布地奈德雾化吸入联合玉屏风颗粒对支气管哮喘患儿肺功能及免疫功能的影响研究

Effect of budesonide aerosol inhalation combined with Yupingfeng granule on lung function and immune function of children with bronchial asthma

目的探讨在布地奈德雾化吸入基础上辅以玉屏风颗粒治疗支气管哮喘患儿的效果。方法选取延安大学附属医院于2020年5月至2022年5月收治的支气管哮喘患儿128例为研究对象。对纳入患儿进行数字编码,按照随机数字表法将其分为对照组、研究组,每组64例。对照组患儿采用常规吸氧、补液与布地奈德雾化吸入治疗,研究组患儿在对照组基础上,联合玉屏风颗粒治疗。治疗3个疗程后评估患儿西医疗效与中医症候积分,检测患儿血清炎性因子、免疫功能指标与肺功能指标水平变化,统计患儿不良反应发生情况。结果西医疗效中,研究组患儿治疗总有效率(93.8%)高于对照组(81.2%),差异有统计学意义(χ2=6.24,P<0.05),中医疗效-中医症候积分比较,治疗后研究组低于对照组(P<0.05)。治疗后,研究组患儿白细胞介素-4、白细胞介素-6、肿瘤坏死因子-α等炎性因子水平与免疫细胞CD8^(+)水平低于对照组,CD4^(+)和CD4^(+)/CD8^(+)水平高于对照组(P<0.05);同时研究组第一秒用力呼气容积(FEV_(1))、用力肺活量(FVC)与FEV_(1)/FVC水平高于对照组(P<0.05)。安全性比较,2组均未发生不良反应。结论采用玉屏风颗粒辅助布地奈德雾化吸入治疗小儿支气管哮喘,能有效抑制炎性因子表达,进一步改善患儿免疫与呼吸功能。

Objective To investigate the effect of budesonide atomization inhalation combined with Yupingfeng granule in the treatment of children with bronchial asthma.Methods A total of 128 children with bronchial asthma admitted to the Affiliated Hospital of Yan′an University from May 2020 to May 2022 were selected as subjects.The included children were digitally coded and divided into control group and study group according to random number table method,with 64 cases in each group.Children in the control group were treated with routine oxygen inhalation,fluid rehydration and budesonide atomization,while children in the research group were treated with Yupingfeng granule on the basis of the control group.After 3 courses of treatment,the western medicine efficacy and traditional Chinese medicine(TCM)syndrome score of the children were evaluated,the changes of serum inflammatory factors,immune function indexes and lung function indexes were detected,and the incidence of adverse reactions was counted.Results In the curative effect of western medicine,the total effective rate of the study group(93.8%)was higher than that of the control group(81.2%)(χ~2=6.24,P<0.05).After treatment,the levels of interleukin 4,interleukin 6,tumor necrosis factorαand other inflammatory factors and CD8^(+)of immune cells in the study group were lower than those in the control group,while the levels of CD4^(+)and CD4^(+)/CD8^(+)were higher than those in the control group(P<0.05).Meanwhile,the first second forced expiratory volume(FEV_(1)),forced vital capacity(FVC)and FEV_(1)/FVC levels in the study group were higher than those in the control group(P<0.05).There were no adverse reactions in the two groups.Conclusion The application of Chinese patent medicine Yupingfeng granule assisted budesonide atomization inhalation in the treatment of pediatric bronchial asthma can effectively inhibit the expression of inflammatory factors,further improve the immune and respiratory function of children,and has positive significance to promote clinical efficacy.