平喘方治疗小儿哮喘发作期的临床观察
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摘要
目的:观察平喘方对小儿哮喘发作期的临床症状、PEF、FeNO、血清EOS、IgE的改善情况,验证平喘方的临床治疗效果,分析其作用机制。方法:采用随机、平行对照的方法,对60例哮喘发作期患儿进行临床研究,治疗组给予平喘方,对照组给予盐酸环丙特罗,治疗7 d,治疗前后均对两组患儿的临床症状、PEF、FeNO、血清EOS、IgE的数据进行分析。结果:治疗组临床疗效及中医症候疗效均优于对照组,差异有统计学意义,并对PEF、FeNO、血清EOS、IgE的改善亦优于对照组(P<0.05)。结论:平喘方具有改善气道炎症及气道重建的作用,同时还具有一定的抗过敏作用,从而缓解哮喘的临床症状。
Objective: To observe the effect of Pingchuan Formula on the clinical symptoms of infantile asthma and the improvement of serum EOS-IgE. To verify the clinical therapeutic effect of Pingchuan Formula and analyze its mechanism. Methods: A randomized, parallel controlled study was conducted in 60 children with asthma. The treatment group was treated with Pingchuan Formula and the control group was treated with cycloproterol hydrochloride for 7 days. The clinical symptoms of both groups were analyzed before and after treatment. Results: The curative effect of treatment group and TCM symptom were better than those of the control group. The improvement of Feno and EOS Ig E in serum was better than that in the control group( P < 0. 05). Conclusion: Pingchuan Formula can not only improve airway inflammation and airway reconstruction but also has anti-allergic effect,thereby relieving the clinical symptoms of asthma.
Objective: To observe the effect of Pingchuan Formula on the clinical symptoms of infantile asthma and the improvement of serum EOS-IgE. To verify the clinical therapeutic effect of Pingchuan Formula and analyze its mechanism. Methods: A randomized, parallel controlled study was conducted in 60 children with asthma. The treatment group was treated with Pingchuan Formula and the control group was treated with cycloproterol hydrochloride for 7 days. The clinical symptoms of both groups were analyzed before and after treatment. Results: The curative effect of treatment group and TCM symptom were better than those of the control group. The improvement of Feno and EOS Ig E in serum was better than that in the control group( P < 0. 05). Conclusion: Pingchuan Formula can not only improve airway inflammation and airway reconstruction but also has anti-allergic effect,thereby relieving the clinical symptoms of asthma.
引文
[1] Masoli M,Fabian D,Holt S,et al.GlobalInitiative for Asthma (GINA) Program.The global burden of asthma:executive summary of the GINA Dissemination Committee report[J].Allergy,2004,59:469-478.
[2] Vercelli D.Does epigenetics play a role in human asthma?[J].Allergol Int,2016:1-4.
[3] Theresa W,Guilbert MD,Wayne J,et al.Long-Term Inhaled Corticosteroids in Preschool Children at High Risk for Asthma[J].The new England journal of medicine,2006,354(19):1985-1997.
[4] Robert F,Lemanske Jr MD,David T Mauger,et al.Step-up Therapy for Children with Uncontrolled Asthma Receiving Inhaled Corticosteroids[J].New England Journal of Medicine,2010,362:975-985.
[5] Abdelaziz RR,Elmahdy MK,Suddek GM.Flavocoxid attenuates airway inflammation in ovalbumin-induced mouse asthma model[J].Chem Biol Interact,2018,292:15-23.
[6] El-Kashef DH.Nicorandil alleviates ovalbumin-induced airway inflammation in a mouse model of asthma[J].Environ Toxicol Pharmacol,2018,59:132-137.
[7] Boulet LP.Airway remodeling in asthma:update on mechanisms and therapeutic approaches[J].Curr Opin Pulm Med,2018,24(1):56-62.
[8] Fehrenbach H,Wagner C,Wegmann M.Airway remodeling in asthma:what really matters[J].Cell Tissue Res,2017,367(3):551-569.
