槐杞黄颗粒联合吸入糖皮质激素对支气管哮喘患儿肺功能、细胞免疫因子及CCL3、CCL5水平的影响

Effects of Huaiqihuang Granule Combined with Inhaled Glucocorticoid on Pulmonary Function,Cellular Immune Factors and CCL3 and CCL5 Levels in Children with Bronchial Asthma

目的:探讨槐杞黄颗粒联合吸入糖皮质激素对支气管哮喘患儿肺功能、细胞免疫因子及趋化因子3(CCL3)、趋化因子5(CCL5)水平的影响。方法:按照随机数字表法,将我院收治的轻度持续性支气管哮喘患儿(n=90),分为对照组(吸入糖皮质激素,45例)和研究组(槐杞黄颗粒联合吸入糖皮质激素,45例),两组均治疗3个月。对比两组患儿治疗前、治疗后1、3、6个月的常规肺功能、细胞免疫因子及CCL3、CCL5水平。观察两组临床疗效、指标和不良反应。结果:研究组的临床总有效率71.11%(32/45)高于对照组91%(41/45),差异有统计学意义(P<0.05)。治疗后1个月(T2)、治疗后3个月(T3)、治疗后6个月(T4)时间点,两组第1秒用力呼气量占预测值百分比(FEV_(1)%)、呼气峰流速占预测值百分比(PEF%)、最大呼气中期流速占预计值的百分比(MMEF75/25)升高,总呼吸阻抗(Z5)、肺弹性阻力(X5)及共振频率(Fres)下降,且研究组的改变程度大于对照组(P<0.05)。T2、T3、T4时间点,两组免疫球蛋白(IgE)、白细胞介素-4(IL-4)、白细胞介素-5(IL-5)、白细胞介素-13(IL-13)、白细胞介素-17(IL-17)下降,且研究组的改变程度大于对照组(P<0.05)。T2、T3、T4时间点,两组CCL3、CCL5下降,且研究组的改变程度大于对照组(P<0.05)。两组不良反应发生率组间对比无差异(P>0.05)。研究组C-ACT评分高于对照组,呼吸道感染次数、哮喘发作次数少于对照组(P<0.05)。两组因哮喘住院次数组间对比未见统计学差异(P>0.05)。结论:槐杞黄颗粒联合吸入糖皮质激素治疗支气管哮喘,可促进患儿肺功能恢复,改善细胞免疫因子及CCL3、CCL5水平。

Objective:To investigate the effects of Huaiqihuang granule combined with inhaled glucocorticoid on pulmonary function,cellular immune factors,chemokine 3(CCL3)and chemokine 5(CCL5)levels in children with bronchial asthma.Methods:According to the random number table method,the children with mild persistent bronchial asthma(n=90)admitted to our hospital were divided into control group(45 cases of inhaled glucocorticoids)and study group(45 cases of Huaiqihuang granule combined with inhaled glucocorticoids).Both groups were treated for 3 months.The routine pulmonary function,cellular immune factors,CCL3 and CCL5levels were compared between the two groups before treatment and 1,3 and 6 months after treatment.The clinical efficacy,index and adverse reactions in the two groups were observed.Results:The total effective rate in the study group was 71.11%(32/45)higher than91%(41/45)in the control group,and the difference was statistically significant(P<0.05).1 month(T2),3 months(T3)and 6 months(T4)after treatment,the percentage of forced expiratory volume in the first second to the predicted value(FEV_(1)%),peak expiratory flow rate in the predicted value(PEF%)and the percentage of maximum mid-expiratory flow rate in the predicted value(MMEF75/25)increased in the two groups,while the total respiratory impedance(Z5),pulmonary elastic resistance(X5)and resonance frequency(Fres)decreased,the degree of change in the study group was greater than that in the control group(P<0.05).T2,T3,T4,immunoglobulin(Ig E),interleukin-4(IL-4),interleukin-5(IL-5),interleukin-13(IL-13)and interleukin-17(IL-17)decreased in two groups,and the degree of change in the study group was greater than that in the control group(P<0.05).T2,T3,T4,CCL3 and CCL5 decreased in two groups and the degree of change in the study group was greater than that in the control group(P<0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05).The C-ACT score in the study group was higher than that in the control group,and the number of respiratory tract infections and number of asthma attack were lower than those in the control group(P<0.05).There was no significant difference in hospitalization times due to asthma between the two groups(P>0.05).Conclusion:Huaiqihuang granule combined with inhaled glucocorticoid in the treatment of bronchial asthma can promote the recovery of pulmonary function and improve the cellular immune factors,CCL3 and CCL5 levels.