小青龙汤加味联合布地奈德雾化吸入治疗小儿毛细支气管炎(风寒闭肺证)临床研究  

Clinical Study of Variant Xiaoqinglong Decoction Combined with Budesonide Inhalation on Children with Capillary Bronchitis of Wind Cold Closed Lung Type

作　　者：刘锋[1] 李丽[1] 陈荣娥 杨子江 张鹏[3] 

机构地区：[1]湖北省十堰市太和医院武当山分院,湖北十堰442714 [2]湖北省十堰市太和医院湖北医药学院附属医院,湖北十堰442000 [3]湖北省中医院,湖北武汉430000

出　　处：《中国中医急症》2017年第11期1911-1914,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：湖北省自然科学基金资助项目(2016CDB306)

摘　　要：目的观察小青龙汤加味联合布地奈德雾化吸入治疗小儿毛细支气管炎(风寒闭肺证)临床效果并探讨其机制。方法选取本院收治的毛细支气管炎(风寒闭肺证)患儿110例作为研究对象,按照随机数字表法分为观察组和对照组各55例,两组均给予吸氧、止咳、退热、化痰等对症治疗,对照组另予布地奈德雾化吸入治疗,观察组在对照组基础上联合小青龙汤加味治疗。比较两组临床疗效、中医证候积分、咳嗽、发热、喘憋、肺部湿啰音以及哮鸣音消失时间,同时检测血清肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、降钙素原(PCT)水平,并检测CD4^+、CD8^+、CD4^+/CD8^+亚群水平。结果观察组总有效率94.55%,显著高于对照组81.82%,差异具有统计学意义(P<0.05);治疗后两组中医证候积分显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);观察组咳嗽、发热、喘憋、肺部湿啰音以及哮鸣音消失时间显著短于对照组,差异具有统计学意义(P<0.05);治疗后两组TNF-α、hs-CRP、PCT水平显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);治疗后两组CD4^+、CD4^+/CD8^+亚群水平显著高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05),两组CD8^+亚群水平显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05)。结论采用小青龙汤加味联合布地奈德雾化吸入能够有效缓解毛细支气管炎(风寒闭肺证)患儿临床症状,改善血清炎性因子和T细胞亚群水平,提高临床疗效。Objective： To explore clinical effect of variant Xiaoqinglong Decoction combined with budesonide inhalation in treatment of children with capillary bronchitis of wind cold closed lung type. Methods： 110 cases of children with capillary bronchitis of wind cold closed lung type were selected as the study objects, and were di- vided into the observation group and the control group according to random number table method,55 cases in each group. All the two groups were given oxygen,cough ,fever,phlegm and other symptomatic treatment. The control group were given budesonide inhalation therapy on the basis of that, and the observation group were com- bined with variant Xiaoqinglong Decoction on the basis of the control group. Clinical effect,symptom scores, cough,fever,wheezing,pulmonary rales,wheezing disappearance time were observed in the two groups. Tumor necrosis factor-α （TNF-α）,high sensitivity C reactive protein （hs-CRP）, and procalcitonin （PCT） levels were ex- amined,and meanwhile, CD4＋, CD8＋, CD4＋/CD8＋ subgroups levels were tested. Results： The total effective rate of the observation group was 94.55% ,significantly higher than that of the control group （81.82%）,with statistically significant difference （P 〈 0.05）. After treatment,TCM symptom scores were significantly lower than that before treatment in the two groups （P〈 0.05）, and the observation group were significantly lower than the control group （P〈 0.05）. Cough,fever,wheezing,pulmonary rales,wheeze disappeared time in the observation group were sig- nificantly lower than those in the control group,with statistically significant difference （P〈 0.05）. After treatment, the levels of TNF-α,hs-CRP and PCT in the two groups were significantly lower than those before treatment（P〈 0.05）, and the observation group were significantly lower than the control group （P 〈 0.05）. After treatment,thelevels of CD4＋ and CD4＋/CD8＋ in the two groups were significantly higher than those before treatmen

关 键 词：毛细支气管炎 小青龙汤 布地奈德 风寒闭肺型 

分 类 号：R725.6[医药卫生—儿科]