基于Th1/Th2失衡机制评估疏风清热宣肺方对儿童咳嗽变异性哮喘的临床疗效

Evaluation of the clinical efficacy of Shufeng Qingre Xuanfei prescription on children with cough variant asthma based on the imbalance mechanism of Th1 and Th2

目的基于辅助性T细胞1/辅助性T细胞2(Th1/Th2)失衡机制评估疏风清热宣肺方对咳嗽变异性哮喘(CVA)患儿的临床疗效。方法选取CVA患儿102例为研究对象,按照随机数字表法分为研究组与对照组,各51例。对照组采用常规西药治疗,研究组在对照组的基础上配合疏风清热宣肺方治疗。观察2组治疗4周后疗效,比较2组治疗前后Th1、Th2、Th1/Th2水平、血清干扰素-γ(IFN-γ)、白细胞介素-4(IL-4)水平、风热袭肺证中医证候评分、及IFN-γ/IL-4,比较2组临床疗效及安全性。结果治疗后,2组Th2水平、IL-4水平、风热袭肺证中医证候评分较治疗前均降低(P<0.05),且研究组低于对照组(P<0.05);治疗后,2组Th1、Th1/Th2水平、血清IFN-γ水平、IFN-γ/IL-4均升高(P<0.05),且研究组更高(P<0.05);治疗4周后,研究组总有效率(90.20%,46/51)高于对照组(74.51%,38/51)(P<0.05);2组治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论采用疏风清热宣肺方联合常规西药治疗风热袭肺证CVA患儿,疗效显著,可促进Th1/Th2平衡的恢复,且安全可靠。

Objective To evaluate the clinical efficacy of the Shufeng Qingre Xuanfei prescription on children with cough variant asthma(CVA)based on the imbalance mechanism of helper T cell 1/helper T cell 2(Th1/Th2).Methods A total of 102 children with CVA were selected as the research subjects and divided into a study group and a control group according to the random number table method,with 51 cases in each group.The control group was treated with the conventional western medicine,while the study group was treated with the Shufeng Qingre Xuanfei Decoction on the basis of the control group,both for 4 continuous weeks.The curative effects of the two groups after treatment were observed.The levels of Th1,Th2,Th1/Th2,serum interferon-γ(IFN-γ),interleukin-4(IL-4),the scores of the TCM syndrome of lung attacked by wind-heat,and the ratio of IFN-γand IL-4 were compared between the two groups before and after treatment.The clinical efficacy and safety of the two groups were compared.Results After treatment,the levels of Th2 and IL-4,and the scores of the TCM syndrome of lung attacked by wind-heat in the two groups were all decreased than those before treatment(P<0.05),and the study group was lower than the control group(P<0.05).The levels of Th1,Th1/Th2 and serum IFN-γ,the ratios of IFN-γand IL-4 were all increased in both groups(P<0.05),and the study group was higher than the control group(P<0.05).After 4 weeks of treatment,the total effective rate of the study group(90.20%,46/51)was higher than that of the control group(74.51%,38/51)(P<0.05),while there was no significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion In the treatment of CVA children with the TCM syndrome of lung attacked by wind-heat,the combination of the Shufeng Qingre Xuanfei Decoction and conventional western medicine has a significant effect,can promote the restoration of the Th1/Th2 imbalance,and is safe and reliable.