俞氏宣通散加味治疗肺脾气虚型儿童腺样体肥大的临床疗效

Clinical observation of Yushi Xuantong Powder in treating adenoid hypertrophy in children with Lung spleen qi deficiency syndrome

目的 探讨俞氏宣通散加味治疗肺脾气虚型儿童腺样体肥大的临床疗效。方法 选取2018年2月—2020年2月浙江中医药大学附属第三医院儿科门诊收治的儿童腺样体肥大患儿82例为研究对象,随机分为西药组和中药组,每组各41例。西药组患儿使用糠酸莫米松鼻喷雾剂治疗,中药组患儿采用俞氏宣通散加味治疗,疗程均为1个月。记录两组患儿治疗前后的主要症状观察指标积分、OSA-18量表评分、腺样体厚度/鼻咽腔宽度(A/N)、最低夜间血氧饱和度(LSaO;)、炎症细胞因子水平及免疫状况,并统计安全性和疗效。结果 治疗后,中药组患儿鼻塞、眠时打鼾及张口呼吸证候积分均显著低于西药组,差异均有统计学意义(均P<0.05);中药组患儿OSA-18量表评分均显著低于西药组,差异均有统计学意义(均P<0.05)。治疗后,中药组患儿A/N比值均显著小于西药组,LSaO;水平显著高于西药组,差异均有统计学意义(均P<0.05)。治疗后,中药组患儿血清中特异性变应原IgE(sIgE)、白三烯C4(LTC4)、可溶性白介素-2受体(sIL-2R)及嗜酸性粒细胞(ECO)水平均显著低于西药组,CD4;、CD4;/CD8;均显著高于西药组,差异均有统计学意义(均P<0.05)。中药组患儿治疗总有效率(97.56%)高于西药组(82.93%),差异有统计学意义(χ^(2)=13.085,P<0.05)。两组患儿不良反应发生率(4.88%vs. 7.32%)比较,差异无统计学意义(χ^(2)=0.519,P>0.05)。结论 俞氏宣通散加味治疗儿童肺脾气虚型腺样体肥大效果满意,可显著改善患儿症状和呼吸功能,减轻炎症反应,改善免疫功能和生活质量,且用药安全。

Objective To explore the clinical effect of Yushi Xuantong Powder in treating adenoid hypertrophy in children with lung-spleen-qi deficiency.Methods 82 children with adenoid hypertrophy admitted to the Pediatric Clinic of the Third Affiliated Hospital of Zhejiang Chinese Medicine University from February 2018 to February 2020 were selected as the research objects, and they were randomly divided into a western medicine group and a traditional Chinese medicine group, with 41 cases in each group.Children in the western medicine group were treated with mometasone furoate nasal spray, and the children in the traditional Chinese medicine group were treated with Yushi Xuantong powder.course of treatment is 1 month.Record the main symptom observation index scores, OSA-18 scale score, adenoid thickness/nasopharyngeal cavity width(A/N), minimum nighttime blood oxygen saturation(LSaO;), and inflammatory cytokine levels before and after treatment in the two groups of children And immune status, and statistics of safety and efficacy.Results After treatment, the scores of nasal congestion, snoring during sleep, and mouth breathing syndrome of children in the Chinese medicine group were significantly lower than those in the western medicine group, and the differences were statistically significant(all P<0.05);the OSA-18 scale score of children in the Chinese medicine group Both were significantly lower than the western medicine group, and the differences were statistically significant(all P<0.05).After treatment, the A/N ratio of children in the Chinese medicine group was significantly lower than that of the western medicine group, and the LSaO;level was significantly higher than that of the western medicine group, and the differences were statistically significant(all P<0.05).After treatment, the levels of specific allergens IgE(sIgE), leukotriene C4(LTC4), soluble interleukin-2 receptor(sIL-2 R) and eosinophils(ECO) in the serum of Hunaer in the traditional Chinese medicine group were significantly lower in the western medicine group, CD4;, CD4;/CD8;were significantly higher than the western medicine group, and the differences were statistically significant(all P<0.05).The total effective rate of children in the Chinese medicine group(97.56%) was higher than that of the western medicine group(82.93%), and the difference was statistically significant(χ~2=13.085, P<0 05).There was no statistically significant difference in the incidence of adverse reactions between the two groups of children(4.88% vs. 7.32%)(χ~2=0.519,P>0.05).Conclusion Yushi Xuantong Powder has a satisfactory effect in treating adenoid hypertrophy with deficiency of lung and spleen qi in children.It can significantly improve the symptoms and respiratory function of children, reduce inflammation, improve immune function and quality of life, and is safe to use.