滋阴清嗓汤联合西药治疗小儿咳嗽变异性哮喘阴虚内热证疗效及对患儿中医证候、肺功能的影响

Curative Effect of Ziyin Qingsang Tang Combined with Western Medicine for Cough Variant Asthma in Children with Syndrome of Yin Deficiency and Internal Heat and Its Effect on Chinese Medicine Syndrome and Lung Function

目的:观察滋阴清嗓汤联合西药治疗小儿咳嗽变异性哮喘阴虚内热证的疗效及对中医证候、肺功能的影响。方法:选取150例咳嗽变异性哮喘阴虚内热证患儿作为研究对象,按随机数字表法分为对照组及试验组各75例。对照组给予吸入用布地奈德混悬液、孟鲁司特钠片进行治疗,试验组在对照组基础上给予滋阴清嗓汤治疗,2组均持续治疗2周。比较2组治疗2周后的临床疗效,比较2组治疗前、治疗2周后的中医证候、肺功能[第1秒用力呼气量(FEV_(1))、呼出气一氧化氮(FeNO)、呼气峰流速(PEF)]及疾病相关因子水平[血清免疫球蛋白(IgE)、嗜酸性粒细胞阳离子蛋白(ECP)、白细胞介素-4(IL-4)、白细胞介素-5(IL-5)]的变化。结果:治疗2周后,试验组总有效率为96.00%,对照组总有效率为92.00%,组间比较,差异无统计学意义(P>0.05)。治疗2周后,2组中医证候咳嗽、咽干咽痒、胸闷气急、咳痰评分及总分均较治疗前下降,试验组各项评分及总分均低于对照组,差异均有统计学意义(P<0.05)。治疗2周后,2组FEV_(1)、PEF指标值均较治疗前升高,FeNO指标值均较治疗前下降,差异均有统计学意义(P<0.05);治疗2周后,试验组FEV_(1)、PEF指标值均高于对照组,FeNO指标值低于对照组,差异均有统计学意义(P<0.05)。治疗2周后,2组血清IgE、ECP、IL-4、IL-5水平均较治疗前下降,试验组上述4项水平均低于对照组,差异均有统计学意义(P<0.05)。结论:滋阴清嗓汤联合西药可有效控制阴虚内热证咳嗽变异性哮喘患儿机体炎症反应,改善患儿中医证候及肺功能,临床疗效较好。

Objective:To observe the curative effect of Ziyin Qingsang tang combined with western medicine for cough variant asthma in children with syndrome of yin deficiency and internal heat and its effect on Chinese medicine syndrome and lung function.Methods:A total of 150 cases of children with cough variant asthma with syndrome of yin deficiency and internal heat were selected as the study subjects and divided into the control group and the experiment group according to the random number table method,with 75 cases in each group.The control group was treated with budesonide suspension for inhalation and montelukast sodium tablets,and the experiment group was additionally treated with Ziyin Qingsang tang based on the treatment of the control group.Both groups were treated for two weeks.After two-week treatment,the clinical effects in the two groups were compared.Before treatment and after two-week treatment,the changes in Chinese medicine syndromes,lung function including forced expiratory volume in one second(FEV_(1)),fractional exhaled nitric oxide(FeNO)and peak expiratory flow(PEF),and levels of disease-related factors including serum immunoglobulin E(IgE),eosinophilic cationic protein(ECP),interleukin-4(IL-4)and interleukin-5(IL-5)in the two groups were compared.Results:After two-week treatment,the total effective rate was 96.00%in the experiment group and 92.00%in the control group,there being no significance in the difference(P>0.05).After two-week treatment,the scores of Chinese medicine syndromes including cough,dryness and itching of the throat,chest distress and breath lessness,and expectoration,as well as the total scores in the two groups were decreased when compared with those before treatment,and the above scores and the total score in the experiment group were lower than those in the control group,differences being significant(P<0.05).After two-week treatment,the values of FEV_(1)and PEF in the two groups were increased when compared with those before treatment,and the FeNO values were decreased,differences being significant(P<0.05);the values of FEV_(1)and PEF in the experiment group were higher than those in the control group,and the Fe NO value was lower,differences being significant(P<0.05).After two-week treatment,the levels of IgE,ECP,IL-4 and IL-5 in serum in the two groups were decreased when compared with those before treatment,and the above four levels in the experiment group were lower than those in the control group,differences being significant(P<0.05).Conclusion:Ziyin Qingsang tang combined with western medicine can effectively control the inflammatory responses in children with cough variant asthma with syndrome of yin deficiency and internal heat,and improve their Chinese medicine syndromes and lung function with a good clinica effect.