[9] Nair P,Martin JG,Cockcroft DC,et al.Airway Hyperresponsiveness in Asthma:Measurement and Clinical Relevance[J].J Allergy Clin Immunol Pract,2017,5(3):649-659.
[10] Park YA,Park HB,Kim YH,et al.Airway hyperresponsiveness to mannitol and methacholine and exhaled nitric oxide in children with asthma[J].J Asthma,2017,54(6):644-651.
[11] 赵毅涛,张新光,白莉,等.平喘方对哮喘模型小鼠肺组织炎症及γ干扰素和白细胞介素4的影响[J].中西医结合学报,2012,10(7):807-813.
[12] 白莉,张新光,吴杰,等.平喘方及其拆方对支气管哮喘小鼠肺组织转录因子T-bet /GATA-3 表达的影响[J].世界中医药,2011,6(5):444-447.
[13] 朱慧华,虞坚尔,张晓峰,等.平喘方对支气管哮喘模型小鼠气道重建的影响[J].中西医结合学报,2009,7(11):261-267.
[14] Fei Liu,Jianer Yu,Li Bai,et al.Pingchuan Formula Improves Asthma via Restoration of the Th17/Treg Balance in a Mouse Model[J].BMC Complementary and Alternative Medicine,2015,15:234.
[15] Kips JC,O’Connor BJ,Inman MD,et al.A long-term study of the antiinflammatory effect of low-dose budesonide plus formoterol versus high-dose budesonide in asthma[J].Am J Respir Crit Care Med,2000,161(1):996-1001.
[16] 王莉,王美芹,张建志.哮喘患儿呼出气一氧化氮浓度、肺功能及哮喘控制测试评分的相关性及其评估价值研究[J].实用心脑肺血管病杂志,2015,23(9):37-40.
[17] 张晓鸥.呼出气一氧化氮检测对支气管哮喘患儿诊治的评估作用[J].临床肺科杂志,2015,20(7):1331-1333.
[18] 谢庆玲,张迪雯,王美春,等.哮喘儿童呼出气一氧化氮检测的临床应用[J].中国临床新医学,2016,9(9):784-787.
[19] 江剑华,王永清.呼出气一氧化氮测定在儿童哮喘治疗中的作用分析[J].吉林医学,2016,37(12):2964-2966.
[20] Papakosta D,Latsios D,Manika K.Asthma control test is correlated to FEV1 and nitric oxide in Greek asthmatic patients:influence of treatment[J].J Asthma,2011,48(9):901-906.
[21] 吴邵霞,沈广礼.呼出气一氧化氮与外周血嗜酸性粒细胞在儿童哮喘中的相关性研究[J].中国儿童保健杂志,2015,23(4):439-441.
[22] 林端,刘接威.血清IgE和血嗜酸性粒细胞在儿童支气管哮喘中的临床意义[J].中外医学研究,2016,14(29):54-55.
[23] 李莉,张建荣,张文华,等.哮喘儿童血清IgE、IL-4、IFN-γ、IgG4 和hs-CRP 的水平变化及意义[J].宁夏医科大学学报,2017,39(5):601-603.
[24] Meng YN,Rao HP,Chen YP,et al.Serum IgE and eosinophil Cationic protein levels in children with cough Variant asthma [J] .Zhongguo Dang Dai Er Ke Za Zhi,2008,10:39-400.
[2] Vercelli D.Does epigenetics play a role in human asthma?[J].Allergol Int,2016:1-4.
[3] Theresa W,Guilbert MD,Wayne J,et al.Long-Term Inhaled Corticosteroids in Preschool Children at High Risk for Asthma[J].The new England journal of medicine,2006,354(19):1985-1997.
[4] Robert F,Lemanske Jr MD,David T Mauger,et al.Step-up Therapy for Children with Uncontrolled Asthma Receiving Inhaled Corticosteroids[J].New England Journal of Medicine,2010,362:975-985.
