固本通络方联合西药治疗缓解期儿童哮喘疗效及对免疫功能的影响
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摘要
目的观察固本通络方联合西药治疗缓解期儿童哮喘的临床疗效及对免疫功能的影响。方法将符合纳入标准的90例缓解期哮喘患儿随机分为2组,对照组45例给予布地奈德粉吸入剂(200μg/次,2次/d)治疗,治疗组45例给予固本通络方联合布地奈德粉吸入剂(200μg/次,2次/d)治疗,2组疗程均为2个月。观察2组治疗后临床疗效和治疗前后、治疗结束3个月及6个月后儿童哮喘控制测试问卷(C-ACT)得分情况,记录2组治疗前及治疗结束后1年内哮喘平均发作次数,检测2组治疗前后肺功能指标及血清免疫球蛋白A(IgA)、IgG、IgM、IgE水平,并评价2组安全性。结果治疗组总有效率显著高于对照组(P<0.05)。2组治疗结束后、治疗结束3个月及6个月后C-ACT评分均显著高于治疗前(P均<0.05),且治疗组上述时间C-ACT评分均显著高于对照组(P均<0.05)。2组治疗结束后1年内哮喘发作次数均显著低于治疗前(P均<0.05),且治疗组显著低于对照组(P<0.05)。2组治疗后PEF变异率及血清IgE水平均显著降低(P均<0.05),FEV_1/FVC、FEV_1%及血清IgA、IgG、IgM水平均显著升高(P均<0.05),且治疗组上述指标改善情况均显著优于对照组(P均<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论固本通络方联合西医常规治疗缓解期儿童哮喘效果更好,可更显著地改善患儿的临床症状及肺功能,提高患儿的免疫功能,并降低血清IgE水平。
Objective It is to observe the clinical efficacy of Guben Tongluo decoction combined with western medicine on asthma at remission stage and its effect on immune function. Methods Ninety children with asthma at remission stage who met the inclusion criteria were randomly divided into two groups. The control group(n=45) was treated with budesonide powder inhalation(200 μg/time, 2 times/d), and the treatment group(n=45) was treated with Guben Tongluo decoction on the basis of therapy in the control group. Both groups were treated for 2 months. The clinical efficacy of the two groups and the scores of the children's asthma control test questionnaire(C-ACT) before and after treatment, 3 months and 6 months after treatment were observed, and the average number of asthma attacks in the 2 groups before and after the treatment was recorded. The lung function indexes and serum immunoglobulin A(IgA), IgG, IgM, and IgE levels were measured before and after treatment, and the safety of the two groups was evaluated. Results The total effective rate of the treatment group was significantly higher than that of the control group(P<0.05). The C-ACT scores of the 2 groups after treatment and 3 months and 6 months after treatment were significantly higher than those before treatment(P<0.05), and the C-ACT scores of the treatment group were significantly higher than those of the control group.(P<0.05). The average number of asthma attacks in the 2 groups after treatment was significantly lower than that before treatment(P<0.05), and the treatment group was significantly lower than the control group(P<0.05). After treatment, PEF mutation rate and serum IgE level were significantly decreased(P<0.05), and FEV_1/FVC, FEV_1% and serum IgA, IgG, IgM levels were significantly increased(P<0.05). Moreover, the improvement of the above indicators in the treatment group was significantly better than the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion Guben Tongluo decoction combined with western medicine can significantly improve the clinical symptoms and lung function, improve the immune function, and reduce serum IgE level in the treatment of asthma at remission stage in children.
Objective It is to observe the clinical efficacy of Guben Tongluo decoction combined with western medicine on asthma at remission stage and its effect on immune function. Methods Ninety children with asthma at remission stage who met the inclusion criteria were randomly divided into two groups. The control group(n=45) was treated with budesonide powder inhalation(200 μg/time, 2 times/d), and the treatment group(n=45) was treated with Guben Tongluo decoction on the basis of therapy in the control group. Both groups were treated for 2 months. The clinical efficacy of the two groups and the scores of the children's asthma control test questionnaire(C-ACT) before and after treatment, 3 months and 6 months after treatment were observed, and the average number of asthma attacks in the 2 groups before and after the treatment was recorded. The lung function indexes and serum immunoglobulin A(IgA), IgG, IgM, and IgE levels were measured before and after treatment, and the safety of the two groups was evaluated. Results The total effective rate of the treatment group was significantly higher than that of the control group(P<0.05). The C-ACT scores of the 2 groups after treatment and 3 months and 6 months after treatment were significantly higher than those before treatment(P<0.05), and the C-ACT scores of the treatment group were significantly higher than those of the control group.(P<0.05). The average number of asthma attacks in the 2 groups after treatment was significantly lower than that before treatment(P<0.05), and the treatment group was significantly lower than the control group(P<0.05). After treatment, PEF mutation rate and serum IgE level were significantly decreased(P<0.05), and FEV_1/FVC, FEV_1% and serum IgA, IgG, IgM levels were significantly increased(P<0.05). Moreover, the improvement of the above indicators in the treatment group was significantly better than the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion Guben Tongluo decoction combined with western medicine can significantly improve the clinical symptoms and lung function, improve the immune function, and reduce serum IgE level in the treatment of asthma at remission stage in children.
