目的 探讨宣肺止嗽合剂联合吸入沙美特罗替卡松治疗咳嗽性变异性哮喘的临床疗效。方法 选取2019年1月—2019年12月在天津市泰达医院治疗的哮喘患者282例，随机分为对照组（141例）和治疗组（141例）。对照组吸入沙美特罗替卡松吸入粉雾剂，50 μg/次，2次/d。治疗组在对照组基础上口服宣肺止嗽合剂，20 mL/次，3次/d。两组连用7 d。观察两组患者临床疗效，同时比较治疗前后两组患者第1秒用力呼气量（FEV1）、第1秒用力呼气容积占预计百分比（FEV1% pred）和FEV1/最大呼吸量（FVC），外周血调节性T细胞（Treg）、辅助性T细胞17（Th17）百分比和Treg/Th17，ACT评分和mMRC评分，及呼出气一氧化氮（FeNO）和嗜酸性粒细胞计数。结果 治疗后，对照组临床有效率为74.47%，显著低于治疗组的95.74%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组FEV1、FEV1% pred和FEV1/FVC明显增加（P<0.05），且治疗组较对照组显著上升（P<0.05）。治疗后，两组Treg细胞百分比显著升高（P<0.05），Th17百分比及Treg/Th17比值明显降低（P<0.05），且治疗组Treg细胞百分比、Th17百分比和Treg/Th17比值明显好于对照组（P<0.05）。治疗后，两组患者ACT评分显著升高（P<0.05），mMRC评分明显降低（P<0.05），且治疗组ACT评分和mMRC评分明显好于同期对照组（P<0.05）。治疗后，两组FeNO和嗜酸性粒细胞计数显著降低（P<0.05），且治疗组FeNO和嗜酸性粒细胞计数较对照组明显下降（P<0.05）。结论 宣肺止嗽合剂联合沙美特罗替卡松治疗咳嗽变异性哮喘疗效显著，能够有效的改善肺部功能，调节免疫能力，降低FeNO和炎症水平。

Objective To explore the clinical effect of Xuanfei Zhisou Mixture combined with salmeterol and fluticasone in treatment of cough variant asthma. Methods Patients (282 cases) with cough variant asthma in Tianjin TEDA Hospital from January 2019 to December 2019 were randomly divided into control (141 cases) and treatment (141 cases) groups. Patients in the control group were inhalation administered with Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation, 50 μg/time, twice daily. Patients in the treatment group were po administered with Xuanfei Zhisou Mixture on the basis of the control group, 20 mL/time, three times daily. Two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and the FEV1, FEV1%pred, FEV1/FVC, Treg, Th17% and Treg/Th17 of peripheral blood, ACT and mMRC scores, FeNO and eosinophil count in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 74.47%, which was significantly lower than 95.74% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the FEV1, FEV1%pred and FEV1/FVC in two groups were significantly increased (P<0.05), and which in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, the Treg% in two groups was significantly increased (P<0.05), but the Th17% and Treg/Th17 were significantly decreased (P<0.05), and the Treg%, Th17% and Treg/Th17 in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the ACT scores in two groups were significantly increased (P<0.05), but the mMRC scores were significantly decreased (P<0.05), and these scores in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the FeNO and eosinophil count in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Xuanfei Zhisou Mixture combined with salmeterol and fluticasone in treatment of cough variant asthma has certain effectiveness, can effectively improve lung function, regulate immune function, and reduce FeNO and inflammation levels.

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