小儿消积止咳口服液治疗儿童慢性咳嗽的机制与效果

Mechanism and efficacy of Xiaoer Xiaoji Zhike Oral Solution in the treatment of children with chronic cough

目的观察小儿消积止咳口服液治疗儿童慢性咳嗽的疗效及机制。方法选取慢性咳嗽患儿110例,随机分为对照组与观察组,每组55例。对照组患儿给予常规治疗,观察组患儿在常规治疗的基础上给予小儿消积止咳口服液治疗。另选取同期健康体检儿童55例作为健康组。比较观察组与对照组的疗效,治疗前后评估咳嗽评分及匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI),检测治疗前后外周血嗜酸性粒细胞(eosinophils,EOS)、降钙素原(procalcitonin,PCT)、肿瘤坏死因子-α(tumor necrosisfactor-α,TNF-α)、干扰素-γ(interferon-γ,IFN-γ)、白细胞介素(interleukins,IL)-4(IL-4)、IL-8以及免疫球蛋白(immunoglobulin,Ig)A、IgG和IgM水平,检测肺功能包括用力肺活量(forced vital capacity,FVC)、第1秒用力呼气量百分比(the percentage of forced expiratory volume in the first second,FEV_(1)%)和呼气峰值流速(peak expiratory flow rate,PEF)。结果观察组的总有效率高于对照组,体温复常时间、肺啰音消失时间、咳痰消失时间及咳嗽消失时间均较对照组缩短,治疗后咳嗽评分及PSQI评分均低于对照组(P<0.05)。观察组和对照组治疗前的外周血EOS、PCT、TNF-α、IL-4和IL-8水平均高于健康组,IFN-γ、IgA、IgG和IgM水平均低于健康组(P<0.05);治疗后,观察组和对照组的外周血EOS、PCT、TNF-α、IL-4和IL-8水平均降低,IFN-γ、IgA、IgG和IgM水平均降低,FVC、FEV_(1)%和PEF均升高,且观察组上述指标均明显优于对照组(P<0.05)。结论外周血EOS、PCT、TNF-α、IL-4和IL-8水平在儿童慢性咳嗽中明显升高,IFN-γ水平明显降低,采用小儿消积止咳口服液治疗能够调节上述各指标平衡,提高临床疗效并促进症状缓解。

Objective To observe the curative effect and mechanism of Xiaoer Xiaoji Zhike Oral Solution in the treatment of children with chronic cough.Methods A total of 110 children with chronic cough were selected and randomly divided into control group and observation group,with 55 cases in each group.Children in the control group were given conventional treatment,children in the observation group were given Xiaoer Xiaoji Zhike Oral Solution on the basis of control group.In addition,55 children with physical examination during the same period were selected as the healthy group.The efficacy between the observation group and the control group was compared,and the cough score and Pittsburgh sleep quality index(PSQI)were evaluated before and after treatment.The peripheral blood eosinophils(EOS),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),interleukin-4(IL-4),interleukin-8(IL-8)and the levels of immunoglobulin(Ig)A,IgG and IgM were measured before and after treatment.The lung function vital capacity(FVC),the percentage of forced expiratory volume in the first second(FEV_(1)%)and the peak expiratory flow rate(PEF)were detected and compared.Results The total effective rate of the observation group was higher than that of the control group.The time to normal body temperature,the disappearance of pulmonary rales,the disappearance of sputum and the disappearance of cough were shorter than those of the control group.The cough score and PSQI score in the observation group after treatment were lower than those of the control group(P<0.05).Before treatment,the peripheral blood EOS,PCT,TNF-α,IL-4,IL-8 of the observation group and the control group were higher than those of the healthy group,and the levels of IFN-γ,IgA,IgG and IgM were lower than that of the healthy group(P<0.05).After treatment,the EOS,PCT,TNF-α,IL-4,and IL-8 in peripheral blood of the observation group and the control group were all decreased,and the levels of IFN-γ,IgA,IgG and IgM were all decreased,the FVC,FEV_(1)%and PEF were all increased.The above indicators in the observation group was significantly better than in the control group(P<0.05).Conclusion The peripheral blood EOS,PCT,TNF-α,IL-4,and IL-8 are significantly increased in children with chronic cough,while the IFN-γis significantly decreased.Xiaoer Xiaoji Zhike Oral Liquid can adjust the balance of the above factors and improve the clinic for children with chronic cough,and can improve clinical efficacy and promote the relief of symptoms.