引文
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[11] 杜娟,凌昌全,陈永安. 淫羊藿和熟地煎剂对糖皮质激素受体下调模型大鼠糖皮质激素受体的影响[J]. 中国中西医结合杂志,2008,28(1):64-67
[12] 赵刚,葛信国. 人参皂甙Rg3对H22荷瘤小鼠免疫微环境的影响[J]. 实用中医内科杂志,2012,23(17):7-9
[13] Rhule A,Rase B,Smith JR,et al. Toll-like receptor ligand-induced activation of murine DC2.4 cells is attenuated by Panax notoginseng[J]. J Ethnopharmacol,2008,116(1):179-186
[14] 董竞成,赵福东,谢瑾玉,等. 黄芪对哮喘大鼠神经内分泌免疫网络相关指标的影响[J]. 中国中西医结合杂志,2007,27(7):619-622
[15] 方思远,方婷娜. 培土生金法防治儿童哮喘46例[J]. 中国中医急症,2008,17(8):1140-1141
[16] 刘小云,牛媛媛,张常然,等. 中药六君子汤对慢性支气管炎大鼠气道炎症因子的影响[J]. 实用医学杂志,2009,25(22):3776-3778
[17] 史磊,张天锡,杜聪颖,等. 中药全蝎活性成分、药理作用及临床应用研究进展[J]. 辽宁中医药大学学报,2015,17(4):89-91
[2] 刘传合,洪建国,尚云晓,等. 中国16城市儿童哮喘患病率20年对比研究[J]. 中国实用儿科杂志,2015,30(8):596-600
[3] 刘丽平,韩志英. 儿童哮喘缓解期小气道功能的监测分析[J]. 中国医药与临床,2013,13(4):483-485
[4] Monadi M,Javadian Y,Cheraghi M,et al. Impact of treatment with inhaled corticosteroids on bone mineral density of patients with asthma:related with age[J]. Osteoporos Int,2015,26(7):2013-2018
[5] 国家中医药管理局. 中医病证诊断疗效标准[S]. 南京:南京大学出版社,1994:6
[6] 中华中医药学会儿科分会临床评价学组. 小儿支气管哮喘中药新药临床试验设计与评价技术指南[J]. 药物评价研究,2015,38(2):120-127
[7] Rottier BL,Duiverman EJ. Anti-inflammatory drug therapy in asthma[J]. Paediatr Respir Rev,2009,10(4):214-219
[8] Vestbo J,Hurd SS,Agusti AG,et al. Global strategy for the diagnosis,management,and prevention of chronic obstructive pulmonary disease:GOLD executive summary[J]. Am J Resp Crit Care,2013,187(4):347-365
[9] Bizzintino JA,Khoo SK,Zhang G,et al. Leukotriene pathway polymorphisms are associated with altered cysteinyl leukotriene production in children with acute asthma[J]. Prostaglandins Leukot Essent Fatty Acids,2009,81(1):9-15
[10] Donohue JF. Safety and efficacy of Beta agonists[J]. Respir Care,2008,53(5):618-624
[11] 杜娟,凌昌全,陈永安. 淫羊藿和熟地煎剂对糖皮质激素受体下调模型大鼠糖皮质激素受体的影响[J]. 中国中西医结合杂志,2008,28(1):64-67
[12] 赵刚,葛信国. 人参皂甙Rg3对H22荷瘤小鼠免疫微环境的影响[J]. 实用中医内科杂志,2012,23(17):7-9
[13] Rhule A,Rase B,Smith JR,et al. Toll-like receptor ligand-induced activation of murine DC2.4 cells is attenuated by Panax notoginseng[J]. J Ethnopharmacol,2008,116(1):179-186
[14] 董竞成,赵福东,谢瑾玉,等. 黄芪对哮喘大鼠神经内分泌免疫网络相关指标的影响[J]. 中国中西医结合杂志,2007,27(7):619-622
[15] 方思远,方婷娜. 培土生金法防治儿童哮喘46例[J]. 中国中医急症,2008,17(8):1140-1141
[16] 刘小云,牛媛媛,张常然,等. 中药六君子汤对慢性支气管炎大鼠气道炎症因子的影响[J]. 实用医学杂志,2009,25(22):3776-3778
[17] 史磊,张天锡,杜聪颖,等. 中药全蝎活性成分、药理作用及临床应用研究进展[J]. 辽宁中医药大学学报,2015,17(4):89-91