青金栀汤联合常规西药对小儿毛细支气管炎临床疗效、症状改善、肺功能、血气指标和炎性因子的影响  

Clinical effect of Qingjinzhi decoction combined with budesonide and ambroterol on children with bronchiolitis

作　　者：史润朦 吴文先 田丽 Shi Run-meng;Wu Wen-xian;Tian Li(West Department of General Pediatrics,Xinzheng Tianyou Hospital of Traditional Chinese Medicine,Xinzheng 451100,Henan,China;Department of Pediatrics,Henan Provincial Hospital of Integrated Traditional Chinese and Western Medicine,Zhengzhou450000,China)

机构地区：[1]新郑天佑中医院普儿科西区,河南新郑451100 [2]河南省中西医结合医院儿科,河南郑州450000

出　　处：《四川生理科学杂志》2024年第10期2154-2157,共4页

基　　金：河南省医学科技攻关联合共建项目(LHGJ20213334)。

摘　　要：目的:探讨青金栀汤联合常规西药对小儿毛细支气管炎临床疗效、症状改善、肺功能、血气指标和炎性因子的影响。方法:选取2022年9月~2023年7月新郑天佑中医院收治的100例毛细支气管炎患儿作为研究对象,随机分为西药组和中药联合组,各50例。西药组予以口服氨溴特罗和布地奈德混悬液雾化方吸入治疗,中药联合组在西药组基础上联合中药青金栀汤治疗。对比两组临床疗效、不良反应、症状消失时间及治疗前后通气功能[呼吸频率(Respiratory rate,RR)、呼气峰流速值(Peak expiratory flow,PEF)、吸呼比(Spiratory to expiratory ratio,tI/tE)]、血气分析指标[动脉血二氧化碳分压(Partial pressure of carbon dioxid,PaCO_(2))、动脉血氧分压(Partial pressure of oxygen,PaO_(2))、动脉血酸碱度(Potential of hydrogen,pH)]、炎性因子[可溶性血管细胞黏附分子1(Soluble vascular cell adhesion factor-1,sVCAM-1)、Nod样受体蛋白3(Nodlike receptor protein 3,NLRP3)、嗜酸粒细胞阳离子蛋白(Eosinophil cationic protein,ECP)]、T细胞免疫相关因子[Treg百分比、Th17百分比、白细胞介素(interleukin,IL)-10、IL-17]。结果:治疗2 w后,中药联合组例临床总有效率明显高于西药组(P<0.05),两组不良反应发生率无明显差异(P>0.05)。中药联合组咳嗽、哮鸣音、气喘、肺部阴影症状消失时间均明显短于西药组(P<0.05);治疗2 w后,中药联合组RR、PaCO_(2)明显低于西药组,PEF、tI/tE、pH、PaO_(2)明显高于西药组(P<0.05);治疗2 w后,中药联合组Treg百分比及血清IL-10水平明显高于西药组,Th17百分比及血清sVCAM-1、NLRP3、ECP水平明显低于西药组(P<0.05)。结论:青金栀汤联合布地奈德、氨溴特罗治疗毛细支气管炎患儿具有更好的临床疗效,可加快病情康复进程,促进通气功能、血气分析指标恢复,减轻气道炎症反应,增强免疫系统调节能力,且具有较好的用药安全性。Objective:To investigate the clinical efficacy of Qingjinzhi decoction combined with budesonide and ambroterol in the treatment of children with bronchiolitis.Methods:A total of 100 children with bronchiolitis admitted to Xinzheng Tianyou Hospital of Traditional Chinese Medicine from September 2022 to July 2023 were collected as research objects and randomly divided into western medicine group and traditional Chinese medicine(TCM)combined group,50 cases in each group.The western medicine group was treated with oral ambroterol and budesonide suspension atomizing prescription,and the TCM combined group was treated with Qingjinzhi decoction based on the western medicine group.The clinical efficacy,adverse reactions,symptom resolution time,ventilation function[respiratory rate(RR),peak expiratory flow(PEF),spiratory to expiratory ratio(tI/tE),blood gas analysis indexes[partial pressure of carbon dioxid(PaCO_(2)),partial pressure of oxygen(PaO_(2)),potential of hydrogen(pH)],inflammatory factors[soluble vascular cell adhesion factor-1(sVCAM-1),nodlike receptor protein 3(NLRP3),Eosinophil cationic protein(ECP)],T-cell immune-related factors[Treg percentage,Th17 percentage,interleukin(IL)-10,IL-17]were compared between the two groups.Results:After 2 weeks of treatment,the total clinical effective rate of the TCM combined group was 96.00%,which was obviously higher than that of the western medicine group(78.00%)(P<0.05),the incidence of adverse reactions had no significant difference Between the two groups(P>0.05).The disappearance time of cough,wheezing,asthma and lung shadow in TCM combined group were obviously shorter than those in western medicine group(P<0.05).After 2 weeks of treatment,RR and PaCO_(2)in TCM combined group were obviously lower than those in western medicine group,while PEF,Ti/Te,pH and PaO_(2)were obviously higher than those in Western medicine group(P<0.05).After 2 weeks of treatment,Treg percentage and serum IL-10 level in TCM combined group were obviously higher than those in western medicine gro

关 键 词：毛细支气管炎 青金栀汤 氨溴特罗 布地奈德 

分 类 号：R725.6[医药卫生—儿科]