目的 探讨止喘灵口服液联合丙酸氟替卡松治疗儿童哮喘的临床疗效。方法 选择2018年2月-2019年2月在延安市人民医院治疗的哮喘患儿86例，根据用药的差别分为对照组（43例）和治疗组（43例）。对照组吸入丙酸氟替卡松吸入气雾剂，125 μg/次，2次/d；治疗组在对照组基础上口服止喘灵口服液，10 mL/次，3次/d。两组均治疗1周。观察两组患者临床疗效，同时比较治疗前后两组患者症候积分，LCQ、PAQLQ、C-ACT和MARS-A评分，最大呼气流量（PEF）、用力肺活量（FVC）和一秒用力呼气容积（FEV1）值，及血清金属蛋白酶抑制因子1（TIMP1）、细胞间粘附分子-1（ICAM-1）、半胱氨酰白三烯（CysLTs）、降钙素原（PCT）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）水平。结果 治疗后，对照组临床有效率为81.40%，显著低于治疗组的97.67%，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者喘息、咳嗽、咳痰及肺部啰音等症候积分均明显下降（P<0.05），且治疗组症候积分明显低于对照组（P<0.05）。治疗后，两组LCQ、PAQLQ、C-ACT和MARS-A评分均明显升高（P<0.05），且治疗组这些评分明显高于对照组（P<0.05）。治疗后，两组FEV1、FVC、PEF均明显升高（P<0.05），且治疗组FEV1、FVC、PEF明显高于对照组（P<0.05）。治疗后，两组血清TIMP-1、ICAM-1、CysLTs、PCT、IL-6、TNF-α水平均显著下降（P<0.05），且治疗组血清TIMP-1、ICAM-1、CysLTs、PCT、IL-6、TNF-α水平明显低于对照组（P<0.05）。结论 止喘灵口服液联合丙酸氟替卡松吸入气雾剂治疗儿童哮喘可有效改善患儿临床症状，促进肺功能改善，提高生活质量，改善机体细胞因子水平，提高免疫。

Objective To explore the clinical efficacy of Zhichuanling Oral Liquid combined with fluticasone propionate in treatment of childhood asthma. Methods Children (86 cases) with asthma in Yan'an People's Hospital from February 2018 to February 2019 were divided into control (43 cases) and treatment (43 cases) groups based on different treatments. Children in the control group were inhalation administered with Fluticasone Propionate Inhalation Aerosol, 125 μg/time, twice daily. Children in the treatment group were po administered with Zhichuanling Oral Liquid on the basis of the control group, 10 mL/time, twice daily. Children in two groups were treated for 1 week. After treatment, the clinical efficacy was evaluated, and the symptom scores, LCQ scores, PAQLQ scores, C-ACT scores, MARS-A scores, PEF, FVC, FEV1, serum levels of TIMP1, ICAM-1, CysLTs, PCT, IL-6, and TNF-α in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 81.40%, which was significantly lower than 97.67% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the symptom scores of wheezing, coughing, expectoration and lung rales in two groups were significantly decreased (P<0.05), and these scores in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the LCQ, PAQLQ, C-ACT, and MARS-A scores in two groups were significantly increased (P<0.05), and these scores in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, the PEF, FVC, and FEV1 in two groups were significantly increased (P<0.05), and the pulmonary function in the treatment group was significantly better than that in the control group (P<0.05). After treatment, the serum levels of TIMP1, ICAM-1, CysLTs, PCT, IL-6, and TNF-α in two groups were significantly decreased (P<0.05), and these indexes in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Zhichuanling Oral Liquid combined with fluticasone propionate in treatment of childhood asthma can effectively improve the clinical symptoms, promote the improvement of pulmonary function, improve the quality of life, the level of cytokines and the immune function.

延安市科技计划资助项目（2018KS-20）