[5] Abdelaziz RR,Elmahdy MK,Suddek GM.Flavocoxid attenuates airway inflammation in ovalbumin-induced mouse asthma model[J].Chem Biol Interact,2018,292:15-23.
[6] El-Kashef DH.Nicorandil alleviates ovalbumin-induced airway inflammation in a mouse model of asthma[J].Environ Toxicol Pharmacol,2018,59:132-137.
[7] Boulet LP.Airway remodeling in asthma:update on mechanisms and therapeutic approaches[J].Curr Opin Pulm Med,2018,24(1):56-62.
[8] Fehrenbach H,Wagner C,Wegmann M.Airway remodeling in asthma:what really matters[J].Cell Tissue Res,2017,367(3):551-569.
[9] Nair P,Martin JG,Cockcroft DC,et al.Airway Hyperresponsiveness in Asthma:Measurement and Clinical Relevance[J].J Allergy Clin Immunol Pract,2017,5(3):649-659.
[10] Park YA,Park HB,Kim YH,et al.Airway hyperresponsiveness to mannitol and methacholine and exhaled nitric oxide in children with asthma[J].J Asthma,2017,54(6):644-651.
[11] 赵毅涛,张新光,白莉,等.平喘方对哮喘模型小鼠肺组织炎症及γ干扰素和白细胞介素4的影响[J].中西医结合学报,2012,10(7):807-813.
[12] 白莉,张新光,吴杰,等.平喘方及其拆方对支气管哮喘小鼠肺组织转录因子T-bet /GATA-3 表达的影响[J].世界中医药,2011,6(5):444-447.
[13] 朱慧华,虞坚尔,张晓峰,等.平喘方对支气管哮喘模型小鼠气道重建的影响[J].中西医结合学报,2009,7(11):261-267.
[14] Fei Liu,Jianer Yu,Li Bai,et al.Pingchuan Formula Improves Asthma via Restoration of the Th17/Treg Balance in a Mouse Model[J].BMC Complementary and Alternative Medicine,2015,15:234.
[15] Kips JC,O’Connor BJ,Inman MD,et al.A long-term study of the antiinflammatory effect of low-dose budesonide plus formoterol versus high-dose budesonide in asthma[J].Am J Respir Crit Care Med,2000,161(1):996-1001.
[16] 王莉,王美芹,张建志.哮喘患儿呼出气一氧化氮浓度、肺功能及哮喘控制测试评分的相关性及其评估价值研究[J].实用心脑肺血管病杂志,2015,23(9):37-40.
[17] 张晓鸥.呼出气一氧化氮检测对支气管哮喘患儿诊治的评估作用[J].临床肺科杂志,2015,20(7):1331-1333.
[18] 谢庆玲,张迪雯,王美春,等.哮喘儿童呼出气一氧化氮检测的临床应用[J].中国临床新医学,2016,9(9):784-787.
[19] 江剑华,王永清.呼出气一氧化氮测定在儿童哮喘治疗中的作用分析[J].吉林医学,2016,37(12):2964-2966.
[20] Papakosta D,Latsios D,Manika K.Asthma control test is correlated to FEV1 and nitric oxide in Greek asthmatic patients:influence of treatment[J].J Asthma,2011,48(9):901-906.
[21] 吴邵霞,沈广礼.呼出气一氧化氮与外周血嗜酸性粒细胞在儿童哮喘中的相关性研究[J].中国儿童保健杂志,2015,23(4):439-441.
[22] 林端,刘接威.血清IgE和血嗜酸性粒细胞在儿童支气管哮喘中的临床意义[J].中外医学研究,2016,14(29):54-55.
[23] 李莉,张建荣,张文华,等.哮喘儿童血清IgE、IL-4、IFN-γ、IgG4 和hs-CRP 的水平变化及意义[J].宁夏医科大学学报,2017,39(5):601-603.
[24] Meng YN,Rao HP,Chen YP,et al.Serum IgE and eosinophil Cationic protein levels in children with cough Variant asthma [J] .Zhongguo Dang Dai Er Ke Za Zhi,2008,10:39-400.