| 王文兰,张勤,许细财.玉屏风颗粒联合普米克令舒雾化吸入治疗儿童咳嗽变异性哮喘的疗效分析[J].浙江中医药大学学报,2023,47(1):58-63, 68. |
| 玉屏风颗粒联合普米克令舒雾化吸入治疗儿童咳嗽变异性哮喘的疗效分析 |
| Effect Analysis of Yupingfeng Granule Combined with Aerosol Inhalation of Pulmicort Respules in the Treatment of Children with Cough Variant Asthma |
| DOI：10.16466/j.issn1005-5509.2023.01.012 |
| 中文关键词: 玉屏风颗粒 脾肺气虚 儿童 咳嗽变异性哮喘 普米克令舒 雾化吸入 细胞免疫因子 肺功能 |
| 英文关键词: Yupingfeng Granule spleen and lung Qi deficiency children cough variant asthma Pulmicort Respules aerosol inhalation cellular immune factor lung function |
| 基金项目:浙江省中医药科技计划项目(2019ZA011)；浙江省医药卫生科技计划面上项目(2019338309) |
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| 中文摘要: |
| [目的] 观察玉屏风颗粒联合普米克令舒雾化剂(吸入用布地奈德混悬液)治疗儿童咳嗽变异性哮喘(cough variant asthma，CVA)的临床疗效及对细胞免疫因子的影响。 [方法] 选择2019年9月至2021年9月在浙江省人民医院门诊治疗的CVA患儿150例，随机分对照组和观察组各75例。对照组患儿仅接受普米克令舒雾化剂治疗，观察组在常规治疗基础上接受玉屏风颗粒联合治疗，每组均治疗2个月。比较治疗前后患儿CVA症状改善状况、肺功能指标、诱导痰中免疫细胞比例及趋化因子水平、骨密度及骨代谢指标、血清免疫球蛋白水平，并随访6个月。 [结果] 观察组治疗总有效率为95.8%，显著高于对照组的82.8%，差异有统计学意义(P＜0.01)。两组治疗后第一秒用力呼气容积/用力肺活量的比值(first second forced expiratory volume/forced vital capacity，FEV1/FVC)、最高呼气流速占预计值的百分比(percentage of maximum expiratory flow rate in the predicted value，PEFpred)均升高(P＜0.05)，且观察组显著优于对照组(P＜0.05)；两组治疗后诱导痰中嗜酸粒细胞与中性粒细胞比值(eosinophil/neutrophil，EOS/NE)均降低，血清趋化因子白细胞介素-5(interleukin 5，IL-5)水平显著降低，IL-10水平显著升高(P＜0.05)，且治疗后观察组优于对照组(P＜0.05)；两组治疗后免疫球蛋白E(immunoglobulin E，IgE)水平均降低(P＜0.05)，IgA和IgG水平均升高(P＜0.05)，且观察组IgE水平下降较对照组显著(P＜0.05)。治疗后对照组患儿骨密度声波速度(speed of sound，SOS)值和血钙(Ca)含量降低，但差异无统计学意义(P＞0.05)；治疗后观察组骨密度SOS值和Ca含量高于对照组，差异无统计学意义(P＞0.05)。随访期间，观察组复发率(5.5%)低于对照组(14.2%)，对照组患儿并发症发生率(17.0%)高于观察组(5.5%)，差异具有统计学意义(P＜0.01)。[结论] 玉屏风颗粒联合普米克令舒雾化剂治疗儿童CVA，可显著提高疗效，改善患儿免疫，降低复发率和并发症风险。 |
| 英文摘要: |
| [Objective] To observe the clinical efficacy and its effect on cellular immune factors of Yupingfeng Granule combined with aerosol inhalation of Pulmicort Respules in the treatment of children with cough variant asthma(CVA). [Methods] In this study， clinical data of 150 children with CVA treated in Zhejiang Provincial People‘s Hospital from September 2019 to September 2021 were selected， and the patients were randomly divided into control group and observation group(75 cases in each group). The children in control group were only treated with Pulmicort Respules atomization agent， and the children in observation group were treated with Yupingfeng Granule assisted with Pulmicort Respules atomization agent. Each group was treated for 2 months. The relief of CVA symptoms， improvement of lung function， the proportion of immune cells in induced sputum， the level of chemokines， bone mineral density， and bone metabolism indicators， and the level of serum immunoglobulin were compared before and after treatment. The recurrence and complications of CVA were counted during a follow-up of 6 months. [Results] The total effective rate in observation group was 95.8%， which was significantly higher than 82.8% in control group(P＜0.01). After treatment， the ratio of first second forced expiratory volume in forced vital capacity(FEV1/FVC) and the percentage of maximum expiratory flow rate in the predicted value(PEFpred) significantly increased in both groups(P＜0.05)， and observation group was significantly better than that in control group(P＜0.05). After treatment， eosinophil(EOS) and neutrophil(NE) ratio(EOS/NE) in induced sputum decreased， the serum level of chemokine interleukin-5(IL-5) was significantly decreased and the level of IL-10 was significantly increased in both groups(P＜0.05)， and the degree of change in observation group was more significant than that in control group after treatment(P＜0.05). After treatment， level of immunoglobulin E(IgE) decreased(P＜0.05)， while level of IgA and IgG increased(P＜0.05) in both groups， and level of IgE decreased significantly in observation group compared with control group(P＜0.05). After treatment， the bone mineral density speed of sound(SOS) and the contents of blood calcium(Ca) in control group decreased， but there was no significant difference(P＞0.05)； the contents of SOS and Ca in observation group were higher than those in control group， but there was no significant difference(P＞0.05). During the follow-up period， the recurrence rate in observation group(5.5%) was lower than that in control group(14.2%)， and the incidence of complications in control group(17.0%) was higher than that in observation group(5.5%)， the difference was statistically significant(P＜0.01). [Conclusion] Yupingfeng Granule combined with Pulmicort Respules aerosol can significantly improve the curative effect and immune level of children with CVA， reduce the recurrence rate and complication risk. |
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