目的探讨黄龙止咳颗粒联合丙酸氟替卡松吸入气雾剂治疗儿童咳嗽变异性哮喘的临床疗效。方法选取2020年9月—2021年3月在开封市儿童医院治疗的94例咳嗽变异性哮喘患儿，根据用药的差别分为对照组和治疗组，每组各47例。对照组口腔吸入丙酸氟替卡松吸入气雾剂，100 μg/次，2次/d；治疗组在对照组基础上口服黄龙止咳颗粒，4~7岁患儿6 g/次，8~14岁患儿10 g/次，3次/d。两组均经8周治疗。观察两组患者临床疗效，比较治疗前后两组患者临床症状改善时间，肺功能指标用力呼出25%肺活量时的瞬间流量（PEF25%）、PEF50%、PEF75%和第1秒用力呼气量（FEV1），炎症介质超敏C反应蛋白（hs-CRP）、白细胞介素-13（IL-13）、白细胞介素-23（IL-23）、基质金属蛋白酶-9（MMP-9）和白细胞介素-5（IL-5）水平。结果治疗后，治疗组临床有效率明显高于对照组（97.87% vs 82.98%，P＜0.05）。治疗后，治疗组在咳嗽缓解时间、咳嗽消失时间均早于对照组（P＜0.05）。经治疗，两组PEF25%、PEF50%、PEF75%、FEV1均显著升高（P＜0.05），且治疗组肺功能水平明显好于对照组（P＜0.05）。经治疗，两组血清hs-CRP、IL-5、IL-13、IL-23、MMP-9水平均显著降低（P＜0.05），且治疗组明显低于对照组（P＜0.05）。结论黄龙止咳颗粒联合丙酸氟替卡松吸入气雾剂治疗儿童咳嗽变异性哮喘，不仅可改善患儿肺功能和临床症状，还降低机体促炎因子的水平，具有一定临床推广应用价值。

Objective To investigate the clinical efficacy of Huanglong Zhike Granules combined with fluticasone propionate in treatment of children with cough variant asthma.Methods Children (94 cases) with cough variant asthma in Kaifeng Children's Hospital from September 2020 to March 2021 were divided into control and treatment group based on different treatments, and each group had 47 cases. Children in the control group were oral inhalation administered with Fluticasone Propionate Inhaled Aerosol, 100 μg/time, twice daily. Children in the treatment group were po administered with Huanglong Zhike Granules on the basis of the control group, 6 g/time for 4 — 7 years old, 10 g/time for 8 — 14 years old, three times daily. Children in two groups were treated for 8 weeks. After treatment, the clinical evaluation was evaluated, the improvement time of clinical symptoms, the lung function indexes PEF25%, PEF50%, PEF75% and FEV1, and the levels of inflammatory mediators hs-CRP, IL-5, IL-13, IL-23 and MMP-9 in two groups before and after treatment were compared.Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (97.87% vs 82.98%, P < 0.05). After treatment, the relief time and disappearance time of cough in the treatment group were earlier than those in the control group (P < 0.05). After treatment, PEF25%, PEF50%, PEF75% and FEV1 in two groups were significantly increased (P < 0.05), and the level of pulmonary function in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the serum levels of hs-CRP, IL-5, IL-13, IL-23 and MMP-9 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 Huanglong Zhike Granules combined with fluticasone propionate in treatment of children with cough variant asthma can not only promote the improvement of lung function and clinical symptoms, but also reduce the level of pro-inflammatory factors, which has a certain clinical application value.

R974

河南省中医药科学研究专项课题（20-21ZY2166）