参苓白术散合消瘰丸加减对脾虚痰聚型腺样体肥大患儿生活质量及血清炎症因子的影响

Effects of Modified Shenling Baizhu Powder(参苓白术散)and Xiaoluo Pills(消瘰丸)on Quality of Life and Serum Inflammatory Factors in Children with Adenoid Hypertrophy due to Spleen Deficiency and Phlegm Accumulation

目的观察参苓白术散合消瘰丸加减治疗儿童腺样体肥大脾虚痰聚型的临床疗效并探讨其可能机制。方法130例脾虚痰聚型腺样体肥大患儿随机分为观察组和对照组各65例。对照组予糠酸莫米松鼻喷雾剂,每个鼻孔各喷1掀,每日1次;观察组予参苓白术散合消瘰丸加减方口服,每日1剂,两组均治疗8周。比较两组治疗前后电子鼻咽镜评分、特异性生活质量调查量表(OSA-18)评分、中医症状总积分及血清半胱氨酸白三烯(CysLTs)、白细胞介素2(IL-2)、肿瘤坏死因子α(TNF-α)、白细胞介素10(IL-10)水平,治疗后判定临床疗效。结果治疗后两组患儿电子鼻咽镜评分、OSA-18评分、中医症状总积分及血清CysLTs、IL-2、TNF-α水平均较治疗前降低,IL-10水平升高(P<0.01)。治疗后两组间比较,观察组电子鼻咽镜评分、OSA-18评分、中医症状总积分及血清CysLTs、IL-2、TNF-α水平低于对照组,IL-10水平高于对照组(P<0.01)。观察组总有效率为95.38%(62/65),对照组为81.54%(53/65),观察组临床疗效优于对照组(P<0.05)。结论参苓白术散合消瘰丸加减治疗脾虚痰聚型腺样体肥大患儿可促进症状改善,提高生活质量及临床疗效,其机制可能与减轻炎症反应有关。

Objective To investigate the clinical effect and possible mechanism of modified Shenling Baizhu Powder(参苓白术散)and Xiaoluo Pill(消瘰丸)in the treatment of children with adenoid hypertrophy due to spleen deficiency and phlegm accumulation.Methods One hundred and thirty children with adenoid hyperplasia due to spleen deficiency and phlegm accumulation were randomly divided into 65 cases each in the observation group and control group.The control group was given mometasone furoate nasal spray,one spray into each nostril,once a day,while the observation group was given modified Shenling Baizhu Powder and Xiaoluo Pill orally,one dose per day,and both groups were treated for 8 months.The pre-and after-treatment electronic nasopharyngoscope scores,specific quality of life survey scale(OSA-18)scores,total TCM symptom scores,serum cysteine leukotrienes(CysLTs),interleukin 2(IL-2),tumor necrosis factorα(TNF-α),and interleukin 10(IL-10)levels were compared to deter⁃mine the clinical efficacy after treatment.Results After treatment,the electronic nasopharyngoscope scores,OSA-18 scores,total TCM symptom scores,serum CysLTs,IL-2 and TNF-αlevels significantly decreased,while IL-10 levels increased in both groups(P<0.01).Compared between the two groups after treatment,the electronic nasopharyngo⁃scope score,OSA-18 score,total TCM symptom score,serum CysLTs,IL-2 and TNF-αlevels were significantly lower,and the IL-10 level was higher in the observation group than in the control group(P<0.01).The total effective rate of the observation group was 95.38%(62/65),superior to 81.54%(53/65)of the control group(P<0.05).Conclusion For children with adenoid hypertrophy due to spleen deficiency and phlegm accumulation,modified Shenling Baizhu Powder and Xiaoluo Pill can help to improve symptoms,increase quality of life and clinical efficacy,and its mecha⁃nism may be related to reducing the inflammatory response.