreatment,the levels of CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)in both groups decreased and CD_(8)^(+)increased compared with that before treatment,and the levels of CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)in the observation group were loweRthan that in the controlled group,and the levels of CD8+was significantly higheRthan that in controlled group(P<0.05).AfteRtreatment,the vital capacity(FVC),expired gas volume in the first second(FEV1),FEV1/FVC in both groups were significantly higher than that before treatment,and the levels of FVC,FEV1,FEV1/FVC in the observation group were higheRthan those in the controlled group,with statistical significance(P<0.05).Conclusion:Malong Pingchuan Decoction combined with Budesonide in the treatment of children with CVA has betteRclinical efficacy,which not only can significantly reduce the level of children's airway inflammation,but also can regulate theiRimmune function and improve lung function,which is worthy of promotion.