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目的:研究布地奈德联合槐杞黄颗粒治疗小儿哮喘的临床疗效及对患儿血清白细胞三烯D4(LTD4)、神经生长因子(NGF)、基质金属蛋白酶抑制剂-1(TIMP-1)水平的影响。方法:选取2014年3月至2015年3月我院接诊的支气管哮喘患儿90例作为本次研究对象,按照随机数表法分为观察组和对照组。每组45例。两组患儿均在入院后给予支气管解痉剂、吸氧、抗生素、糖皮质激素等常规治疗,对照组患儿在此基础上采用雾化吸入布地奈德混悬液治疗,每次0.5 mg,加入3 mL生理盐水进行持续吸入,每天两次。观察组患儿在对照组的基础上加用槐杞黄颗粒治疗,每天两次。治疗12周后,观察和比较两组患儿的治疗疗效,喘憋、咳嗽、肺部湿罗音、肺部哮鸣音等临床症状消失时间,肺功能用力肺活量(FVC)、一秒用力呼气容积(FEV1),血清LTD4、NGF、TIMP-1水平及T淋巴亚群CD3+、CD4+、CD8+。结果:治疗后,观察组总有效率显著高于对照组[93.33%(42/45)vs77.77%(35/45)](P<0.05);喘憋消失、咳嗽缓解、肺部湿罗音、肺部哮鸣音消失时间显著短于对照组[(4.32±1.03)d vs(6.08±1.24)d,(5.60±1.12)d vs(7.21±1.30)d,(3.19±0.98)d vs(4.98±1.02)d,(3.25±1.03)d vs(5.89±1.35)d](P<0.05);FEV1、FEV1/FVC显著高于对照组[(92.63±10.01)L/s vs(78.36±9.19)L/s,(95.37±11.72)%vs(80.19±10.23)%](P<0.05);血清LTD4、NGF、TIMP-1水平显著低于对照组[(7.24±0.86)ng/ml vs(12.68±1.01)ng/mL,(68.18±9.01)pg/mL vs(80.78±10.24)pg/mL,(34.16±5.06)ng/mL vs(49.76±5.47)ng/mL](P<0.05);CD3+、CD4+显著高于对照组[(66.15±7.20)%vs(62.03±6.85)%,(45.13±7.90)%vs(37.42±7.06)%](P<0.05),CD8+显著低于对照组[(34.16±5.06)%vs(49.76±5.47)%](P<0.05)。结论:布地奈德联合槐杞黄颗粒治疗小儿哮喘的疗效显著,能够增强患儿的免疫功能,改善肺功能,降低血清LTD4、NGF、TIMP-1的水平。
Objective: To study the clinical efficacy of budesonide combined with Huai Qi Huang Granules in treating pediatric asthma and its effects on the levels of serum leukotriene D4 (LTD4), nerve growth factor (NGF) and tissue inhibitor of metalloproteinase-1 (TIMP-1) Impact. Methods: Totally 90 children with bronchial asthma admitted from March 2014 to March 2015 in our hospital were selected as the study subjects and divided into observation group and control group according to random number table. 45 cases in each group. Both groups were given routine treatment of bronchial spasmodic agent, oxygen inhalation, antibiotics and glucocorticoids after admission. The children in the control group were treated with inhaled budesonide suspension at a dose of 0.5 mg , Add 3 mL saline for continuous inhalation twice daily. Observation group of children in the control group based on the use of Huai Qi Huang particles, twice daily. Twelve weeks after treatment, the curative effect, wheezing and coughing, the disappearance of pulmonary rales, the disappearance of pulmonary wheezing and other clinical symptoms, the lung functional forced vital capacity (FVC) Gas volume (FEV1), serum LTD4, NGF, TIMP-1 levels and T lymphocyte subsets CD3 +, CD4 +, CD8 +. Results: After treatment, the total effective rate in the observation group was significantly higher than that in the control group [93.33% (42/45) vs 77.77% (35/45)] (P <0.05); disappearance of wheezing, cough relief, (4.32 ± 1.03) d vs (6.08 ± 1.24) d, (5.60 ± 1.12) d vs (7.21 ± 1.30) d, (3.19 ± 0.98) d vs (4.98 ± 1.02) d, (3.25 ± 1.03) d vs (5.89 ± 1.35) d] (P <0.05). FEV1 and FEV1 / FVC were significantly higher than those in the control group [(92.63 ± 10.01) vs The levels of LTD4, NGF and TIMP-1 in serum were significantly lower than those in the control group [(7.24 ± 0.86) ng / ml vs 9.19) (95.37 ± 11.72 vs 80.19 ± 10.23%, P <0.05) (12.68 ± 1.01) ng / mL, (68.18 ± 9.01) pg / mL vs (80.78 ± 10.24) pg / mL and (34.16 ± 5.06) ng / mL vs (49.76 ± 5.47) ng / (66.15 ± 7.20)% vs (62.03 ± 6.85)%, (45.13 ± 7.90)% vs (37.42 ± 7.06)%] (P <0.05), and the level of CD8 + was significantly lower in the control group than in the control group [(34.16 ± 5.06)% vs (49.76 ± 5.47)%] (P <0.05). Conclusion: Budesonide combined with Huai Qi Huang Granules has a significant therapeutic effect on pediatric asthma. It can enhance the immune function, improve lung function and decrease the levels of LTD4, NGF and TIMP-1 in children.