目的 探讨玉屏风颗粒联合硫酸沙丁胺醇治疗小儿支气管哮喘的临床疗效。方法 选取2014年8月—2015年8月锦州市中心医院收治的小儿支气管哮喘患者82例,依据不同的治疗方法分成治疗组和对照组,每组各41例。所有患者均给予止咳、化痰及抗感染等常规治疗。对照组在此基础上雾化吸入吸入用硫酸沙丁胺醇溶液0.5 mL,用0.9%生理盐水稀释到2.5 mL,3~5min/次,3次/d。治疗组在对照组用药基础上口服玉屏风颗粒,1袋/次,3次/d。两组患者均连续治疗2周。比较两组临床疗效、肺功能变化、动脉血气指标、临床症状及体征消失时间以及肿瘤坏死因子α(TNF-α)、白介素-6(IL-6)和免疫球蛋白E(IgE)表达水平。结果 治疗后,对照组和治疗组总有效率分别为75.61%和92.68%,两组比较差异有统计学意义(P<0.05)。治疗后,两组一秒用力呼气容积(FEV1)、最大呼气流量(PEF)均较同组治疗前显著升高,同组治疗前后差异具有统计学意义(P<0.05);且治疗后,治疗组这些观察指标显著高于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组氧分压(PO₂)、血氧饱和度(SpO₂)和二氧化碳分压(PCO₂)均好于同组治疗前,同组治疗前后差异具有统计学意义(P<0.05);且治疗后,治疗组这些观察指标显著高于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,治疗组患儿咳嗽、喘憋和肺部哮鸣音的消失时间少于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组TNF-α、IL-6和IgE表达水平均降低,同组治疗前后差异具有统计学意义(P<0.05);且治疗后,治疗组这些观察指标显著低于对照组,两组比较差异具有统计学意义(P<0.05)。结论 玉屏风颗粒联合硫酸沙丁胺醇治疗小儿支气管哮喘具有较好的临床疗效,可以明显改善患儿肺功能,抑制炎性因子表达,具有一定的临床推广应用价值。

Objective To observe the clinical effect of clinical study on Yupingfeng Granules combined with salbutamol sulfate in treatment of children with bronchial asthma. Methods Children (82 cases) with bronchial asthma in Center Hospital of Jinzhou from August 2014 to August 2015 divided into control and treatment groups based on different treatment method, and each group had 41 cases. All patients were treated with conventional treatments including antitussive, expectorant, anti-infective treatment. Patients in control group were aerosol inhalation administered with Salbutamol Sulfate Solution for inhalation diluted to 2.5 mL with 0.9% normal saline on the basis of conventional treatment, 3—5 min/time, 3 time/d. Patients in treatment group were po administered with Yupingfeng Granules on the basis of control group, 1 bag/time, 3 time/d. The patients in two groups were treated for 2 week. After treatment, the efficacy was evaluated, and pulmonary function changes, arterial blood gas indexs, disappeared time of clinical symptoms and signs, tumor necrosis factor α (TNF-α), interleukin-6 (IL-6) and immunoglobulin E (IgE) in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 75.61% and 92.68%, respectively, and there were differences between two groups (P< 0.05). After treatment, forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) in two groups were significantly increased, and the difference was statistically significant in the same group (P< 0.05). After treatment, the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P< 0.05). After treatment, partial pressure of oxygen (PO₂), oxygen saturation (SpO₂) and partial pressure of carbon dioxide (PCO₂) in two groups were significantly improved, and the difference was statistically significant in the same group (P< 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P< 0.05). After treatment, disappeared time of cough, shortness of breath and wheezing of children in treatment group were lower than those in the control group, with significant difference between two groups (P< 0.05). After treatment, IL-6, TNF-α and IgE in two groups were significantly increased, and the difference was statistically significant in the same group (P< 0.05). After treatment, the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P< 0.05). Conclusion Yupingfeng Granules combined with salbutamol sulfate has clinical curative effect in the treatment of children with bronchial asthma, and can significantly improve lung function of children, inhibit the expression of inflammatory factors, which has a certain clinical application value.