槐杞黄颗粒在年幼儿童支气管哮喘长期管理中作用的多中心真实世界研究  

The role of Huaiqihuang Granules in the long-term management of bronchial asthma in young children:a multicenter real-world study

作　　者：王慧敏 牟京辉[1] 刘传合[1] 刘长山[2] 王莹[3] 韩志英[4] 孙新 陈星[6] 安淑华[7] 多力坤·木扎帕尔[8] 芦爱萍 王敏[10] 程燕[11] 尹小梅 刘瀚旻[13] 王红[14] 华山 董丽[16] 黄英[17] 姜毅[18] 熊建新 丁圣刚[20] 王维[21] 赵顺英[21] 陈育智[1] Wang Huimin;Mu Jinghui;Liu Chuanhe;Liu Changshan;Wang Ying;Han Zhiying;Sun Xin;Chen Xing;An Shuhua;Muzapar Dolikon;Lu Aiping;Wang Min;Cheng Yan;Yin Xiaomei;Liu Hanmin;Wang Hong;Hua Shan;Dong Li;Huang Ying;Jiang Yi;Xiong Jianxin;Ding Shenggang;Wang Wei;Zhao Shunying;Chen Yuzhi(Department of Allergy,Children′s Hospital of Capital Institute of Pediatrics,Beijing 100020,China;Department of Pediatrics,the Second Hospital of Tianjin Medical University,Tianjin 300211,China;Department of Respiratory Diseases,Wuhan Children′s Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430015,China;Department of Respiratory,Children′s Hospital of Shanxi,Taiyuan 300013,China;Department of Pediatrics,the First Affiliated Hospital of the Air Force Medical University,Xi′an 710068,China;Department of Pediatrics,Shandong Provincial Hospital,Ji′nan 250021,China;Department of Respiratory Diseases,Children′s Hospital of Hebei Province,Shijiazhuang 050031,China;Department of Pediatrics,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830001,China;Department of Respiratory,Shenzhen Far East Women′s and Children′s Hospital,Shenzhen 518001,China;Department of Pediatrics,Yichang Central People′s Hospital,Yichang 443008,China;Department of Pedia-trics,the Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300143,China;Department of Pediatrics,Beijing Tsinghua Changgung Hospital,Beijing 102218,China;Department of Respiratory,West China Second Hospital,Sichuan University,Chengdu 610044,China;Department of Pediatrics,Civil Aviation General Hospital,Beijing 100123,China;Department of Respiratory,Anhui Provincial Children′s Hospital,Hefei 230022,China;Department of Respiratory Diseases,Eight-First Children′s Hospital Affiliated to the Seventh Medical Center of the General Hospital of the People′s Liberation Army,Beijing 100010,China;Department of Respiratory,Children′s Hospital of Chongqing Medical University,Chongqing 400014,China;Departm

机构地区：[1]首都儿科研究所附属儿童医院变态反应科,北京100020 [2]天津医科大学第二医院儿科,天津300211 [3]华中科技大学同济医学院附属武汉儿童医院呼吸科,武汉430015 [4]山西省儿童医院呼吸科,太原300013 [5]空军军医大学第一附属医院儿科,西安710068 [6]山东省立医院儿科,济南250021 [7]河北省儿童医院呼吸科,石家庄050031 [8]新疆医科大学第一附属医院儿科,乌鲁木齐830001 [9]深圳远东妇儿科医院呼吸科,深圳518001 [10]宜昌市中心人民医院儿科,宜昌443008 [11]天津中医药大学第二附属医院儿科,天津300143 [12]北京清华长庚医院儿科,北京102218 [13]四川大学华西第二医院呼吸科,成都610044 [14]北京民航总医院儿科,北京100123 [15]安徽省儿童医院呼吸科,合肥230022 [16]解放军总医院第七医学中心附属八一儿童医院呼吸科,北京100010 [17]重庆医科大学附属儿童医院呼吸科,重庆400014 [18]武汉大学人民医院儿科,武汉430060 [19]常州市儿童医院呼吸科,常州213003 [20]安徽医科大学第一附属医院儿科,合肥230022 [21]首都医科大学附属北京儿童医院呼吸科,北京100045

