定喘汤加减联合糖皮质激素治疗肺脾气虚型支气管哮喘患儿的疗效及对其呼吸道重塑、血清TGFβ水平的影响  

Clinical Efficacy of Modified Dingchuan Decoction Combined with Glucocorticoid for Pediatric Bronchial Asthma with Lung-Spleen Qi Deficiency Type and Its Impact on Airway Remodeling and Serum TGFβLevels

作　　者：吕民英 张宏[1] 付晓梅[1] 孟凡威[1] LV Min-ying;ZHANG Hong;FU Xiao-mei;MENG Fan-wei(The First Affiliated Hospital of Henan University,Henan Kaifeng 475000)

机构地区：[1]河南大学第一附属医院,河南开封475000

出　　处：《世界中西医结合杂志》2024年第1期125-128,133,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200538)。

摘　　要：目的探讨定喘汤加减联合糖皮质激素用于肺脾气虚型支气管哮喘儿童对呼吸道重塑及血清转化生长因子β(TGFβ)的影响。方法选取2022年1月-2022年12月期间河南大学第一附属医院收治的肺脾气虚型支气管哮喘患儿82例,按随机数字表法分为对照组和观察组,每组各41例,对照组采用糖皮质激素吸入治疗,观察组在对照组基础上加用定喘汤加减治疗。治疗3个月后,观察比较两组患儿临床疗效、不良反应发生率,治疗前后中医症候评分、气道重构指标[支气管总面积(TA)、管壁面积(WA)、管腔面积(LA)]、血清指标[白细胞介素-4(Interleukin 4,IL-4)、白细胞介素-5(Interleukin-5,IL-5)、转化生长因子β(Transforming growth factor-β,TGFβ)]。结果治疗后观察组总有效率92.68%(38/41)明显高于对照组75.61%(31/41),差异有统计学意义(P<0.05)。治疗后两组患儿中医症状喘促、气急、气短评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组中医症状喘促、气急、气短评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患儿气道重构TA、WA、LA指标均较治疗前降低,差异有统计学意义(P<0.05);且观察组气道重构TA、WA、LA指标均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患儿血清IL-4、IL-5、TGFβ水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组血清IL-4、IL-5、TGFβ水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患儿不良反应发生率比较,差异无统计学意义(P>0.05)。结论采用定喘汤加减联合糖皮质激素治疗肺脾气虚型支气管哮喘患儿后,能明显降低TGFβ水平,逆转气道重塑,提高临床治疗疗效。Objective To explore the effect of modified Dingchuan Decoction combined with glucocorticoid on airway remodeling and serum transforming growth factorβ(TGFβ)in children with bronchial asthma of lung-spleen qi deficiency.Methods A total of 82 children with lung-spleen qi deficiency type bronchial asthma admitted to The First Affiliated Hospital of Henan University from January 2022 to December 2022 were randomly divided into a control group and an observation group according to random number table method,with 41 cases in each group.The control group was treated with glucocorticoid inhalation therapy,and the observation group was treated with Dingchuan Decoction in addition to the treatment in the control group.After 3 months of treatment,the clinical efficacy,incidence of adverse reactions,the scores of traditional Chinese medicine(TCM)symptoms before and after treatment,airway remodeling indicators[total bronchial area(TA),wall area(WA),lumen area(LA)],and serum indicators[interleukin-4(IL-4),interleukin-5(IL-5),TGFβ]were observed and compared between the two groups.Results The total effective rates in the observation group after treatment was 92.68%(38/41),significantly higher than the control group′s 75.61%(31/41),with a statistically significant difference(P<0.05).After treatment,the scores of wheezing,shortness of breath and dyspnea in the both groups were significantly reduced compared to before treatment,with statistically significant differences(P<0.05).Moreover,the observation group had significantly lower scores for wheezing,shortness of breath,and dyspnea compared to the control group(P<0.05).After treatment,the levels of TA,WA and LA in both groups were significantly reduced compared to before treatment(P<0.05).The observation group had significantly lower airway remodeling indicators(TA,WA,LA)than the control group(P<0.05).After treatment,the serum levels of IL-4,IL-5 and TGFβin both groups were significantly lower compared to before treatment(P<0.05).The observation group had significantly lowe

关 键 词：定喘汤加减 糖皮质激素 支气管哮喘 呼吸道重塑 转化生长因子β 

分 类 号：R562.25[医药卫生—呼吸系统]