清宣止咳颗粒与维生素D滴剂结合治疗对儿童哮喘CD4^(+)T淋巴细胞免疫功能及预后复发率影响的前瞻性研究

A prospective study on effect of combined treatment of Qingxuan Zhike Granules and vitamin D drops on immune function of CD4^(+)T lymphocytes and prognostic recurrence rate of childhood asthma

目的:分析清宣止咳颗粒与维生素D滴剂结合治疗对儿童哮喘CD4^(+)T淋巴细胞免疫功能及预后复发率的影响。方法:选取2017年6月至2020年6月承德医学院附属医院收治的哮喘患儿116例采取前瞻性研究,按1∶1比例以随机数字表法分为观察组(n=58)和对照组(n=58)。在常规治疗基础上,对照组予以清宣止咳颗粒治疗,观察组予以清宣止咳颗粒联合维生素D滴剂治疗,均治疗2周。比较两组临床疗效、治疗前、治疗2周后CD4^(+)T淋巴细胞免疫功能指标[外周血辅助型T细胞17(Th17)、Th2、Treg百分比]、儿童哮喘控制测试(C-ACT)评分、哮喘日间与夜间症状评分、肺功能指标[第1秒呼气量(FEV_(1))、FEV_(1)/用力肺活量(FVC)、最大呼气峰流速(PEF)、PEF昼夜变异率]水平,治疗后随访6个月,统计治疗后3个月、6个月复发率。结果:观察组治疗2周后总有效率(91.38%)高于对照组(74.14%)(P<0.05);观察组治疗2周后外周血Th17、Th2、Treg百分比均低于对照组(P<0.05);观察组治疗2周后C-ACT、哮喘日间与夜间症状评分、PEF昼夜变异率均低于对照组,FEV_(1)、FEV_(1)/FVC、PEF均高于对照组(P<0.05);观察组治疗后6个月复发率(3.85%)低于对照组(19.05%)(P<0.05)。结论:应用清宣止咳颗粒与维生素D滴剂结合治疗儿童哮喘可减轻哮喘症状,提升CD4^(+)T淋巴细胞免疫功能及肺功能,降低预后复发率,效果显著。

Objective:To analyze the effect of combined treatment of Qingxuan Zhike Granules and vitamin D drops on immune function of CD4^(+)T lymphocytes and prognostic recurrence rate of childhood asthma.Methods:From June 2017 to June 2020,one hundred and sixteen children with asthma in Affiliated Hospital of Chengde Medical University were selected for a prospective study.They were divided into observation group(n=58)and control group(n=58)according to a 1∶1 ratio by a random number table. On the basis of conventional treatment,control group was treated with Qingxuan Zhike Granules,and observation group was treated with Qingxuan Zhike Granules combined with vitamin D drops for 2 weeks. Comparison of clinical efficacy,CD4^(+)T lymphocyte immune function indicators before treatment and 2 weeks after treatment[peripheral blood helper T cell 17(Th17),Th2,Treg percentage],childhood asthma control Test(C-ACT)score,asthma day and night symptom score,lung function index[expiratory volume in the first second(FEV_(1)),FEV_(1)/forced vital capacity(FVC),maximum peak expiratory flow rate(PEF),PEF diurnal variation rate]levels,follow up for 6 months after treatment,and calculate the recurrence rate at 3 and 6 months after treatment.Results:Total effective rate of observation group after 2 weeks of treatment was(91.38%)higher than that of control group(74.14%)(P<0.05);after 2 weeks of treatment in observation group,percentages of Th17,Th2 and Treg in peripheral blood were lower than those of control group(P<0.05);after 2 weeks of treatment in observation group,C-ACT,asthma day and night symptom scores and PEF circadian variation rate were lower than those in control group. FEV_(1),FEV_(1)/FVC and PEF were all higher than those in control group(P<0.05);recurrence rate of observation group after 6 months of observation group(3.85%)was lower than that of control group(19.05%)(P<0.05).Conclusion:Combination of Qingxuan Zhike Granules and vitamin D drops in treatment of childhood asthma can alleviate asthma symptoms,improve CD4^(+)T lymphocyte immune function and lung function,and reduce the prognostic recurrence rate,the effect is significant.