金沸草散联合酮替芬治疗小儿咳嗽变异性哮喘发作期临床研究

Clinical Study on the Combined Use of Jinfeicao San and Ketotifen for Exacerbation of Cough Variant Asthma in Children

目的:观察金沸草散辅助酮替芬治疗小儿咳嗽变异性哮喘发作期的临床疗效。方法:将120例风寒袭肺型咳嗽变异性哮喘发作期患儿按随机数字表法分为联合组与对照组各60例。对照组给予酮替芬片治疗,联合组在对照组的基础上加用金沸草散治疗。比较2组治疗前后中医证候评分、肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、呼气峰值流速(PEF)]、血清学指标[白细胞介素-4(IL-4)、嗜酸性粒细胞(EOS)、免疫球蛋白E(IgE)],比较2组临床疗效、复发率及不良反应发生率。结果:联合组总有效率为91.67%,对照组为78.33%;联合组复发率为7.72%,对照组为29.79%;2组总有效率、复发率比较,差异均有统计学意义(P<0.05)。治疗后,2组阵发性呛咳、痰少咽痒、恶寒发热、鼻塞流涕等中医证候评分均较治疗前降低(P<0.05),且联合组上述各项评分均低于对照组(P<0.05)。治疗后,2组FEV1、FVC、PEF水平均较治疗前升高(P<0.05),且联合组上述各项指标水平均高于对照组(P<0.05)。治疗后,2组血清EOS、IgE、IL-4水平均较治疗前降低(P<0.05),且联合组上述各项指标水平均低于对照组(P<0.05)。联合组不良反应发生率为5.00%,对照组为11.67%,2组比较,差异无统计学意义(P>0.05)。结论:金沸草散辅助酮替芬治疗风寒袭肺型小儿咳嗽变异性哮喘发作期疗效更佳、复发率更低,能改善患儿临床症状及肺功能,减轻变态反应,且安全性良好。

Objective:To observe the clinical effect of the combined use of Jinfeicao San and Ketotifen on exacerbation of cough variant asthma in children.Methods:A total of 120 children with exacerbation of cough variant asthma of wind-cold attacking the lung type were assigned to the combination group and the control group according to the random number table method,with 60 cases in each group.The control group was treated with Ketotifen,and the combination group was additionally treated with Jinfeicao San based on the treatment of the control group.The traditional Chinese medicine(TCM)syndrome scores and the levels of lung function indexes[forced vital capacity(FVC),forced expiratory volume in one second(FEV1)and peak expiratory flow(PEF)]and serology indexes[interleukin-4(IL-4),eosinophil(EOS)and immunoglobulin E(IgE)]before and after treatment,the clinical effects,recurrence rates and incidence of adverse reactions were compared between the two groups.Results:The total effective rate was 91.67%in the combination group,lower than that of 78.33%in the control group;the recurrence rate was 7.72%in the combination group,lower than that of 29.79%in the control group,differences being significant(P<0.05).After treatment,the TCM syndrome scores of paroxysmal irritating cough,itchy throat with scanty phlegm,aversion to cold and fever,nasal congestion and runny nose in both groups were reduced when compared with those before treatment(P<0.05),and the above four scores in the combination group were lower than those in the control group(P<0.05).After treatment,the levels of FEV1,FVC and PEF in both groups were up-regulated when compared with those before treatment(P<0.05),and the above three levels in the combination group were higher than those in the control group(P<0.05).After treatment,the levels of serum EOS,IgE and IL-4 in both groups were dwindled when compared with those before treatment(P<0.05),and the above three levels in the combination group were lower than those in the control group(P<0.05).The incidence of adverse reactions was 5.00%in the combination group and 11.67%in the control group,there being no significance in the difference(P>0.05).Conclusion:The combined use of Jinfeicao San and Ketotifen renders a better curative effect on exacerbation of cough variant asthma of wind-cold attacking the lung type in children with a lower recurrence rate,which can improve the clinical symptoms and lung function and mitigate the hypersensitivity with great safety.