桑芩止咳浓煎剂对咳嗽变异性哮喘急性发作期患者小气道功能的影响

Influence of Concentrated Sangqin Zhike Decoction on Small Airway Function in Patients with Acute Phase of Cough Variant Asthma

目的探讨桑芩止咳浓煎剂对咳嗽变异性哮喘(CVA)急性发作期患者小气道功能的影响及其部分作用机制。方法将160例CVA急性发作期患者随机分为对照组与观察组各80例。对照组采用布地奈德/福莫特罗吸入治疗,观察组在对照组基础上加用桑芩止咳浓煎剂治疗,治疗2周后评定疗效。结果两组疗效比较,观察组的显控率高于对照组(P<0.05),观察组的咳嗽缓解时间、日咳消退时间及夜咳消失时间较对照组缩短,且观察组中医证候(TCM)评分明显低于对照组(P<0.05)。观察组治疗后血清干扰素-γ(INF-γ)高于对照组,嗜酸性粒细胞百分比(EOS)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、神经生长因子(NGF)、基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶抑制剂-1(TIMP-1)低于对照组(P<0.05)。治疗后,观察组的肺功能及小气道功能参数均优于对照组(P<0.05)。结论桑芩止咳浓煎剂治疗CVA急性发作疗效确切,可促进症状缓解,提高临床疗效,改善小气道功能,其机制与抑制气道炎症反应及气道重塑有关。

Objective:To investigate the influence of concentrated Sangqin Zhike Decoction on small airway function in patients with acute phase of cough variant asthma(CVA)and its partial mechanism.Methods:A total of 160 cases of CVA patients were randomly divided into two groups.Eighty cases in the control group were treated with budesonide/formoterol inhalation,80 cases in the observation group were treated with concentrated Sangqin Zhike Decoction on the basis of the control group.The curative effect was evaluated after two weeks of treatment.Results:Comparison of the efficacy of the two groups showed that the apparent control rate of the observation group was higher than that of the control group(P<0.05),the cough relief time,daily cough resolution time and night cough disappearance time of the observation group were shorter than the control groups,and the TCM score of the observation group was significantly lower than that of the control group(P<0.05).After treatment,the serum interferon-γ(INF-γ)in the observation group was higher than that of the control group,the percentage of eosinophils(EOS),interleukin-4(IL-4),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),nerve growth factor(NGF),metal matrix protease-2(MMP-2),metal matrix protease-9(MMP-9),metal matrix protease inhibitor-1(TIMP-1)were lower than the control group(P<0.05).After treatment,the pulmonary function and small airway function parameters of the observation group were better than those of the control group(P<0.05).Conclusion:The concentrated Sangqin Zhike Decoction is effective in treating acute phase of CVA,which can promote symptom relief,improve clinical efficacy,and improve small airway function.The mechanism may be related to the inhibition of airway inflammation and airway remodeling.