目的 观察咳喘顺丸联合沙美特罗替卡松吸入粉雾剂治疗支气管哮喘的临床疗效。方法 选择2017年3月—2020年12月南阳医学高等专科学校第一附属医院收治的98例支气管哮喘患者，将患者按随机数字表法分为对照组和治疗组，每组各49例。对照组给予沙美特罗替卡松吸入粉雾剂，1泡/次，2次/d。治疗组在对照组治疗的基础上口服咳喘顺丸，5 g/次，3次/d。两组均连续治疗2周。观察两组疗效，比较两组临床症状消失时间、肺功能指标和炎症因子指标。结果 治疗后，治疗组的总有效率95.92%，对照组的总有效率73.47%，治疗组的总有效率明显高于对照组（P<0.05）。治疗后，治疗组的咳嗽、喘憋、肺部啰音消失时间均明显短于对照组（P<0.05）。治疗后，两组第1秒用力呼气容积（FEV₁）、最大呼气流速（PEF）、用力肺活量（FVC）均较治疗前升高（P<0.05），且治疗组FEV₁、PEF、FVC高于对照组（P<0.05）。治疗后，两组患者干扰素-γ（IFN-γ）水平较治疗前升高，白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平较治疗前降低（P<0.05），且治疗组IFN-γ水平高于对照组，IL-6、TNF-α水平低于对照组（P<0.05）。结论 咳喘顺丸联合沙美特罗替卡松吸入粉雾剂治疗支气管哮喘可促进症状缓解和肺功能改善，减轻机体炎症反应。

Objective To observe the clinical effect of Kechuanshun Pills combined with salmeterol and fluticasone in treatment of bronchial asthma. Methods Patients (98 cases) with bronchial asthma in the First Affiliated Hospital of Nanyang Medical College from March 2017 to December 2020 were randomly divided into control and treatment groups, and each group had 49 cases. Patients in the control group were given Salmeterol Xinafoate and Fluticasone Propionate Powder for inhalation, 1 bubble/time, twice daily. Patients in the treatment group were po administered with Kechuanshun Pills on the basis of the control group, 5 g/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and the disappearance times of clinical symptoms, the pulmonary function index, and the inflammatory factor index in two groups were compared. Results After treatment, the total effective rate of the treatment group was 95.92%, that of the control group was 73.47%, and the total effective rate of the treatment group was significantly higher than that of the control group (P< 0.05). After treatment, the disappearance time of cough, wheezing, and pulmonary rale in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the FEV₁, PEF, and FVC in two groups were higher than those before treatment (P< 0.05), and the FEV₁, PEF, and FVC in the treatment group were higher than those in the control group (P < 0.05). After treatment, the levels of IFN-γ in two groups were higher than those before treatment, while the levels of IL-6 and TNF-α were lower than those before treatment (P < 0.05). And the level of IFN-γ in the treatment group was higher than that in the control group, but the levels of IL-6 and TNF-α were lower than those in the control group (P < 0.05). Conclusion Kechuanshun Pills combined with salmeterol and fluticasone in the treatment of bronchial asthma can promote the remission of symptoms, the improvement of lung function, and reduce the body's inflammatory response.

R974

河南省医学科技攻关计划项目（2017T03241）