清宣止咳颗粒联合特布他林治疗小儿支气管哮喘的临床研究
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摘要
目的探讨清宣止咳颗粒联合特布他林治疗小儿支气管哮喘的临床疗效。方法选取2017年5月—2018年5月在罗田县人民医院接受治疗的78例支气管哮喘患儿,根据用药方案分为对照组和治疗组,每组各39例。对照组通过雾化器给予硫酸特布他林雾化液,体质量小于20 kg患儿1 mL/次,体质量大于20 kg患儿2 mL/次,3次/d。治疗组在对照组治疗基础上口服清宣止咳颗粒,1～3岁,1/2袋/次,4～6岁,3/4袋/次,7～14岁,1袋/次,3次/d。两组均治疗2周。观察两组的临床疗效,比较两组症状改善时间、肺功能指标、炎症因子水平的变化情况。结果治疗后,对照组和治疗组的总有效率分别是82.05%、97.44%,两组比较差异具有统计学意义(P<0.05)。治疗后,治疗组患儿喘憋改善时间、咳嗽改善时间及肺部啰音改善时间均显著短于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患儿一秒用力呼气容积(FEV1)、用力肺活量(FVC)、最大呼气流量(PEF)均较治疗前明显升高,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组这些肺功能指标明显高于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组患儿血清白细胞介素-4(IL-4)、细胞间黏附分子-1(ICAM-1)、半胱氨酰白三烯(CysLTs)、基质金属蛋白酶-9(MMP-9)水平均较治疗前显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组这些炎症因子水平低于对照组,两组比较差异有统计学意义(P<0.05)。结论清宣止咳颗粒联合特布他林治疗小儿支气管哮喘具有较好的临床疗效,可有效改善患儿临床症状,促进患儿肺功能改善,并可降低机体炎症反应,具有一定的临床推广应用价值。
Objective To investigate the clinical efficacy of Qingxuan Zhike Granules combined with terbutaline in treatment of bronchial asthma in children. Methods Children(78 cases) with bronchial asthma in People's Hospital of Luotian County from May2017 to May 2018 were divided into treatment group(39 cases) and control group(39 cases) according to different drug regimens.Patients in the control group were given Terbutaline Sulphate Solution for Nebulization by atomizer, 1 m L/time for children with weight less than 20 kg and 2 m L/time for children with weight more than 20 kg, three times daily. Patients in the treatment group were po administered with Qingxuan Zhike Granules on the basis of control group, 1 — 3 years old, 1/2 bag/time; 4 — 6 years old,3/4 bag/time; 7 — 14 years old, 1 bag/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and symptom improvement time, lung function indexes and inflammatory factors levels in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment group were 82.05% and 97.44%, respectively,and there were differences between two groups(P < 0.05). After treatment, wheezing improvement time, cough improvement time,lung rale improvement time in the treatment group were significantly shorter than those in the control group, and there were differences between two groups(P < 0.05). After treatment, FEV1, FVC, and PEF in the two groups were significantly increased, and there were differences in the same group(P < 0.05). After treatment, the lung function indicators in the treatment group were higher than those in the control group, and there were differences between two groups(P < 0.05). After treatment, IL-4, ICAM-1, CysLTs,and MMP-9 in the two groups were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, the inflammatory cytokines in the treatment group were lower than those in the control group, and there were differences between two groups(P < 0.05). Conclusion Qingxuan Zhike Granules combined with terbutaline has significant effect in treatment of bronchial asthma in children, and can effectively improve the clinical symptoms, and promote the improvement of lung function, and also can reduce the body inflammatory reaction, which has a certain clinical application value.
