目的 探讨固本咳喘胶囊联合硫酸特布他林雾化液治疗儿童支气管哮喘的临床疗效。方法 选取2019年7月—2020年7月在信阳市第一人民医院治疗的136例支气管哮喘患儿，根据随机数字表法分为对照组和治疗组，每组各68例。对照组吸入硫酸特布他林雾化液，患儿体质量≥20 kg用药5 mg，3次/d；患儿体质量≤20 kg用药2.5 mg，4次/d。治疗组在对照组的基础上口服固本咳喘胶囊，3粒/次，3次/d。两组患儿连续用药7 d。观察两组患者临床疗效，比较治疗前后两组患儿临床症状好转时间，肺功能第1秒用力呼气量（FEV1）、用力肺活量（FVC）、1秒率（FEV1/FVC）和最大呼气峰流速（PEF）指标，血清白细胞介素4（IL-4）、白细胞介素17（IL-17）、干扰素-γ（IFN-γ）和转化生长因子β2（TGF-β2）水平及不良反应情况。结果 治疗组总有效率明显高于对照组（P<0.05）。治疗后，治疗组症状好转时间均明显早于对照组（P<0.05）。治疗后，两组患儿肺功能FEV1、FVC、FEV1/FVC、PEF指标均高于治疗前（P<0.05），且治疗组明显高于对照组（P<0.05）。治疗后，两组患儿血清炎性因子IL-17、IL-4、IFN-γ、TGF-β2水平均低于治疗前（P<0.05），且治疗组明显低于对照组（P<0.05）。治疗期间，治疗组不良反应总发生率明显低于对照组（P<0.05）。结论 固本咳喘胶囊联合硫酸特布他林雾化液治疗支气管哮喘患儿，临床效果明显，能有效恢复肺功能，降低炎性反应，用药安全。

Objective To investigate the curative effect of Guben Kechuan Capsules combined with terbutaline in treatment of bronchial asthma in children. Methods Children (136 cases) with bronchial asthma in the First People's Hospital of Xinyang from July 2019 to July 2020 were randomly divided into control and treatment groups, and each group had 68 cases. Children in the control group were inhalation administered with Terbutaline Sulphate Solution for Nebulization, 5 mg for the weight more than 20 kg, three times daily, 2.5 mg for the weight less than 20 kg, four times daily. Children in the treatment group were po administered with Guben Kechuan Capsules on the basis of the control group, 3 grains/time, three times daily. Children in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the improvement time of clinical symptoms, the lung function of FEV1, FVC, FEV1/FVC and PEF, the serum levels of IL-17, IL-4, IFN-γ and TGF-β2, and adverse reactions in two groups before and after treatment were compared. Results The total clinical effective rate in the treatment group was significantly higher than that in the control group (P < 0.05). After treatment, the time of symptom improvement in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the pulmonary function indexes of FEV1, FVC, FEV1/FVC, and PEF in two groups were significantly higher than those before treatment (P < 0.05), and which in the treatment group were significantly higher than those in the control group (P < 0.05). After treatment, the levels of serum inflammatory factors IL-17, IL-4, IFN-γ and TGF-β2 in two groups were significantly lower than those before treatment (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). During the treatment, the total incidence of adverse reactions in the treatment group was significantly lower than that in the control group (P < 0.05). Conclusion Guben Kechuan Capsules combined with terbutaline in treatment of bronchial asthma in children has obvious clinical effect, which can effectively restore the pulmonary function, reduce the inflammatory reaction, and the medication is safe.

R974

国家自然科学基金资助项目（81574020）