小青龙汤合三子养亲汤治疗小儿咳嗽变异性哮喘风寒袭肺证临床观察

Clinical observation of Xiaoqinglong Decoction and Sanzi Yangqin Decoction on pediatric cough variant asthma with wind-cold attacking lung syndrome

目的观察小青龙汤合三子养亲汤治疗小儿咳嗽变异性哮喘(CVA)风寒袭肺证的临床疗效。方法将92例CVA风寒袭肺证患儿按照随机数字表法分为2组,对照组46例予西医常规治疗,治疗组46例在对照组治疗基础上应用小青龙汤合三子养亲汤。2组均治疗4周。比较2组疗效;比较2组治疗前后肺功能指标用力肺活量(FVC)、第1 s用力呼气容积(FEV_(1))、最大呼气峰流速(PEF)变化;比较2组治疗前后气道高反应性;比较2组治疗前后血清白细胞介素4(IL-4)、IL-5及外周血嗜酸性粒细胞(EOS)水平变化;观察2组痊愈患儿复发情况;进行安全性评估。结果治疗组总有效率91.30%(42/46),对照组总有效率76.09%(35/46),治疗组疗效优于对照组(P<0.05)。2组治疗后FVC、FEV_(1)、PEF均较本组治疗前升高(P<0.05),治疗后治疗组FVC、FEV_(1)、PEF均高于对照组(P<0.05)。2组治疗后最小诱发累积剂量、促使呼吸阻力增加至基础值135%所消耗组胺累积量(PD35)均较本组治疗前增加(P<0.05),治疗后治疗组最小诱发累积剂量、PD35均大于对照组(P<0.05)。2组治疗后血清IL-4、IL-5及外周血EOS水平均较本组治疗前降低(P<0.05),治疗后治疗组血清IL-4、IL-5及外周血EOS水平均低于对照组(P<0.05)。治疗组复发率33.33%(8/24),对照组复发率88.24%(15/17),治疗组复发率低于对照组(P<0.05)。结论小青龙汤合三子养亲汤治疗小儿CVA风寒袭肺证,能改善患儿肺功能,降低气道高反应性,调节血清IL-4、IL-5及外周血EOS水平,且能降低复发率,疗效显著。

Objective To observe the effects of Xiaoqinglong Decoction combined with Sanzi Yangqin Decoction on pediatric cough variant asthma(CVA)with wind-cold attacking lung syndrome.Methods A total of 92 pediatric CVA with wind-cold attacking lung syndromewere randomly assigned into the control group(n=46)and the treatment group(n=46).The patients in the treatment groupwere additionally given Xiaoqinglong Decoction combined with Sanzi Yangqin Decoction on the basis of conventional treatment.A 4-week treatment was performed in the both groups,aiming to compare the curative effect,the levels of forced vital capacity(FVC),forced expiratory volume in one second(FEV_(1))and peak expiratory flow(PEF),and airway hyperresponsiveness(AHR),as well as the levels of serum interleukin-4(IL-4),IL-5 and peripheral blood eosinophil(EOS)before and after treatment between groups.The recurrence and conduct safety assessments in the two groups were observed.Results The total effective rate in the treatment group wasbetter than that in the control group(91.30%[42/46]vs 76.09%[35/46],P<0.05).After treatment,FVC,FEV_(1)and PEF in the two groups were significantly increased(P<0.05),and the increase was more prevalent in the treatment group(P<0.05).The log minimum dose(Dmin)and provoking dose(PD35)in the two groups were significantly increased(P<0.05),and the increase was more pronounced in the treatment group(P<0.05).The levels of serum IL-4,IL-5 and peripheral blood EOS in the two groups were significantly lower(P<0.05),which were significantly lower in the treatment group than the control group(P<0.05).The recurrence rate of the treatment group was significantly lower than the control group(33.33%[8/24]vs 88.24%[15/17],P<0.05).Conclusion For children with CVA with wind-cold attacking lung syndrome,Xiaoqinglong Decoction combined with Sanzi Yangqin Decoction can improve their lung function,reduce AHR,regulate the levels of serum IL-4,IL-5 and peripheral blood EOS,and reduce the recurrence rate,with significant curative effect.