健脾化痰益肺汤治疗儿童闭塞性细支气管炎疗效及对肺功能、抗中性粒细胞抗体的影响  

Efficacy of the Jianpi Huatan Yifei decoction on bronchiolitis obliterans in children and its effect on pulmonary function and ANCA

作　　者：范鹏 吴涛 葛胜男 FAN Peng

机构地区：[1]深圳市罗湖区中医院,广东深圳518000

出　　处：《中医临床研究》2023年第23期88-93,共6页Clinical Journal Of Chinese Medicine

摘　　要：目的:探讨中药健脾化痰益肺汤治疗儿童闭塞性细支气管炎的临床疗效。方法:选择深圳市罗湖区中医院2017年8月-2021年8月收治的闭塞性细支气管炎患儿89例,按照随机数字表法分为两组,治疗组45例,对照组44例。治疗期间,治疗组脱落6例,对照组脱落5例,两组均有39例患儿纳入研究。对照组予以西药治疗,治疗组服用中药组方健脾化痰益肺汤,疗程均为6周。比较两组治疗前后症状评分(咳嗽、喘息、咳痰)和血氧饱和度(Oxygen Saturation,SaO_(2))评分,并比较两组第1秒用力呼气容积(Forced Expiratory Volume in One Second,FEV_(1))、一秒率(FEV_(1)/FVC)和呼气中段最大流量(Maximal Mid-expiratory Flow,MMEF);比较两组胸部高分辨率CT(High Resolution CT,HRCT)评分、血清髓过氧化物酶(Myeloperoxidase,MPO)-抗中性粒细胞抗体(Anti-neutrophil Cytoplastic Antibody,ANCA)、蛋白酶3(Recombinant Proteinase 3,PR3)-ANCA浓度,疗程结束后比较两组临床疗效。结果:治疗后治疗组咳嗽、喘息、咳痰等评分均低于对照组(P<0.01);FEV_(1)、FEV_(1)/FVC、MMEF高于对照组(P<0.01);血清MPO-ANCA、PR3-ANCA浓度低于对照组(P<0.01);临床疗效优于对照组(P<0.05),差异均有统计学意义。结论:中药健脾化痰益肺汤可缓解症状,改善肺功能,降低血液ANCA的浓度,治疗儿童闭塞性细支气管炎效果显著。Objective:To investigate the clinical effect of the Jianpi Huatan Yifei decoction(健脾化痰益肺汤)on children with bronchiolitis obliterans(BO).Methods:A total of 89 children with BO treated in Luohu District Hospital of traditional Chinese medicine from August 2017 to August 2021 were randomly divided into two groups,with 45 cases in the treatment group and 44 cases in the control group.During the treatment period,6 cases of the treatment group and 5 cases of the control group fell off.Then 39 children in both groups were included in the study.The control group was treated with western medicine,and the treatment group were treated with the Jianpi Huatan Yifei decoction.The course of treatment was for 6 weeks.The symptom scores(cough,wheezing,expectoration)and blood oxygen saturation(SaO_(2))in the two groups were compared before and after treatment,and the first second forced expiratory volume(FEV_(1)),the percentage of FEV_(1)in forced vital capacity(FEV_(1)/FVC)and the maximum middle expiratory flow(MMEF)were compared between the two groups.The chest high-resolution CT(HRCT)score,serum myeloperoxidase(MPO)-anti neutrophil antibody(ANCA)and protease 3(PR3)-ANCA concentrations were compared between the two groups.The clinical effects in the two groups were compared after the course of treatment.Results:The scores of cough,wheezing,expectoration,SaO_(2) and chest HRCT in the treatment group were lower than those in the control group after treatment(P<0.01).FEV_(1),FEV_(1)/FVC and MMEF were higher than those in the control group(P<0.01).The concentrations of serum MPO-ANCA and PR3-ANCA were lower than those in the control group(P<0.01),and the clinical effect was better than that in the control group(P<0.05).Conclusion:The Jianpi Huatan Yifei decoction can alleviate symptoms,improve lung function and reduce the concentration of blood ANCA.It has a significant effect on children with BO.

关 键 词：儿童 闭塞性细支气管炎 健脾化痰益肺汤 肺功能 抗中性粒细胞抗体 

分 类 号：R562.21[医药卫生—呼吸系统]