麻黄附子细辛汤联合孟鲁司特钠对咳嗽变异性哮喘症状改善及外周血树突状细胞mDCs和pDCs水平的影响

Effects of Mahuang Fuzi Xixin Decoction(麻黄附子细辛汤)Combined with Montelukast Sodium on Symptom Improvement and Levels of Dendritic Cell mDCs and pDCs in Peripheral Blood in Children with Cough Variant Asthma

目的分析麻黄附子细辛汤联合孟鲁司特钠对咳嗽变异性哮喘患儿症状改善及外周血髓样树突状细胞(myeloid dendritic cells,mDCs)和浆细胞样树突状细胞(plasmacytoid dendritic cells,pDCs)及肺功能的影响。方法选取医院2019年1月—2020年12月收治的132例咳嗽变异性哮喘患儿作为研究对象。按随机数字表法分为两组,对照组66例,在常规雾化治疗基础上给予孟鲁司特钠治疗;观察组66例,在对照组基础上给予麻黄附子细辛汤治疗。检测两组患儿治疗前、治疗后1、2、3、4周外周血mDCs、pDCs及mDCs/pDCs数据变化、症状改善情况及肺功能的影响。随访1年观察复发情况。结果两组治疗前后外周血mDCs比例没有变化(P>0.05);两组治疗后外周血pDCs比例均持续下降(P<0.05),但观察组治疗后2周和3周外周血pDCs比例低于对照组(P<0.05);两组治疗后mDCs/pDCs比值升高(P<0.05),但观察组治疗后2周和3周的mDCs/pDCs比值高于对照组(P<0.05)。治疗4周后,观察组早晚的咳嗽评分低于对照组(P<0.05);治疗4周后观察组肺功能各指标优于对照组(P<0.05);随访1年后,病例均未脱落,观察组复发率4.55%(3/66)低于对照组15.15%(10/66)(P<0.05)。结论麻黄附子细辛汤联合孟鲁司特钠治疗咳嗽变异性哮喘,更能快速降低外周血pDCs比例、提升mDCs/pDCs比值,有助于快速纠正患儿体内Th1/Th2的失衡状态同时减轻临床症状、优化肺功能,预后较好。

Objective To analyze the effect of Mahuang Fuzi Xixin Decoction(麻黄附子细辛汤)combined with montelukast sodium on symptom improvement,the levels of myeloid dendritic cells(mDCs)and plasmacytoid dendritic cells(pDCs)in peripheral blood and lung function after treatment.Methods A total of 132 children with cough variant asthma who were admitted to the hospital from January 2019 to December 2020 were selected as the research objects.They were divided into two groups according to random number table method.The control group(66 cases)received montelusna on the basis of conventional atomization therapy.The observation group(66 cases)were treated with Mahuang Fuzi Xixin Decoction based on the control group.The changes of mDCs and pDCs in peripheral blood and the ratio of mDCs/pDCs,symptom improvement and lung function of the two groups were detected before and after treatment at 1,2,3 and 4 weeks.The recurrence was observed after one year follow-up.Results There was no change in the proportion of mDCs in peripheral blood of the two groups before and after treatment(P>0.05).The proportion of pDCs in peripheral blood of both groups continued to decrease after treatment(P<0.05),but the proportion of pDCs in peripheral blood of the observation group was lower than that of the control group at 2 and 3 weeks after treatment(P<0.05).The ratio of mDCs/pDCs in the two groups increased after treatment(P<0.05),but the ratio of mDCs/pDCs in the observation group was higher than that of the control group at 2 and 3 weeks after treatment(P<0.05).After 4 weeks of treatment,the cough score of the observation group was lower than that of the control group(P<0.05).After 4 weeks of treatment,the indexes of lung function in the observation group were better than those in the control group(P<0.05).After one year of follow-up,all cases did not shed,and the recurrence rate of the observation group was 4.55%(3/66),lower than that of the control group[15.15%(10/66)](P<0.05).Conclusion Mahuang Fuzi Xixin Decoction combined with montelukast sodium in the treatment of cough variant asthma can more rapidly reduce the proportion of peripheral blood pDCs and increase the ratio of mDCs/pDCs,which is helpful to quickly correct the imbalance of Th1/Th2 in children and relieve clinical symptoms and optimize the lung function,and the prognosis is better.