三拗二陈颗粒辅助治疗儿童毛细支气管炎痰湿闭肺型50例临床观察

Clinical observation on 50 cases of San’ao Erchen Keli(三拗二陈颗粒) in adjuvant treatment of bronchiolitis in children with phlegm-damp blocking the lung syndrome

目的观察三拗二陈颗粒辅助治疗儿童毛细支气管炎痰湿闭肺型的临床疗效。方法选取2019年12月至2021年1月温州市中西医结合医院中医儿科门诊就诊的毛细支气管炎痰湿闭肺型患儿100例,采用随机数字表法分为对照组和治疗组,各50例。对照组给予吸入布地奈德混悬液、硫酸特布他林雾化液治疗,治疗组在对照组治疗方法的基础上口服三拗二陈颗粒。2组均治疗7 d后统计临床疗效,比较2组治疗前后中医证候评分和炎症因子水平,临床症状消失时间和不良反应发生情况。结果治疗组总有效率为94.0%(47/50),显著高于对照组的84.0%(42/50),2组比较,差异有统计学意义(P<0.05)。治疗前,2组咳嗽、气促、痰鸣、鼻翼煽动、大便偏溏、舌淡红等中医证候评分比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述中医证候评分与同组治疗前比较,均显著降低(P<0.05),且治疗组降低更显著(P<0.05)。治疗前,2组血清肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、白细胞介素-6(IL-6)水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述炎症因子水平与同组治疗前比较,均显著降低(P<0.05),且治疗组降低更显著(P<0.05)。治疗组咳嗽缓解、喘促缓解、肺部啰音消失时间均明显短于对照组,2组比较,差异有统计学意义(P<0.05)。对照组不良反应发生率为18.00%(9/50),治疗组为8.00%(4/50),2组比较,差异有统计学意义(P<0.05)。结论三拗二陈颗粒辅助治疗小儿毛细支气管炎痰湿闭肺型不仅能显著改善其临床症状,降低中医证候评分和气道炎症反应,而且无明显不良反应,值得临床推广应用。

Objective To observe the clinical efficacy of San’ao Erchen Keli(三拗二陈颗粒)in the adjuvant treatment of bronchiolitis in children with phlegm-damp blocking the lung syndrome.Methods From January 2019 to January 2021,100 children of bronchiolitis with phlegm-damp blocking the lung syndrome admitted to the Pediatric Clinic Department of Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine were divided into a control group and a treatment group in a random number table,with 50 cases in each group.The control group was given budesonide suspension and terbutaline sulfate atomization inhalation treatment,while the treatment group was given San’ao Erchen Keli on the basis of the control group.We kept statistics about the efficacy,TCM syndrome scores,levels of inflammatory factors,time for clinical symptoms to disappear and occurrence of adverse reactions after the 2 groups were both continuously treated for 7days.Results The total effective rate of the treatment group was 94.0%(47/50), which was significantly higher than 84.0%(42/50) of the control group, and the difference was statistically significant (P<0.05).Before treatment, there was no significant difference being found in the comparison of the scores of TCM syndromes such as cough, shortness of breath, phlegm,nasal wing incitement,loose stool and pale red tongue between the two groups(P>0.05), indicating that they were comparable.After treatment,the above TCM syndrome scores in the two groups were significantly decreased when compared with those in the same group before treatment(P<0.05),and the decrease in the treatment group was more significant(P<0.05).Before treatment, there was no significant difference being found in the comparison of the levels of serum tumor necrosis factor-α(TNF-α),interleukin-8(IL-8) and interleukin-6(IL-6) between the two groups(P>0.05),indicating that they were comparable.After treatment, the levels of inflammatory factors in the two groups were significantly decreased when compared with those in the same group before treatment(P<0.05),and the decrease in the treatment group was more significant(P<0.05).The cough relief,wheezing relief and lung rale disappearance time in the treatment group were significantly shorter than those in the control group,and the difference was statistically significant (P<0.05).The incidence of adverse reactions was 18.00%(9/50) in the control group and 8.00%(4/50) in the treatment group,the difference being significant(P<0.05).Conclusion San’ao Erchen Keli in the adjuvant treatment of bronchiolitis in children with phlegm-damp blocking the lung syndrome can significantly improve the clinical symptoms,reduce the TCM syndrome score and airway inflammatory response with no obvious adverse reactions.It is worthy of clinical promotion and application.