Objective To investigate the clinical efficacy of Qingxuan Zhike Granules combined with terbutaline in treatment of bronchial asthma in children. Methods Children(78 cases) with bronchial asthma in People's Hospital of Luotian County from May2017 to May 2018 were divided into treatment group(39 cases) and control group(39 cases) according to different drug regimens.Patients in the control group were given Terbutaline Sulphate Solution for Nebulization by atomizer, 1 m L/time for children with weight less than 20 kg and 2 m L/time for children with weight more than 20 kg, three times daily. Patients in the treatment group were po administered with Qingxuan Zhike Granules on the basis of control group, 1 — 3 years old, 1/2 bag/time; 4 — 6 years old,3/4 bag/time; 7 — 14 years old, 1 bag/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and symptom improvement time, lung function indexes and inflammatory factors levels in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment group were 82.05% and 97.44%, respectively,and there were differences between two groups(P < 0.05). After treatment, wheezing improvement time, cough improvement time,lung rale improvement time in the treatment group were significantly shorter than those in the control group, and there were differences between two groups(P < 0.05). After treatment, FEV1, FVC, and PEF in the two groups were significantly increased, and there were differences in the same group(P < 0.05). After treatment, the lung function indicators in the treatment group were higher than those in the control group, and there were differences between two groups(P < 0.05). After treatment, IL-4, ICAM-1, CysLTs,and MMP-9 in the two groups were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, the inflammatory cytokines in the treatment group were lower than those in the control group, and there were differences between two groups(P < 0.05). Conclusion Qingxuan Zhike Granules combined with terbutaline has significant effect in treatment of bronchial asthma in children, and can effectively improve the clinical symptoms, and promote the improvement of lung function, and also can reduce the body inflammatory reaction, which has a certain clinical application value.
引文
[1]中国支气管哮喘防治指南(基层版)-支气管哮喘的诊断与鉴别诊断[J].中国全科医学,2013,16(25):3030.
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[7]栗丽丽,师强华,梁淑芬,等.支气管哮喘发病机制的研究进展[J].中医临床研究,2014,6(36):27-29.
[8]高志刚,袁永红,詹建华.沙丁胺醇气雾剂联合硫酸镁对小儿哮喘IL-2、IL-4、IL-5、IFN-γ及T淋巴细胞亚群的影响[J].中国生化药物杂志,2015,35(8):110-115.
[9]张晓鸣,朱海涛,常明.血管细胞间黏附分子-1在毛细支气管炎患儿中的表达及意义[J].中国当代儿科杂志,2018,20(1):43-47.
[10]陈桂金.支气管哮喘患儿治疗前后血清CGRP、MMP-9、TIMP-1检测的临床意义[J].放射免疫学杂志,2011,24(6):621-622.
[11]李兰,王智斌,李敏,等.毛细支气管炎患儿血清半胱氨酰白三烯测定的临床意义[J].临床儿科杂志,2006,4(5):390-391.
[2]葛均波,徐永健.内科学[M].第8版.北京:人民卫生出版社,2013:28.
[3]杨波,黄开明,黄文洁.特布他林雾化剂联合布地奈德混悬液治疗咳嗽变异性哮喘研究[J].临床肺科杂志,2013,18(5):854-856.
[4]张晓丽,伏慧琴.清宣止咳颗粒治疗小儿咳嗽变异性哮喘疗效观察[J].临床医药文献电子杂志,2017(73):172.
[5]中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南[J].中华结核与呼吸杂志,2008,31(3):817-822.
[6]中华医学会儿科学分会呼吸学组.儿童支气管哮喘诊断与防治指南(2016年版)[J].中华儿科杂志,2016,54(3):167-181.
[7]栗丽丽,师强华,梁淑芬,等.支气管哮喘发病机制的研究进展[J].中医临床研究,2014,6(36):27-29.
[8]高志刚,袁永红,詹建华.沙丁胺醇气雾剂联合硫酸镁对小儿哮喘IL-2、IL-4、IL-5、IFN-γ及T淋巴细胞亚群的影响[J].中国生化药物杂志,2015,35(8):110-115.
[9]张晓鸣,朱海涛,常明.血管细胞间黏附分子-1在毛细支气管炎患儿中的表达及意义[J].中国当代儿科杂志,2018,20(1):43-47.
[10]陈桂金.支气管哮喘患儿治疗前后血清CGRP、MMP-9、TIMP-1检测的临床意义[J].放射免疫学杂志,2011,24(6):621-622.
[11]李兰,王智斌,李敏,等.毛细支气管炎患儿血清半胱氨酰白三烯测定的临床意义[J].临床儿科杂志,2006,4(5):390-391.