槐杞黄颗粒联合酮替芬和孟鲁司特对小儿咳嗽变异性哮喘患者免疫功能的影响
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摘要
目的探讨槐杞黄颗粒联合酮替芬和孟鲁司特治疗小儿咳嗽变异性哮喘的疗效,并分析其对患儿免疫功能的影响。方法选取2016年8月至2017年12月收治的咳嗽变异性哮喘患儿92例为研究对象,随机分为治疗组与对照组,各46例。对照组患儿给予酮替芬和孟鲁司特治疗,治疗组患儿在此基础上给予槐杞黄颗粒治疗,疗程均为3个月。对比两组患儿临床疗效、治疗前后免疫功能指标、肺功能指标及细胞因子水平,并观察两组患儿不良反应发生情况。结果治疗组患儿的总有效率高于对照组(93. 48%vs 76. 09%,P <0. 05)。治疗后,两组患儿CD4+/CD8+、CD4+较治疗前降低,CD8+较治疗前升高,且治疗组患儿的CD4+/CD8+、CD4+低于对照组,CD8+高于对照组(P <0. 01)。治疗后两组患儿FEV1、FVC、FEV1/FVC均较治疗前升高,且治疗组患儿的FEV1、FVC、FEV1/FVC高于对照组(P <0. 01)。治疗后,两组患儿的IL-4水平较治疗前降低,IFN-γ升高,且治疗组患儿IL-4水平低于对照组,IFN-γ水平高于对照组(P <0. 05,P <0. 01)。两组患儿在治疗期间均未发生明显的不良反应。结论槐杞黄颗粒联合酮替芬和孟鲁司特治疗小儿咳嗽变异性哮喘临床疗效显著,且能有效改善患儿免疫功能、肺功能。
Objective To investigate the clinical effect of huaiqihuang granule combined with ketotifen and montelukast in the treatment of children with cough variant asthma,and analyze its influence on the immune function. Methods A total of92 children with cough variant asthma who received 3-month treatment from August 2016 to December 2017 were selected and divided into control group and treatment group( n = 46,each). The control group patients received ketotifen and montelukast,and the treatment group received huaiqihuang granule combined with ketotifen and montelukast. The clinical efficacy,immune function,pulmonary function and cytokine levels before and after treatment were compared between the two groups,and adverse reactions were observed. Result The total clinical effect in treatment group was significantly higher than that in control group( 93. 48% vs 76. 09%,P < 0. 05). After the treatment,the CD4+/CD8+ratio and CD4+level were lower and the CD8+level was higher in both group and the CD4+/CD8+ratio and CD4+level were lower and the CD8+level was higher in treatment group than those in control group( all P < 0. 01). Forced expiratory volume in 1 second( FEV1),forced vital capacity( FVC) and FEV1/FVC ratio were higher in both group after the treatment( all P < 0. 05),and they were higher in treatment group than those in control group( all P < 0. 01). After the treatment,the level of interleukin-4( IL-4) was lower and interferon gamma( IFN-γ) was higher in both group,and IL-4 was lower and IFN-γ was higher in treatment group than those in control group( P < 0. 05,P < 0. 01). There was no adverse reaction in both group during the treatment. Conclusion Huaiqihuang granule combined with ketotifen and montelukast has a significant clinical effect in the treatment of children with cough variant asthma,and it could improve the immune function and pulmonary function.
Objective To investigate the clinical effect of huaiqihuang granule combined with ketotifen and montelukast in the treatment of children with cough variant asthma,and analyze its influence on the immune function. Methods A total of92 children with cough variant asthma who received 3-month treatment from August 2016 to December 2017 were selected and divided into control group and treatment group( n = 46,each). The control group patients received ketotifen and montelukast,and the treatment group received huaiqihuang granule combined with ketotifen and montelukast. The clinical efficacy,immune function,pulmonary function and cytokine levels before and after treatment were compared between the two groups,and adverse reactions were observed. Result The total clinical effect in treatment group was significantly higher than that in control group( 93. 48% vs 76. 09%,P < 0. 05). After the treatment,the CD4+/CD8+ratio and CD4+level were lower and the CD8+level was higher in both group and the CD4+/CD8+ratio and CD4+level were lower and the CD8+level was higher in treatment group than those in control group( all P < 0. 01). Forced expiratory volume in 1 second( FEV1),forced vital capacity( FVC) and FEV1/FVC ratio were higher in both group after the treatment( all P < 0. 05),and they were higher in treatment group than those in control group( all P < 0. 01). After the treatment,the level of interleukin-4( IL-4) was lower and interferon gamma( IFN-γ) was higher in both group,and IL-4 was lower and IFN-γ was higher in treatment group than those in control group( P < 0. 05,P < 0. 01). There was no adverse reaction in both group during the treatment. Conclusion Huaiqihuang granule combined with ketotifen and montelukast has a significant clinical effect in the treatment of children with cough variant asthma,and it could improve the immune function and pulmonary function.
引文
[1]林寒梅.孟鲁司特钠联合布地奈德治疗儿童咳嗽变异性哮喘临床疗效及对炎症因子的影响[J].中国妇幼保健,2015,30(5):796-797.
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[3]曹明岭.小儿咳嗽变异性哮喘与肺炎支原体感染关系研究[J].河北医学,2013,19(6):919-921.
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[5]中华医学会儿科学会呼吸学组,《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南[J].中华儿科杂志,2008,46(10):745-753.
