杏苏饮联合揿针对变应性鼻炎合并支气管哮喘患儿的临床疗效及对免疫平衡、血清IL-37和IL-27水平的影响

Clinical Efficacy of Xingsu Decoction Combined with Thumbtack Needle in the Treatment of Children with Allergic Rhinitis Complicated with Bronchial Asthma and Its Effects on Immune Balance,Serum IL-37 and IL-27

目的:观察杏苏饮联合揿针对变应性鼻炎合并支气管哮喘患儿的临床疗效及对免疫平衡、血清白细胞介素(IL)37、IL-27水平的影响。方法:选择2021年8月至2023年8月该院收治的变应性鼻炎合并支气管哮喘患儿88例,按照随机数字表法分为西医组、杏苏饮联合揿针组。西医组44例患儿进行西医基础治疗,杏苏饮联合揿针组44例患儿在西医组的基础上给予杏苏饮联合揿针治疗。比较两组患儿的临床疗效,观察两组患儿治疗前后的中医证候评分,进行过敏性鼻炎症状评分(TNSS+TNNSS)、哮喘控制测试表(ACT)评价,检测患儿鼻阻力、第1秒用力呼气量(FEV 1)及鼻分泌物嗜酸性粒细胞(EOS)水平,检测并计算Th17/Treg值,检测IL-37、IL-27水平。结果:杏苏饮联合揿针组患儿的总有效率为97.73%(43/44),高于西医组的81.82%(36/44),差异有统计学意义(P<0.05)。治疗后,杏苏饮联合揿针组患儿动则发喘或早晚轻喘、遇寒作嚏、晨起痰咳、神疲纳差、自汗懒言和大便黏腻不爽评分较西医组降低,ACT评分较西医组升高,TNSS+TNNSS评分较西医组降低,差异均有统计学意义(P<0.05)。治疗后,杏苏饮联合揿针组患儿鼻阻力、EOS水平较西医组降低,FEV 1水平较西医组升高,IL-27、IL-37水平较西医组升高,Th17/Treg值较西医组降低,差异均有统计学意义(P<0.05)。结论:杏苏饮联合揿针治疗变应性鼻炎合并支气管哮喘患儿,可调节免疫平衡,提高IL-27、IL-37水平,抑制机体炎症,降低鼻阻力、EOS水平,缓解病情,提高肺功能及临床疗效。

OBJECTIVE:To observe the clinical efficacy of Xingsu decoction combined with thumbtack needle in the treatment of children with allergic rhinitis complicated with bronchial asthma and its effects on immune balance,serum interleukin(IL)37 and IL-27.METHODS:A total of 88 children with allergic rhinitis complicated with bronchial asthma admitted into the hospital from Aug.2021 to Aug.2023 were divided into Western medicine group and Xingsu decoction combined with thumbtack needle group according to the random number table method.Forty-four patients in the Western medicine group received basic Western medicine treatment,and 44 patients in the Xingsu decoction combined with thumbtack needle group received Xingsu decoction combined with thumbtack needle on the basis of the Western medicine group.The clinical efficacy of two groups was compared,the traditional Chinese medicine syndrome scores of two groups were observed before and after treatment,the allergic rhinitis symptom score(TNSS+TNNSS)and asthma control test(ACT)form were evaluated,and the nasal resistance,forced expiratory volume at one second(FEV 1)and nasal secretion eosinophils(EOS)levels were detected.Th17/Treg values,IL-37 and IL-27 levels were detected.RESULTS:The total effective rate of Xingsu decoction combined with thumbtack needle was 97.73%(43/44),higher than 81.82%(36/44)of Western medicine group,the difference was statistically significant(P<0.05).After treatment,the scores of wheezing or light wheezing in the morning and evening,sneezing in case of cold,phlegm cough in the morning,poor appetite,spontaneous sweating,and sticky stool in Xingsu decoction combined with thumbtack needle group were lower than those in Western medicine group,the score of ACT was higher than that of Western medicine group,and the score of TNSS+TNNSS was lower than that of Western medicine group,with statistically significant differences(P<0.05).After treatment,the nasal resistance and EOS in the Xingsu decoction combined with thumbtack needle group were lower than those in the Western medicine group,FEV 1 was higher than that of Western medicine group,IL-27 and IL-37 levels were higher than those of Western medicine group,and Th17/Treg was lower than that of Western medicine group,with statistically significant differences(P<0.05).CONCLUSIONS:Xingsu decoction combined with thumbtack needle in the treatment of children with allergic rhinitis complicated with bronchial asthma can regulate the immune balance,increase the IL-27 and IL-37 levels,inhibit the inflammation,reduce the nasal resistance and EOS level,alleviate the disease conditions,improve the lung function and clinical efficacy.