太子参五味子汤联合低剂量布地奈德福莫特罗粉吸入剂治疗儿童哮喘慢性持续期的临床观察

Clinical observation on Taizishen Wuweizi Decoction combined with Budesonide and Formoterol Fumarate Powder Inhalant in treatment of chronic persistent asthma in children

目的:观察太子参五味子汤联合低剂量布地奈德福莫特罗粉吸入剂治疗儿童哮喘慢性持续期的临床疗效。方法:纳入82例支气管哮喘慢性持续期患儿,随机分为治疗组42例和对照组40例。对照组患儿给予常规剂量布地奈德福莫特罗粉吸入剂吸入治疗,治疗组患儿给予太子参五味子汤口服联合低剂量布地奈德福莫特罗粉吸入剂吸入治疗,两组治疗周期均为3个月。评价两组患儿的临床疗效;比较两组患儿的急性发作情况;治疗前后评价并比较两组患儿的中医证候评分;治疗前后,测定两组患儿的血清总免疫球蛋白E(TIgE)、呼出气一氧化氮(FeNO)水平,比较两组患儿的第一秒用力呼气容积(FEV1)、用力肺活量(FVC)实测值占预计值的百分比及FEV1/FVC。结果:治疗过程中,治疗组2例患儿被剔除,最终纳入统计分析者治疗组40例、对照组40例。(1)治疗后,两组患儿的临床疗效比较,差异无统计学意义(P>0.05)。(2)治疗3个月期间,治疗组6例患儿出现哮喘急性发作,对照组11例患儿出现哮喘急性发作,组间比较差异无统计学意义(P>0.05)。(3)治疗后,两组患儿的各项中医证候评分较治疗前均显著降低(P<0.05),且治疗组患儿的咳痰、汗出、饮食、大便证候评分低于对照组(P<0.05)。(4)治疗后,治疗组患儿的FEV1实测值占预计值百分比较治疗前升高(P<0.05),且治疗组患儿的FEV1、FVC实测值占预计值百分比及FEV1/FVC均高于对照组(P<0.05)。(5)治疗后,两组患儿的TIgE水平较治疗前均降低(P<0.05),治疗组患儿的FeNO水平较治疗前亦降低(P<0.05),且治疗组患儿的TIgE水平低于对照组(P<0.05)。结论:太子参五味子汤口服联合低剂量布地奈德福莫特罗粉吸入剂吸入治疗哮喘慢性持续期患儿,可有效改善患儿的临床症状,降低哮喘急性发作风险,改善肺功能。

Objective:To observe the clinical efficacy of Taizishen Wuweizi Decoction combined with low-dose Budesonide and Formoterol Fumarate Powder Inhalant in the treatment of chronic persistent asthma in children.Methods:A total of 82 children with asthma in chronic persistent stage were included and randomly divided into the treatment group(42 cases)and the control group(40 cases).The children in the control group were treated with conventional dose Budesonide and Formoterol Fumarate Powder Inhalant,and the children in the treatment group were treated with Taizishen Wuweizi Decoction orally combined with low-dose Budesonide and Formoterol Fumarate Powder Inhalant,with a course of 3 months.The clinical efficacy of the two groups was evaluated.The acute attacks of the two groups were compared.Before and after treatment,the traditional Chinese medicine syndrome scores of the two groups were evaluated and compared.Before and after treatment,the levels of serum total immunoglobulin E(TIgE)and fractional exhaled nitric oxide(FeNO)in the two groups were detected,and the ratios of measured value to the predicted value of forced expiratory volume in one second(FEV1)and forced vital capacity(FVC)and FEV1/FVC ratio in the two groups were compared.Results:In the course of treatment,two children in the treatment group were eliminated.Finally,40 cases in the treatment group and 40 cases in the control group were included in the statistical analysis.①After treatment,there was no statistically significant difference on clinical efficacy between the two groups(P>0.05).②In the course of 3-month treatment,six children in the treatment group and eleven children in the control group had acute attacks of asthma,with no statistically significant difference between the two groups(P>0.05).③After treatment,the scores of all the traditional Chinese medicine syndromes in the two groups were significantly decreased compared with those before treatment(P<0.05),and the scores of phlegm,sweating,diet and stool syndromes in the treatment group were lower than those in the control group(P<0.05).④After treatment,the ratio of measured value to the predicted value of FEV1 in the treatment group was increased compared with that before treatment(P<0.05),and the ratios of measured value to the predicted value of FEV1 and FVC and FEV1/FVC ratio in the treatment group were higher than those in the control group(P<0.05).⑤After treatment,the level of TIgE in the two groups was decreased compared with that before treatment(P<0.05),the level of FeNO in the treatment group was also decreased compared with that before treatment(P<0.05),and the level of TIgE in the treatment group was lower than that in the control group(P<0.05).Conclusion:Taizishen Wuweizi Decoction orally combined with low-dose Budesonide and Formoterol Fumarate Powder Inhalant can effectively improve the clinical symptoms in children with asthma in chronic persistent stage,reduce the risk of acute asthma attack,and improve the pulmonary function.