二陈平喘方治疗小儿哮喘慢性持续期的临床效果

Clinical effect of Erchen Pingchuan prescription in treatment of children with chronic persistent asthma

目的观察二陈平喘方治疗小儿哮喘慢性持续期的临床效果。方法选取2020年5月—2022年10月上海中医药大学附属第七人民医院、附属市中医医院门诊哮喘病儿124例,随机分为治疗组和对照组,每组62例。治疗组采用中药二陈平喘方联合布地奈德福莫特罗粉吸入剂(信必可)治疗,对照组采用信必可治疗,治疗3个月后观察哮喘控制程度、中医症状体征、肺功能及血清白细胞介素1β(IL-1β)、白细胞介素18(IL-18)的改善情况。结果治疗后,治疗组哮喘控制率高于对照组(χ^(2)=4.501,P<0.05),中医证候积分疗效高于对照组(Z=3.037,P<0.05),第一秒用力呼气容积、呼气峰流速以及用力呼气流速25%、50%、75%的改善值高于对照组(t=4.30~4.89,P<0.05),血清IL-1β、IL-18的改善值高于对照组(t=3.10、6.50,P<0.05)。结论二陈平喘方联合信必可治疗小儿哮喘持续期能提高哮喘控制率,缓解中医临床症状,改善肺功能气道阻塞指标及血清中IL-1β、IL-18炎症因子表达,值得临床推广应用。

Objective To investigate the clinical effect of Erchen Pingchuan prescription in the treatment of children with chronic persistent asthma.Methods A total of 124 children with asthma who attended the outpatient service of Shanghai Se-venth People’s Hospital and Shanghai Municipal Hospital of Traditional Chinese Medicine affiliated to Shanghai University of Traditional Chinese Medicine from May 2020 to October 2022 were enrolled and randomly divided into treatment group and control group,with 62 children in each group.The children in the treatment group were given the traditional Chinese medicine Erchen Pingchuan prescription combined with budesonide and formoterol fumarate powder for inhalation(Symbicort),while those in the control group were given Symbicort alone,and after 3 months of treatment,the two groups were observed in terms of the degree of asthma control and the improvements in traditional Chinese medicine(TCM)symptoms and signs,pulmonary function,and se-rum levels of interleukin-1β(IL-1β)and interleukin-18(IL-18).Results After treatment,compared with the control group,the treatment group had a significantly higher asthma control rate(χ^(2)=4.501,P<0.05),a significantly better treatment outcome of TCM syndrome score(Z=3.037,P<0.05),and significantly better improvements in forced expiratory volume in 1 second,peak expiratory flow,and forced expiratory flow at 25%,50%,and 75%of forced vital capacity(t=4.30-4.89,P<0.05),as well as significantly better improvements in the serum levels of IL-1βand IL-18(t=3.10,6.50,P<0.05).Conclusion The combination of Erchen Pingchuan prescription and Symbicort can increase asthma control rate and improve TCM symptoms,the indicators of pulmonary function and airway obstruction,and the expression of the inflammatory factors IL-1βand IL-18 in serum,and therefore,it holds promise for clinical application.