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薛峥峰,赵力芳,李元霞,雷娟娟.平喘汤治疗小儿非急性期哮喘的临床疗效研究[J].湖南中医药大学学报,2017,37(8):900-904[点击复制] |
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| 平喘汤治疗小儿非急性期哮喘的临床疗效研究 |
| 薛峥峰,赵力芳,李元霞,雷娟娟 |
| (延安大学附属医院儿科, 陕西 延安 716000) |
| 摘要: |
| 目的 研究平喘汤治疗小儿非急性期哮喘的疗效和作用机制。方法 纳入我院80例非急性期哮喘患儿作为研究对象，随机抽签分为两组，各40例，观察组在常规糖皮质激素干预基础上加用平喘汤治疗，对照组行糖皮质激素干预治疗。比较两组治疗效果及治疗前后肺泡痰液中白细胞介素-4（IL-4）、白细胞介素-10（IL-10）、肿瘤坏死因子（TNF-α）、内皮素1（ET-1），分析患儿肺功能第1秒用力呼气量（FEV1）与免疫功能指标CD4+、CD8+T淋巴细胞、嗜酸性粒细肥（EOS）计数]表达的关系。结果 观察组治疗总有效率为97.5%，显著高于对照组82.5%，差异有统计学意义（P< 0.05）。观察组治疗后IL-4、TNF-α、ET-1、CD4+T淋巴细胞、EOS计数均显著低于治疗前和对照组治疗后，IL-10、CD8+T淋巴细胞显著高于治疗前和对照组治疗后，差异均有统计学意义（P< 0.05）。两组患者治疗前后24小时尿游离皮质醇（24 h-UFC）、骨密度（BMD）、体质量水平及呼吸道感染发生率比较，差异无统计学意义（P> 0.05）。经一元线性回归分析，CD4+T淋巴细胞和EOS计数与FEV1具有显著负相关性，CD8+T淋巴细胞计数与FEV1具有显著正相关性。结论 平喘汤干预治疗非急性期哮喘患儿较单纯糖皮质激素治疗疗效更为显著，能显著缓解咳嗽、咳痰、喘息等临床症状，改善肺功能，且安全性高，其增效机制可能与强化抗炎效果，增强免疫功能有关。 |
| 关键词: 非急性期哮喘 平喘汤 糖皮质激素 肺功能 免疫功能指标 线性相关 麻黄 杏仁 |
| DOI：10.3969/j.issn.1674-070X.2017.08.021 |
| 投稿时间：2016-10-10 |
| 基金项目:延安市科技惠民计划项目（2016HM-08-02）。 |
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| Study of Xingren Pingchuan Decoction on Treatment of Children with Asthma in Non-Acute Stage |
| XUE Zhengfeng,ZHAO Lifang,LI Yuanxia,LEI Juanjuan |
| (Department of Pediatrics, Affiliated Hospital of Yan'an University, Yan'an, Shanxi 716000, China) |
| Abstract: |
| Objective To investigate the effect and mechanism of Pingchuan decoction in the treatment of children with non-acute asthma. Methods Eighty children with non-acute asthma in our hospital were randomly divided into two groups, 40 cases in each group. Based on the conventional glucocorticoid intervention, the observation group was treated with Pingchuan decoction, while the control group was treated with glucocorticoid alone. The interleukin-4 (IL-4) and interleukin-10 (IL-10), tumor necrosis factor alpha (TNF-α), endothelin-1 (ET-1) in alveolar sputum before and after treatment were compared. The relationship of the first second forced expiratory volume (FEV1) of pulmonary function with immune function inidicators [CD4+, CD8+ T lymphocyte and eosinophil (EOS) count] was analyzed. Results The total effective rate in the observation group (97.5%) was significantly higher than that in the control group (82.5%) (P<0.05). After treatment, IL-4, TNF-α, ET-1, CD4+ T lymphocyte count and EOS count were significantly lower than those before treatment and the control group, and IL-10 and CD8+ T lymphocytes were significantly higher than those before treatment and the control group the difference was statistically significant (P<0.05). After treatment, there were no significant differences in 24 h-UFC, BMD, weight and the incidence of respiratory tract infection between the two groups (P> 0.05). The unitary linear regression analysis showed that CD4+ T lymphocytes and EOS counts were significantly negatively correlated with FEV1. CD8+ T lymphocyte count was significantly positively correlated with FEV1. Conclusion Pingchuan decoction in treatment of non-acute asthma shows more significant effect than glucocorticoid therapy alone, which could significantly relieve cough and expectoration, wheezing and other symptoms and improve lung function, with high safety. It may be related with enhancement of anti-inflammatory effect and immune function. |
| Key words: non-acute asthma Pingchuan decoction glucocorticoid pulmonary function immune function index linear correlation ephdra |
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