连花清瘟颗粒结合重组人干扰素α1b治疗小儿急性毛细支气管炎效果观察

Effect of Lianhua Qingwen Granule(连花清瘟颗粒)Combined with Recombinant Human Interferonα1b on Acute Bronchiolitis in Children

目的观察连花清瘟颗粒结合重组人干扰素α1b治疗小儿急性毛细支气管炎效果。方法研究纳入小儿急性毛细支气管炎共计91例(2018年1月—2020年11月收治),将其以随机数字表法分成对照组与观察组,分别为45例、46例,对照组采取西医常规治疗,并雾化吸入布地奈德与复方异丙托溴铵溶液、重组人干扰素α1b治疗,观察组在对照组西医常规疗法基础上联合连花清瘟颗粒治疗,数据观察:临床疗效、治疗前后两组患儿中医证候积分变化、治疗后两组患儿咳嗽消失时间及喘息消失时间、三凹征消失时间及发热消失时间、肺部罗音消失时间等、治疗前后患儿血气指标变化及肺功能指标变化、T细胞亚群指标变化、患儿不良反应情况。结果两组患儿治疗总有效率无差异,对照组为93.33%(42/45),观察组为97.83%(45/46)(P>0.05),而观察组患儿治疗后显效率(85.78%)显著高于对照组患儿(57.78%)(P<0.05);治疗前,两组患儿中医证候积分、氧分压(partialpressureofoxygen,SpO_(2))及二氧化碳分压(carbon dioxide partial pressure,PaCO_(2))、动脉血酸碱度(arterial blood,pH值)等血气指标、肺功能各项指标(达峰时间比、达峰容积比、呼吸比及潮气等)、白介素-4(interleukin-4,IL-4)及白介素-6(interleukin-6,IL-6)、超敏C反应蛋白(high sensitive C-reactive protein,hs-CRP)、肿瘤坏死因子α(tumor necrosis factorα,TNF-α)等炎性因子水平、T细胞亚群指标(CD^(+)_(3)、CD^(+)_(4)、CD^(+)_(8))比较,P>0.05,治疗后两组患儿中医证候积分、SpO_(2)及PaCO_(2)、肺功能指标(达峰时间比、达峰容积比、呼吸比及潮气等)、IL-4及IL-6、hs-CRP、TNF-α、T细胞亚群指标(CD^(+)_(3)、CD^(+)_(4)、CD^(+)_(8))等均改善,观察组患儿治疗后中医证候积分、SpO_(2)及PaCO_(2)、肺功能指标(达峰时间比、达峰容积比、呼吸比及潮气等)、IL-4及IL-6、hs-CRP、TNF-α、T细胞亚群指标(CD^(+)_(3)、CD^(+)_(4)、CD^(+)_(8))等优于对照组患儿(P<0.05);与对照组患儿相比,观察组咳嗽消失时间与喘息消失时间、发热消失时间、三凹征消失时间、肺部罗音消失时间等指标均更短(P<0.05);观察组不良反应率为4.35%(2/46),对照组不良反应率为4.44%(2/45)。结论连花清瘟颗粒结合重组人干扰素α1b治疗小儿急性毛细支气管炎效果显著,治疗不良反应少,安全可靠,患儿恢复佳,值得应用。

Objective To observe the effect of Lianhua Qingwen Granule(连花清瘟颗粒)combined with recombinant human interferonα1b on acute bronchiolitis in children.Methods A total of 91 children with acute bronchiolitis treated from January 2018 to November 2020 were included in the study.They were randomly divided into control group and observation group,45 ca⁃ses and 46 cases respectively.The children in the control group were treated with conventional western medicine and atomized budesonide,compound ipratropium bromide solution and recombinant human interferonα1b treatment.The observation group was treated with Lianhua Qingwen Granule on the basis of conventional western medicine in the control group.The clinical efficacy,changes in traditional Chinese medicine syndrome scores of the two groups before and after treatment,disappearance time of cough and wheezing,disappearance time of three concave sign and fever,disappearance time of lung rale of the two groups after treat⁃ment,changes in blood gas indicators and pulmonary function indicators before and after treatment,changes in T cell subsets and adverse reactions were observed.Results There was no difference in the total effective rate between the two groups,93.33%(42/45)in the control group and 97.83%(45/46)in the observation group(P>0.05),while the effective rate after treatment(85.78%)in the observation group was significantly higher than that in the control group(57.78%)(P<0.05).Before treat⁃ment,traditional Chinese medicine syndrome scores,partial pressure of oxygen(SpO_(2))and carbon dioxide partial pressure(PaCO_(2)),arterial blood pH value,lung function indicators(peak time ratio,peak volume ratio,respiratory ratio and tidal air),the levels of other inflammatory factors interleukin-4(IL-4),interleukin-6(IL-6),high sensitive C-reactive protein(hs-CRP)and tumor necrosis factorα(TNF-α)and T cell subsets(CD^(+)_(3),CD^(+)_(4),CD^(+)_(8))were not significant(P>0.05).After treat⁃ment,the traditional Chinese medicine syndrome scores,SpO_(2)and PaCO_(2),pulmonary function indicators(peak time ratio,peak volume ratio,respiratory ratio,tidal,etc.),the levels of interleukin-4(IL-4),interleukin-6(IL-6),high sensitive C-reac⁃tive protein(hs-CRP)and tumor necrosis factorα(TNF-α)and T cell subsets(CD^(+)_(3),CD^(+)_(4),CD^(+)_(8))were improved.After treatment,traditional Chinese medicine syndrome scores,SpO_(2)and PaCO_(2),pulmonary function indicators(peak time ratio,peak volume ratio,respiratory ratio and tidal),the levels of interleukin-4(IL-4),interleukin-6(IL-6),high sensitive C-reactive protein(hs-CRP)and tumor necrosis factorα(TNF-α)and T cell subsets(CD^(+)_(3),CD^(+)_(4),CD^(+)_(8))were better than those in the control group(P<0.05).Compared with those of the control group,the disappearance time of cough,wheezing,fever,three con⁃cave sign and lung rale in the observation group were shorter(P<0.05).The adverse reaction rate of the observation group was 4.35%(2/46),and that of the control group was 4.44%(2/45).Conclusion Lianhua Qingwen Granule combined with recombi⁃nant human interferonα1b is effective in the treatment of acute bronchiolitis in children,with less adverse reactions.It is safe and reliable,and has good recovery,worthy of application.