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[7] Bie M,Lv Y,Ren C,et al. Lycium barbarum polysaccharide improvesbipolar pulse current-induced microglia cell injury through modula-ting autophagy[J]. Cell Transplant,2015,24(3):419-428.
[8] Shiau M,Harkin TJ,Naidich DP. Imaging of the central airways withbronchoscopic correlation:pictorial essay[J]. Clin Chest Med,2015,36(2):313-334.
[9]吴艳玲,张海邻.儿童咳嗽变异性哮喘诊治进展[J].中华儿科杂志,2016,54(4):314-317.
[10] Redasani VK,Kothawade AR,Surana SJ. Stability indicating RP-HPLC method for simultaneous estimation of rupatadine fumarate andmontelukast sodium in bulk and tablet dosage form[J]. J AnalChem,2014,69(4):384-389.
[11]吴娥玲.孟鲁司特联合布地奈德对咳嗽变异性哮喘患儿肺功能和免疫功能的影响[J].实用临床医药杂志,2016,20(17):91-94.
[12]皇甫春荣,李平.孟鲁司特钠治疗小儿咳嗽变异性哮喘的临床研究[J].中国临床药理学杂志,2013,29(12):908-910.
[13]赵淑琴.孟鲁司特钠与酮替酚治疗小儿咳嗽变异性哮喘的近远期疗效比较[J].中国实用医刊,2015,42(12):59-60.
[14]蔡跃明,吴镇洲.寒喘祖帕颗粒联合茶碱缓释片治疗咳嗽变异性哮喘临床观察[J].新中医,2015,47(1):78-79.
[15]贾春梅,王冬梅,宁立华,等.槐杞黄辅助治疗哮喘儿童疗效及外周血中Th1 Th2相关细胞因子对氧磷酶1水平的影响[J].中国实用儿科杂志,2018,33(5):365-369.
[16]刘雅娟,曹译丹,赵强,等.槐杞黄颗粒联合布地奈德治疗儿童咳嗽变异性哮喘的临床研究[J].现代药物与临床,2018,33(4):832-836.
[17]汤景平.槐杞黄颗粒佐治小儿咳嗽变异性哮喘的疗效及其对机体免疫功能的影响[J].儿科药学杂志,2016,22(6):22-25.
[18]景晓平,陈文霞.槐杞黄颗粒预防支气管哮喘儿童呼吸道反复感染的临床观察[J].上海中医药大学学报,2014,28(3):39-42.
[2]吴莉菁,肖国军.孟鲁司特钠片联合布地奈德混悬液治疗咳嗽变异性哮喘患儿的临床研究[J].中国临床药理学杂志,2016,32(22):2032-2034,2038.
[3]曹明岭.小儿咳嗽变异性哮喘与肺炎支原体感染关系研究[J].河北医学,2013,19(6):919-921.
[4]李红燕,隆红艳.儿童咳嗽变异性哮喘气道炎症研究[J].长春中医药大学学报,2015,31(2):414-417.
[5]中华医学会儿科学会呼吸学组,《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南[J].中华儿科杂志,2008,46(10):745-753.
[6]朱文玲.内科疾病诊断与疗效标准[M].上海:上海中医药大学出版社,2006:89-92.
[7] Bie M,Lv Y,Ren C,et al. Lycium barbarum polysaccharide improvesbipolar pulse current-induced microglia cell injury through modula-ting autophagy[J]. Cell Transplant,2015,24(3):419-428.
[8] Shiau M,Harkin TJ,Naidich DP. Imaging of the central airways withbronchoscopic correlation:pictorial essay[J]. Clin Chest Med,2015,36(2):313-334.
[9]吴艳玲,张海邻.儿童咳嗽变异性哮喘诊治进展[J].中华儿科杂志,2016,54(4):314-317.
[10] Redasani VK,Kothawade AR,Surana SJ. Stability indicating RP-HPLC method for simultaneous estimation of rupatadine fumarate andmontelukast sodium in bulk and tablet dosage form[J]. J AnalChem,2014,69(4):384-389.
[11]吴娥玲.孟鲁司特联合布地奈德对咳嗽变异性哮喘患儿肺功能和免疫功能的影响[J].实用临床医药杂志,2016,20(17):91-94.
[12]皇甫春荣,李平.孟鲁司特钠治疗小儿咳嗽变异性哮喘的临床研究[J].中国临床药理学杂志,2013,29(12):908-910.
[13]赵淑琴.孟鲁司特钠与酮替酚治疗小儿咳嗽变异性哮喘的近远期疗效比较[J].中国实用医刊,2015,42(12):59-60.
[14]蔡跃明,吴镇洲.寒喘祖帕颗粒联合茶碱缓释片治疗咳嗽变异性哮喘临床观察[J].新中医,2015,47(1):78-79.
[15]贾春梅,王冬梅,宁立华,等.槐杞黄辅助治疗哮喘儿童疗效及外周血中Th1 Th2相关细胞因子对氧磷酶1水平的影响[J].中国实用儿科杂志,2018,33(5):365-369.
[16]刘雅娟,曹译丹,赵强,等.槐杞黄颗粒联合布地奈德治疗儿童咳嗽变异性哮喘的临床研究[J].现代药物与临床,2018,33(4):832-836.
[17]汤景平.槐杞黄颗粒佐治小儿咳嗽变异性哮喘的疗效及其对机体免疫功能的影响[J].儿科药学杂志,2016,22(6):22-25.
[18]景晓平,陈文霞.槐杞黄颗粒预防支气管哮喘儿童呼吸道反复感染的临床观察[J].上海中医药大学学报,2014,28(3):39-42.