养肺通络方治疗气阴两虚兼痰瘀证感染后闭塞性细支气管炎患儿随机对照临床观察  

Randomized controlled clinical observation on treatment of bronchiolitis obliterans in children with Qi Yin deficiency and phlegm stasis syndrome after infection with Yangfei Tongluo Formula

作　　者：王立彪[1,2] 陈文霞[1,2] 相恒杰 黄文龙[1,2] 樊明会 WANG Li-biao;CHEN Wen-xia;XIANG Heng-jie;HUANG Wen-long;FAN Ming-hui(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450099,China;School of Pediatrics,Henan University of Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]河南中医药大学第一附属医院儿科医院,郑州450099 [2]河南中医药大学儿科医学院,郑州450046

出　　处：《医药论坛杂志》2024年第24期2577-2583,共7页Journal of Medical Forum

基　　金：河南省科技攻关项目(232102310457);河南省中医药科学研究专项课题(2021JDZX2098);河南省特色骨干学科中医学学科建设项目(STG-ZYXKY-2020033)。

摘　　要：目的 观察养肺通络方联合西医常规手段治疗气阴两虚兼痰瘀证感染后闭塞性细支气管炎患儿的临床疗效及探讨其可能的作用机制。方法选取2021年12月1日至2023年5月31日在河南中医药大学第一附属医院收治的感染后闭塞性细支气管炎患儿63例,随机分为治疗组32例,对照组31例。对照组给予西医常规手段治疗,治疗组在对照组的基础上加用养肺通络方,两组均治疗3个月。比较治疗前后两组患儿的临床症状积分、潮气肺功能:潮气量(Tidal Volume/kg)、达峰时间比(TPTEF/TE)、达峰容积比(VPEF/VE)及血清白细胞介素6(IL-6)、白细胞介素8(IL-8)、基质金属蛋白酶9(MMP-9)、基质金属蛋白酶组织抑制因子1(TIMP-1)及基质金属蛋白酶9/基质金属蛋白酶组织抑制因子1(MMP-9/TIMP-1)水平,治疗后判断临床疗效。结果治疗后两组患儿的临床症状积分、IL-6、IL-8、MMP-9、MMP-9/TIMP-1水平均较治疗前下降(P<0.05),TIMP-1水平较治疗前无明显变化(P>0.05)。治疗后两组间比较,治疗组临床症状积分、IL-6、IL-8、MMP-9水平低于对照组(P<0.05)。两组患者潮气肺功能均表现为潮气量正常,TPTEF/TE、VPEF/VE下降,两种治疗方案均不能改善患者阻塞性通气功能障碍。治疗组总有效率83.33%(25/30),对照组总有效率58.06%(18/31),治疗组临床疗效优于对照组(P<0.05)。结论养肺通络方联合常规西医手段治疗气阴两虚兼痰瘀证患儿可显著改善患儿的临床症状,疗效优于单纯常规西医常规手段治疗,其机制可能与下调IL-6、IL-8及MMP-9/TIMP-1水平有关。Objective To observe the clinical efficacy of Yangfei Tongluo Formula combined with conventional Western medicine methods in treating children with bronchiolitis obliterans caused by Qi Yin deficiency and phlegm stasis syndrome infection,and to explore its possible mechanism of action.Methods Totally 63 children with post infectious bronchiolitis obliterans admitted to the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from December 1,2021 to May 31,2023 were randomly divided into a treatment group of 32 cases and a control group of 31 cases.The control group was treated with conventional Western medicine methods,while the treatment group received an additional treatment of lung nourishing and meridian unblocking formula on the basis of the control group.Both groups were treated for 3 months.Compared the clinical symptom scores,tidal lung function,tidal volume(Tidal Volume/kg),time to peak ratio(TPTEF/TE),volume to peak ratio(VPEF/VE),and serum levels of interleukin-6(IL-6),interleukin-8(IL-8),matrix metalloproteinase 9(MMP-9),tissue inhibitor of matrix metalloproteinase 1(TIMP-1),and matrix metalloproteinase 9/tissue inhibitor of matrix metalloproteinase 1(MMP-9/TIMP-1)before and after treatment in two groups of children,and evaluated the clinical efficacy after treatment.Results After treatment,the clinical symptom scores,IL-6,IL-8,MMP-9,MMP-9/TIMP-1 levels of both groups of children decreased compared to before treatment(P<0.05),while the level of TIMP-1 showed no significant change compared to before treatment(P>0.05).After treatment,the clinical symptom score,IL-6,IL-8,and MMP-9 levels in the treatment group were lower than those in the control group(P<0.05).Both groups of patients showed normal tidal volume and decreased TPTEF/TE and VPEF/VE in tidal lung function.Neither treatment regimen improved the obstructive ventilation dysfunction of the patients.The total effective rate of the treatment group was 83.33%(25/30),while the total effective rate of the control group was 58.

关 键 词：感染后闭塞性细支气管炎 养肺通络方 气阴两虚兼痰瘀 炎症因子 

分 类 号：R272[医药卫生—中医儿科学]