舒肺化痰汤治疗痰湿蕴肺型儿童慢性咳嗽的临床疗效及对炎症的调节作用  

Clinical Efficacy of Shufei Huatan Decoction in the Treatment of Children with Chronic Cough of Phlegm-Damp Accumulating in Lung Type and Its Inflammatory Regulatory Effect

作　　者：许柏华 叶慧诗 冯杏珍 王佩瑶 罗桂平 XU Baihua;YE Huishi;FENG Xingzhen;WANG Peiyao;LUO Guiping(Dept.of Paediatrics,Dongguan Hospital,Guangzhou University of Chinese Medicine,Dongguan 523000 Guangdong,China)

机构地区：[1]广州中医药大学东莞医院儿科,广东东莞523000

出　　处：《广州中医药大学学报》2025年第3期629-634,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局中医药科研项目(编号:20241347);东莞市卫健局汇入省级中医重点专科奖励(儿科)项目(编号:21000003);广东省许尤佳名医传承工作室建设项目。

摘　　要：【目的】观察舒肺化痰汤治疗痰湿蕴肺型儿童慢性咳嗽的临床疗效及其对炎症的调节作用。【方法】将2022年2月至2024年2月在广州中医药大学东莞医院门诊或者住院部接受治疗的116例痰湿蕴肺型慢性咳嗽患儿随机分为观察组和对照组,每组各58例。对照组给予常规西药治疗(即抗生素联合抗组胺药物治疗),观察组给予自拟中药方剂舒肺化痰汤治疗。疗程为2周并随访4周。观察2组患儿治疗前后咳嗽、咳痰、肺部听诊等症状体征评分和2型炎症因子[白细胞介素4(IL-4)、总免疫球蛋白E(IgE)]以及气道炎症指标[嗜酸性粒细胞趋化因子(Eotaxin)、呼出气一氧化氮(FeNO)]的变化情况,比较2组患儿的临床疗效、不良反应发生率和复发率。【结果】(1)疗效方面,治疗2周后,观察组的总有效率为94.83%(55/58),对照组为86.21%(50/58),组间比较(χ^(2)检验),观察组的疗效明显优于对照组(P<0.05)。(2)症状体征评分方面,治疗后,2组患儿的咳嗽、咳痰、肺部听诊等各项症状体征评分及总积分均较治疗前降低(P<0.05),且观察组的降低幅度均明显优于对照组(P<0.05)。(3)2型炎症因子及气道炎症指标方面,治疗后,2组患儿的FeNO值及血清Eotaxin、IL-4、总IgE水平均较治疗前降低(P<0.05),且观察组的降低幅度均明显优于对照组(P<0.05)。(4)不良反应方面,观察组的不良反应发生率为8.62%(5/58),对照组为5.17%(3/58),组间比较,差异无统计学意义(P>0.05)。(5)复发率方面,随访4周,观察组的复发率为3.64%(2/55),对照组为10.00%(5/50),组间比较,差异无统计学意义(P>0.05)。【结论】舒肺化痰汤治疗痰湿蕴肺型慢性咳嗽患儿疗效确切,可显著改善患儿临床症状,降低炎症因子释放,抑制炎症反应,且具有较高的安全性。Objective To investigate the clinical efficacy of Shufei Huatan Decoction in the treatment of children with chronic cough of phlegm-dampness accumulating in lung type and to observe its inflammatory regulatory effect.Methods A total of 116 children with chronic cough of phlegm-damp accumulating in lung type who were treated in the outpatient or inpatient departments of Dongguan Hospital,Guangzhou University of Chinese Medicine from February 2022 to February 2024 were randomly divided into the observation group and the control group,with 58 cases in each group.The control group was treated with conventional western medicine of antibiotics and antihistamines,while the observation group was treated with Shufei Huatan Decoction,a self-formulated Chinese medicine prescription.The course of treatment covered two weeks and then the patients were followed up for four weeks.Before and after treatment,the changes of scores of cough,expectoration,and pulmonary auscultation findings,levels of type 2 inflammatory factors of interleukin 4(IL-4)and total immunoglobulin E(IgE),and indicators of airway inflammation such as Eotaxin,fractional exhaled nitric oxide(FeNO)of the two groups were observed.After treatment,the clinical efficacy,the incidence of adverse reactions and the recurrence rate of the children in the two groups were compared.Results(1)After two weeks of treatment,the total effective rate of the observation group was 94.83%(55/58)and that of the control group was 86.21%(50/58),and the intergroup comparison(tested by chi-square test)showed that the therapeutic efficacy of the observation group was significantly superior to that of the control group(P<0.05).(2)After treatment,the scores of cough,expectoration,and pulmonary auscultation findings as well as their total scores in the two groups were decreased compared with those before treatment(P<0.05),and the decrease in the observation group was significantly superior to that in the control group(P<0.05).(3)After treatment,the levels of inflammatory factors of FeNO v

关 键 词：舒肺化痰汤 慢性咳嗽 痰湿蕴肺型 儿童 临床疗效 炎症因子 气道炎症指标 

分 类 号：R256.11[医药卫生—中医内科学]