柴胡六味汤加减联合沙美特罗替卡松粉吸入剂治疗小儿咳嗽变异性哮喘临床研究

Clinical Study on Modified Chaihu Liuwei Tang Combined with Salmeterol Fluticasone Powder Inhalation for Cough Variant Asthma in Children

目的:观察柴胡六味汤加减联合沙美特罗替卡松粉吸入剂治疗小儿咳嗽变异性哮喘 (CVA) 的临床疗效。方法:将90 例小儿 CVA 患者按照随机数字表法分为对照组与观察组各 45 例。对照组采用沙美特罗替卡松粉吸入剂治疗,观察组采用柴胡六味汤加减联合沙美特罗替卡松粉吸入剂治疗。比较 2 组临床疗效、症状缓解时间及 2 组治疗前后症状积分、肺功能、血清指标水平。结果:观察组总有效率 93.33%,高于对照组 77.78% (P<0.05)。与同组治疗前比较,治疗后 2 组日间、夜间症状积分及外周血嗜酸性粒细胞计数 (EOS)、免疫球蛋白 E (IgE) 水平均降低 (P<0.05),呼吸峰值流速 (PEFR)、第 1 秒用力呼气容积 (FEV_(1))、第 1 秒用力呼气容积/用力肺活量 (FEV_(1)/FVC) 水平均升高 (P<0.05);与对照组治疗后比较,观察组治疗后日间、夜间症状积分及 EOS、IgE 水平均较低 (P<0.05),PEFR、FEV_(1)、FEV_(1)/FVC 水平均较高 (P<0.05)。与对照组比较,观察组咳嗽缓解及消失时间均较短 (P<0.05)。结论:柴胡六味汤加减联合沙美特罗替卡松粉吸入剂治疗 CVA 疗效确切,可快速控制患者的临床症状,改善患者肺功能。

Objective:To observe the clinical effect of modified Chaihu Liuwei tang combined with salmeterol fluticasone powder inhalation for cough variant asthma(CVA) in children. Methods:A total of 90 cases of CVA children were divided into the control group and the observation group according to the random number table method,with 45 cases in each group. The control group was treated with salmeterol fluticasone powder inhalation,and the observation group was additionally treated with modified Chaihu Liuwei tang based on the treatment of the control group. Symptom scores, the lung function, and levels of serum indexes before and after treatment as well as clinical effects and the remission time of symptoms were compared between the two groups. Results:The total effective rate was 93.33% in the observation group,higher than that of 77.78% in the control group(P<0.05). When compared with those in the same group before treatment,the daytime and nighttime symptom scores,eosinophil(EOS) counts,and immunoglobulin E(IGE) levels in peripheral blood after treatment were decreased in the two groups(P<0.05),and levels of peak respiratory flow rate(PEFR),forced expiratory volume in the first second(FEV_(1)),and forced expiratory volume in the first second/forced vital capacity(FEV_(1)/FVC) were increased(P<0.05).After treatment,the daytime and nighttime symptom scores as well as levels of EOS and IgE in the observation group were lower than those in the control group(P<0.05), and levels of PEFR, FEV_(1), and FEV_(1)/FVC were higher(P<0.05). The remission time and disappearance time of cough in the observation group were shorter than those in the control group(P<0.05). Conclusion:The therapy of modified Chaihu Liuwei tang combined with salmeterol fluticasone powder inhalation has a defined curative effect in the treatment of CVA,which can quickly control clinical symptoms and improve the lung function.