小儿治哮灵片对发作期小儿咳嗽变异性哮喘气道反应性的影响

发布时间：2018-03-16 20:17

本文选题：咳嗽变异性哮喘　切入点：儿童　出处：《中国实验方剂学杂志》2017年18期 　论文类型：期刊论文

【摘要】：目的:评价小儿治哮灵片对发作期咳嗽变异性哮喘(CVA)的临床疗效及对气道反应性和慢性炎症反应的影响。方法:将170例发作期CVA患儿,采用区组随机按数字表法分为对照组和观察组各85例。两组患儿均采用布地奈德气雾剂+孟鲁司特钠咀嚼片进行治疗,观察组加服小儿治哮灵片。两组疗程均为4周,并进行16周的随访。进行日间咳嗽、夜间咳嗽情况和咳嗽视觉模拟(VAS)评分;进行治疗前后莱塞斯特咳嗽问卷(LCQ)评分和中医证候评分;记录咳嗽缓解时间和16周内的复发情况;进行治疗前后气道反应检测;进行治疗前后白细胞介素-4(IL-4),IL-5,IL-13,嗜酸性粒细胞(EOS)和血清免疫球蛋白(Ig E)检测。结果:观察组中医疗效总有效率为93.59%,高于对照组的81.33%(χ~2=5.281,P0.05);治疗后观察组患儿日间咳嗽、夜间咳嗽、咳嗽总积分及咳嗽VAS评分均低于对照组(P0.01);观察组平均咳嗽缓解时间短于对照组(P0.01);在16周的随访期中,观察组复发率为39.74%,低于对照组的61.33%(χ~2=5.281,P0.05),观察组平均复发次数低于对照组(P0.01);治疗后观察组LCQ量表2个维度评分和总分均高于对照组(P0.01);观察组患儿血清IL-4,IL-5,IL-13,总Ig E和EOS水平均低于对照组(P0.01);观察组患儿最小诱发累积剂量(Dmin)和PD35水平均高于对照组(P0.01)。结论:小儿治哮灵片治疗发作期咳嗽变异性哮喘,能进一步的缓解咳嗽等临床症状,提高患者的生活质量,并能降低复发频率,其作用机制可能是通过减轻气道炎症反应、降低气道高反应性来实现的。
[Abstract]:Objective: to evaluate the clinical effect of Xiaojixiaoling tablet on cough variant asthma (CVA) and its effect on airway reactivity and chronic inflammation. Group A was randomly divided into control group (n = 85) and observation group (n = 85) according to the method of digital table. The two groups were treated with budesonide aerosol montelukast sodium chewable tablet. The patients were followed up for 16 weeks. The scores of day cough, night cough and visual simulated cough (VAS), Lysst cough questionnaire (LCQQ) and TCM syndromes were evaluated before and after treatment, the time of cough remission and the recurrence of cough within 16 weeks were recorded. Airway reaction was measured before and after treatment. IL-5 IL-13, eosinophilic granulocyte (EOS) and serum immunoglobulin (Ig E) were detected before and after treatment. Results: the total effective rate of TCM in the observation group was 93.59, higher than that in the control group (81.33). The total score of cough and VAS score of cough were lower than those of the control group (P 0.01), the average cough relief time of the observation group was shorter than that of the control group (P 0.01). The recurrence rate of the observation group was 39.74, which was lower than that of the control group (61.33%). The average number of recurrence in the observation group was lower than that in the control group (P 0.01). After treatment, the two dimensional scores and total scores of the LCQ scale in the observation group were higher than those in the control group (P 0.01), and the levels of IL-4 IL-5 IL-13, total IgE and EOS in the observation group were higher than those in the control group. Both of them were lower than those of the control group (P 0.01), and the levels of minimum cumulative dose (min) and PD35 in the observation group were higher than those in the control group (P 0.01). It can further alleviate the clinical symptoms such as cough, improve the quality of life of patients, and reduce the recurrence rate. The mechanism may be achieved by reducing airway inflammation and airway hyperresponsiveness.
【作者单位】：潍坊市益都中心医院;南昌大学医学院;山东省立医院;
【基金】：国家自然科学基金项目(81301556)
【分类号】：R272

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