通络平喘方治疗儿童咳嗽变异性哮喘的临床应用研究  

Clinical Study on Tongluo Pingchuan Decoction in the Treatment of Infantile Cough Variant Asthma

作　　者：刘斐[1] 王羽 潘玮[1] 金洁 严平[1] 林洁[2] LIU Fei;WANG Yu;PAN Wei(Wuxi TCM Hospital,Wuxi(214000),China)

机构地区：[1]无锡市中医医院,江苏无锡214000 [2]上海市中医医院

出　　处：《浙江中医药大学学报》2024年第5期590-596,共7页Journal of Zhejiang Chinese Medical University

基　　金：江苏省科技项目(BK20210069);无锡市卫健委科研项目(MS201946);无锡市“双百”中青年医疗卫生拔尖人才培养计划(BJ2020065)。

摘　　要：[目的]观察通络平喘方治疗咳嗽变异性哮喘(cough variant asthma,CVA)的疗效及作用机制。[方法]将72例CVA患儿随机分为2组,试验组和对照组各36例。试验组予通络平喘方口服,对照组予氨溴特罗+孟鲁司特钠口服,均治疗2周,比较患者用药前后症状积分、外周血嗜酸性粒细胞(eosinophils,EOS)、血清总免疫球蛋白E(immunoglobulin E,IgE)、白细胞介素-4(interleukin-4,IL-4)、干扰素-γ(interferon-γ,IFN-γ)的变化。[结果]用药后两组患儿的症状积分较前均有改善(P<0.01),试验组明显优于对照组(P<0.01,P<0.05);试验组总有效率为94.44%,明显优于对照组80.56%(P<0.05);试验组的起效时间明显短于对照组(P<0.05)。与本组用药前比较,两组患儿EOS、IgE、IL-4水平均有所降低(P<0.01);IFN-γ水平有所升高(P<0.01),两组间比较差异无统计学意义(P>0.05)。随访3个月,试验组复发率为15%,对照组复发率为33%,差异有统计学意义(P<0.01)。[结论]通络平喘方可有效治疗CVA,可明显改善患儿的咳嗽及相关症状,降低CVA的复发率,作用机制与降低炎症因子水平有关。[Objective]To investigate the clinical efficacy and possible mechanism of Tongluo Pingchuan Decoction in the treatment of infantile cough variant asthma(CVA).[Methods]Seventy-two patients with CVA were randomized into treatment group(36 cases)and control group(36 cases).Treatment group were treated with Tongluo Pingchuan Decoction while the cases in control group were treated with oral Ambroxol and Montelukast.Then the mitigation of cough symptoms and the changes of immunoglobulin E(IgE),eosinophils(EOS),interleukin-4(IL-4)and interferon-γ(IFN-γ)were observed.[Results]After treatment,the symptom scores were both decreased(P<0.01),and the treatment group was superior to the control group(P<0.01,P<0.05).The efficacy of the treatment group was better than that of the control group(P<0.05),and the onset time of the treatment group was significantly shorter than that of the control group(P<0.05).The level of EOS,IgE,IL-4 and IFN-γof two groups were improved after treatment(P<0.01),and there was no statistically difference between the two groups(P>0.05).After 3 months of follow-up,the recurrence rate of the two groups was statistically different(P<0.01).[Conclusion]Tongluo Pingchuan Decoction can significantly relieve the cough symptoms of in children with CVA,reduce the recurrence rate,and the possible mechanism may be associated with regulating inflammatory factor levels.

关 键 词：通络平喘方 咳嗽变异性哮喘 炎症因子 气道高反应 化痰祛瘀通络 疗效 作用机制 

分 类 号：R273[医药卫生—中西医结合]