宣肺运脾汤治疗儿童慢性咳嗽(痰湿蕴肺型)的疗效及对患儿炎症因子、免疫功能的影响

Clinical efficacy of Xuanfei Yunpi Decoction in the treatment of children with chronic cough of phlegm dampness accumulating lung type and its effect on inflammatory factors and immune function

目的观察宣肺运脾汤治疗儿童慢性咳嗽(痰湿蕴肺型)的疗效,并探讨其对患儿炎症因子和免疫功能的影响。方法选取2019年6月至2021年7月期间陕西省中医医院儿科收治的130例痰湿蕴肺型慢性咳嗽患儿作为研究对象,按照随机数表法将其分为观察组和对照组各65例。对照组采用常规西医治疗,观察组在对照组治疗的基础上给予宣肺运脾汤治疗,两组患儿均治疗10 d。比较两组患儿的治疗效果、治疗前后的炎症因子和免疫功能指标水平。结果观察组患儿的治疗总有效率为98.46%,明显高于对照组的87.69%,差异有统计学意义(P<0.05);治疗前,两组患儿的血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平比较差异均无统计学意义(P>0.05),治疗后,两组患儿的血清IL-6、IL-8、CRP、TNF-α水平均明显降低,且观察组患儿血清IL-6、IL-8、CRP、TNF-α水平分别为(78.59±12.08)ng/mL、(67.16±9.87)pg/mL、(2.94±0.43)mg/L、(1.42±0.46)μg/L,明显低于对照组的(94.03±12.86)ng/mL、(91.78±13.26)pg/mL、(6.03±1.49)mg/L、(2.64±0.39)μg/L,差异均有统计学意义(P<0.05);治疗前,两组患儿的分化簇3(CD3^(+))、分化簇4(CD4^(+))、分化簇8(CD8^(+))、CD4^(+)/CD8^(+)水平比较差异均无统计学意义(P>0.05),治疗后,两组患儿的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均明显升高,且观察组患儿的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平分别为(64.89±5.46)%、(43.68±4.97)%、1.62±0.34,明显高于对照组的(58.16±5.31)%、(39.03±5.13)%、1.21±0.29,而CD8^(+)水平明显降低,且观察组为(25.97±3.12)%,明显低于对照组的(28.73±2.84)%,差异均有统计学意义(P<0.05)。结论宣肺运脾汤治疗儿童慢性咳嗽(痰湿蕴肺型)可显著改善患儿的临床咳嗽症状,有效地降低患儿的炎症反应,改善患儿的免疫功能,临床应用效果显著,值得推广应用。

Objective To observe the curative effect of Xuanfei Yunpi Decoction in the treatment of children with chronic cough(phlegm dampness accumulating lung type),and to explore its effect on inflammatory factors and im-mune function.Methods A total of 130 children with chronic cough(phlegm dampness accumulating lung type)treat-ed in Department of Pediatrics,Shaanxi Traditional Chinese Medicine Hospital from June 2019 to July 2021 were select-ed as the research objects.They were randomly divided into an observation group and a control group,with 65 children in each group.The control group was treated with conventional western medicine,and the observation group was treated with Xuanfei Yunpi Decoction on the basis of the control group.The children in both groups were treated for 10 days.The therapeutic effect,inflammatory factors,and immune function indexes before and after treatment were compared be-tween the two groups.Results The total effective rate of the observation group was 98.46%,which was significantly higher than 87.69%of the control group(P<0.05).Before treatment,there were no significant differences in serum interleu-kin-6(IL-6),interleukin-8(IL-8),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α)levels between the two groups(P>0.05);after treatment,the levels of serum IL-6,IL-8,CRP,and TNF-αin the two groups were significantly de-creased,and the serum levels of IL-6,IL-8,CRP,and TNF-αin the observation group were(78.59±12.08)ng/mL,(67.16±9.87)pg/mL,(2.94±0.43)mg/L,(1.42±0.46)μg/L,which were significantly lower than(94.03±12.86)ng/mL,(91.78±13.26)pg/mL,(6.03±1.49)mg/L,(2.64±0.39)μg/L in the control group(P<0.05).Before treatment,there were no signifi-cant differences in the levels of differentiation cluster 3(CD3^(+)),differentiation cluster 4(CD4^(+)),differentiation cluster 8(CD8^(+)),CD4^(+)/CD8^(+)between the two groups(P>0.05);after treatment,the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the two groups were significantly increased,and CD8^(+)level significantly decreased;the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the observation group after treatment were(64.89±5.46)%,(43.68±4.97)%,and 1.62±0.34,which were signifi-cantly higher than(58.16±5.31)%,(39.03±5.13)%,1.21±0.29 in the control group,and CD8^(+)level in the observation group was (25.97±3.12)%,which was significantly lower than (28.73±2.84)%in the control group;the differences were statistically significant(P<0.05).Conclusion Xuanfei Yunpi Decoction in the treatment of children's chronic cough(phlegm dampness accumulating lung type)can significantly improve the clinical cough symptoms of children,effective-ly reduce the inflammatory response of children,and improve the immune function of children,with remarkable clinical application effect,which is worthy of popularization and application.