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目的:观察用生脉饮合枳术丸加减辨治小儿咳嗽变异性哮喘缓解期的临床效果。方法:选取2012年2月—2014年1月就诊于我院的缓解期咳嗽变异性哮喘患儿96例,按照随机数字表法分为对照组和治疗组各48例。对照组患儿给予孟鲁司特钠片治疗,治疗组患儿则联合给予由生脉饮合枳术丸加减而成的中药汤剂内服治疗,每月连续治疗14 d,治疗3个月。治疗前后观察患儿主要症状的改善情况,对证候根据轻重有无给予0~3分评分,观察证候积分变化;观察患儿肺功能的改善情况,对最大呼气流速(PEF)、一秒用力呼气容积(FEV1)进行检测;测定患儿痰中嗜酸性粒细胞的含量;检测患儿治疗前后与机体免疫功能相关的T淋巴细胞亚群、血清免疫球蛋白的水平变化情况,计算临床治疗的有效率。结果:对照组的有效率为70.8%,明显低于治疗组的有效率为91.7%,差异有统计学意义(P<0.05);两组患儿汗多、乏力、食滞、大便干等临床症状有所改善,证候评分下降明显,治疗组的下降程度较对照组更明显,差异有统计学意义(P<0.05);患儿经治疗后肺功能有所改善,治疗组患儿PEF、FEV1水平均较对照组改善明显,差异有统计学意义(P<0.05);患儿经治疗后痰中嗜酸性粒细胞的含量有所见减少,治疗组的减少程度更大,差异有统计学意义(P<0.05);两组患儿经治疗后机体免疫力有所提高,T淋巴细胞亚群CD3+、CD4+、CD8+及血清免疫球蛋白Ig G、Ig A、Ig M水平较治疗前有所升高,治疗组的改善更为明显,差异具有统计学意义(P<0.05)。结论:生脉饮合枳术丸治疗小儿咳嗽变异性哮喘疗效确切,能有效缓解患儿的临床症状,提高肺功能,降低痰中嗜酸性粒细胞的含量,增强患儿机体免疫抵抗力,值得临床深入推广运用。
Objective: To observe the clinical effect of using Shengmai Yin Heizhu Pill in treating cough variant asthma in remission stage. Methods: A total of 96 children with cough variant asthma who were treated in our hospital from February 2012 to January 2014 were divided into control group and treatment group according to random number table. Children in the control group were treated with montelukast sodium tablets. The children in the treatment group were treated with Chinese herbal decoction supplemented by Shengmai Yin and Zhi Zu pill. The patients were treated for 14 consecutive months for 3 months . Before and after treatment to observe the improvement of the main symptoms in children, whether the syndromes were given according to the severity of the score 0 to 3 points to observe the syndrome score changes; observe the improvement of pulmonary function in children, the maximum expiratory flow rate (PEF), a Seconds forced expiratory volume (FEV1) were detected; sputum eosinophils in children with the determination of content; before and after treatment of children with immune function-related T lymphocyte subsets, serum immunoglobulin levels change calculated Effective clinical treatment. Results: The effective rate of the control group was 70.8%, significantly lower than the effective rate of the treatment group was 91.7%, the difference was statistically significant (P <0.05); two groups of children with sweating, fatigue, food stagnation, dry stool and other clinical Symptoms were improved, syndrome scores decreased significantly, the treatment group decreased more significantly than the control group, the difference was statistically significant (P <0.05); children with pulmonary function improved after treatment, the treatment group of children with PEF, FEV1 levels were significantly improved compared with the control group, the difference was statistically significant (P <0.05); children after treatment of sputum eosinophil content decreased, the treatment group decreased more significantly, the difference was statistically significant (P <0.05). The immunity of the two groups was improved after treatment, the levels of T lymphocyte subsets CD3 +, CD4 +, CD8 + and serum immunoglobulin Ig G, Ig A, Ig M were higher than those before treatment Increased, the treatment group improved more significantly, the difference was statistically significant (P <0.05). Conclusion: Shengmai Yinzhuozhu pill is effective in treating children with cough variant asthma, which can effectively relieve the clinical symptoms, improve lung function, reduce the content of eosinophils in sputum and enhance immunity immunity, which is worth Clinical application in depth.