益气固本汤联合西药治疗小儿肺肾阳虚型支气管哮喘的疗效及其对血清MMP-9、TIMP-1、IL-6、IL-8和免疫功能的影响

Efficacy of Yiqi Guben Decoction Combined with Western Medicine for theTreatment of Pediatric Bronchial Asthma with Lung-Kidney YangDeficiency Syndrome and Its Effects on Serum MMP-9,TIMP-1,IL-6,IL-8 and Immune Function

【目的】探讨益气固本汤治疗小儿肺肾阳虚型支气管哮喘的疗效及其对血清基质金属蛋白酶9(MMP-9)、基质金属蛋白酶组织抑制物1(TIMP-1)、白细胞介素6(IL-6)、白细胞介素8(IL-8)和免疫功能的影响。【方法】将124例肺肾阳虚型支气管哮喘患儿随机分为对照组和观察组,每组各62例。2组患儿均接受抗炎、平喘、吸氧等基础治疗,对照组同时给予孟鲁司特钠口服治疗,观察组在对照组的基础上加用益气固本汤治疗,疗程为28 d。观察2组患儿治疗前后哮喘症状积分、血清MMP-9、TIMP-1、IL-6、IL-8水平及免疫功能指标、肺功能指标的变化情况,并评价2组治疗方案的安全性。【结果】(1)治疗过程中,2组各有2例患儿脱落,最终各有60例患儿完成全部疗程的治疗。(2)治疗后,2组患儿的日间哮喘症状积分及晚间哮喘症状积分均较治疗前明显降低(P<0.05),且观察组对日间哮喘症状积分及晚间哮喘症状积分的降低作用均明显优于对照组(P<0.01)。(3)治疗后,2组患儿的用力肺活量(FVC)、第一秒用力呼气容积(FEV1)及FVE1/FVC等肺功能指标均较治疗前明显改善(P<0.05),且观察组对FVC、FVE1、FVE1/FVC等肺功能指标的改善作用均明显优于对照组(P<0.01)。(4)治疗后,2组患儿血清MMP-9水平均较治疗前降低(P<0.05),血清TIMP-1水平均较治疗前升高(P<0.05),且观察组对血清MMP-9水平的降低作用及对血清TIMP-1水平的升高作用均明显优于对照组(P<0.01)。(5)治疗后,2组患儿血清IL-6、IL-8水平均较治疗前明显降低(P<0.05),且观察组对血清IL-6、IL-8水平的降低作用均明显优于对照组(P<0.01)。(6)治疗后,2组患儿血清免疫球蛋白M(IgM)、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)水平均较治疗前明显升高(P<0.05),且观察组对血清IgM、IgG、IgA水平的升高作用均明显优于对照组(P<0.01)。(7)治疗过程中,2组患儿均未发生明显不良反应,具有较高的安全性。【结论】益气固本汤联合西药治疗肺肾阳虚型支气管哮喘患儿疗效确切,可有效缓解患儿哮喘症状,减轻炎性反应,增强免疫功能,改善肺功能,且用药安全性较高。

Objective To investigate the efficacy of Yiqi Guben Decoction combined with western medicine for the treatment of pediatric bronchial asthma with lung-kidney yang deficiency syndrome and to observe its effects on serum matrix metalloproteinase 9(MMP-9),tissue inhibitor of matrix metalloproteinase 1(TIMP-1),interleukin 6(IL-6),interleukin 8(IL-8)and immune function of the patients. Methods A total of 124 children sufferingfrom bronchial asthma with lung-kidney yang deficiency syndrome were randomly divided into the control groupand the observation group,with 62 cases in each group. The children in both groups received basic treatment ofanti-inflammation,relieving asthma,and oxygen inhalation. And additionally,the control group was given oraluse of Montelukast Sodium Tablets,and the observation group was treated with Yiqi Guben Decoction on the basisof the treatment for the control group. Both groups of patients were treated for 28 days. Changes in asthma symptomscores,serum MMP-9,TIMP-1,IL-6,and IL-8 levels,immune function indexes and lung function indexesin the two groups were observed before and after treatment. Moreover,the safety of the treatment regimen for thetwo groups was evaluated after treatment. Results(1)During the trial,2 cases from each group fell off,and 60 casesin each group eventually completed the whole course of treatment.(2)After treatment, the daytime asthmasymptom scores and night asthma symptom scores of children in both groups were significantly decreased comparedwith those before treatment(P<0.05),and the effect on decreasing the asthma scores in the observation group wassignificantly superior to that in the control group(P<0.01).(3)After treatment, the lung function indexes offorced vital capacity(FVC),forced expiratory volume in one second(FEV1)and the ratio of FVE1 to FVC(FVE1/FVC) in both groups were significantly improved compared with those before treatment(P<0.05), and theimprovement of FVC,FVE1 and FVE1/FVC in the observation group was significantly superior to that in the controlgroup(P<0.01).(4)After treatment,the serum MMP-9 level was decreased and the serum TIMP-1 level wasincreased in both groups compared with those before treatment(P<0.05),and the effect on decreasing MMP-9level and increasing TIMP-1 level in the observation group was significantly superior to that in the control group(P<0.01).(5)After treatment, the serum IL-6 and IL-8 levels in both groups were significantly decreasedcompared with those before treatment(P<0.05),and the effect on decreasing serum IL-6 and IL-8 levels in theobservation group was significantly superior to that in the control group(P<0.01).(6)After treatment,the serumimmunoglobulin M(IgM), immunoglobulin G(IgG)and immunoglobulin A(IgA)levels in both groups weresignificantly increased compared with those before treatment(P<0.05),and the effect on increasing serum IgM,IgG and IgA levels in the observation group was significantly superior to that in the control group(P<0.01).(7)Duringthe treatment, no obvious adverse reactions occurred in the two groups, and high safety was presented.Conclusion The combination of Yiqi Guben Decoction and western medicine is effective in treating childrensuffering from bronchial asthma of lung- kidney yang deficiency syndrome type by effectively relieving thesymptoms of asthma, reducing the inflammatory response, enhancing immune function and improving lungfunction,and the medication is with high safety.