出　　处：《中华实用儿科临床杂志》2023年第4期286-290,共5页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的观察槐杞黄颗粒在年幼儿童支气管哮喘(哮喘)长期管理中的作用及对伴发鼻炎的效果。方法采用多中心、前瞻性、真实世界研究的方式,门诊依序纳入2~5岁的哮喘且接受以下治疗方案之一的患儿(2016年4月至2019年3月),包括给予吸入糖皮质激素和/或白三烯受体拮抗剂等长期控制药物,未给予槐杞黄(控制药物组);给予长期控制药物,同时给予槐杞黄(联合治疗组);仅给予槐杞黄,未给予长期控制药物(槐杞黄组)。收集患儿的基线资料,于治疗4周、8周、12周后进行随访,内容包括近4周哮喘症状天数、重度哮喘发作次数、哮喘控制水平、鼻炎症状天数等,采用Kruskal-Wallis H检验或Wilcoxon秩和检验比较患儿治疗前后以及治疗后不同组间的差异。结果共纳入患儿2234例,完成随访2147例,其中控制药物组477例,联合治疗组1374例,槐杞黄组296例。与基线比较,治疗4周时各组患儿的哮喘症状天数、哮喘重度发作次数、鼻炎症状天数均显著减少(均P<0.01),哮喘良好控制率显著提高(P<0.01),并持续至随访结束。不同组间比较,治疗8周、12周时联合治疗组患儿哮喘症状天数均少于槐杞黄组[0(0,0.9)d比0(0,0.3)d,P<0.05;0(0,1.0)d比0(0,1.0)d,P<0.01];治疗12周时,联合治疗组、槐杞黄组患儿哮喘重度发作次数均低于控制药物组[0(0,1),0(0,1),0(0,2),均P<0.05]。联合治疗组患儿哮喘良好控制率在治疗8周、12周时均高于控制药物组和槐杞黄组(89.6%比85.9%、82.1%;90.9%比84.1%、81.8%,χ^(2)=15.28、29.32,均P<0.01)。结论槐杞黄颗粒作为附加治疗或单独使用均可减少年幼儿童哮喘症状和重度发作以及鼻炎症状,提高哮喘控制率。Objective To observe the role of Huaiqihuang Granules(HQ)in the long-term management of bronchial asthma in young children,and the effective effect on concomitant rhinitis.Methods A prospective real-world multicenter study was conducted in children aged 2-5 years with asthma diagnosed in the outpatient department(from April 2016 to March 2019)who received either inhaled corticosteroid(ICS)/leukotriene receptor antagonist(LTRA)(control group);inhaled ICS/LTRA plus HQ(combination group),or HQ alone(HQ group).All patients were followed up at week 4,8,12 after treatment.The number of days with asthma symptoms,the frequency of severe asthma attacks,the level of asthma control,and the days with rhinitis symptoms in the last 4 weeks were recorded.Differences before and after treatment,and those among groups after treatment were compared using Kruskal-Wallis H test or Wilcoxon rank-sum test.Results A total of 2234 eligible patients were recruited,and 2147 cases completed followed-up visits,including 477,1374 and 296 cases in the control group,combination group,and HQ group,respectively.After the treatment,all 3 groups showed significant declines in the days with asthma symptoms,frequency of severe asthma attack and the days with rhinitis symptoms(all P<0.01),and the rate of well-controlled asthma increased significantly(P<0.01).It lasted until the end of follow-up.Among groups,patients in the combination group showed significantly less days of asthma symptoms than those of the other 2 group at week 8 and 12[0(0,0.9)d vs.0(0,0.3)d,P<0.05;0(0,0.1)d vs.0(0,1.0)d,P<0.01].Patients in the combination group and HQ group showed a significantly lower rate of severe asthma attacks than that of the control group at week 12[0(0,1),0(0,1),0(0,2),all P<0.05].The well-controlled rate of asthma in the combination group was significantly higher than that of the control group and HQ group at week 8 and 12(89.6%vs.85.9%vs.82.1%,H=15.28;90.9%vs.84.1%vs.81.8%,χ^(2)=29.32,all P<0.01).Conclusions HQ can significantly alleviate symptoms of ast

关 键 词：儿童 支气管哮喘 治疗 槐杞黄颗粒 

分 类 号：R725.6[医药卫生—儿科]