目的 观察清咳平喘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2021年5月—2023年1月在自贡市第一人民医院就诊的136例咳嗽变异性哮喘患儿，采用随机数字法分为对照组（68例）和治疗组（68例）。对照组给予丙酸氟替卡松吸入气雾剂，50～100 μg/次，2次/d。治疗组在对照组基础上开水冲服清咳平喘颗粒，5岁≤年龄≤8岁，6 g/次，8岁＜年龄≤14岁，8 g/次，3次/d。两组患儿均连续治疗4周。比较两组患儿的临床疗效、肺功能指标、炎症因子指标、T淋巴细胞亚群指标、免疫球蛋白指标。结果 治疗后，治疗组的临床控制率为94.12%，高于对照组的临床控制率77.94%（P＜0.05）。治疗后，两组用力肺活量（FVC）、一秒用力呼气容积（FEV₁）和最大呼气流量（PEF）均升高（P＜0.05），且治疗组FVC、FEV₁、PEF高于对照组（P＜0.05）。治疗后，两组血清白细胞介素（IL）-10水平升高，血清IL-6、基质金属蛋白酶-9（MMP-9）水平均下降（P＜0.05），且治疗组血清IL-10水平高于对照组，血清IL-6、MMP-9水平低于对照组（P＜0.05）。治疗后，两组CD3⁺、CD4⁺、CD4⁺/CD8⁺升高，CD8⁺下降（P＜0.05），且治疗组CD3⁺、CD4⁺、CD4⁺/CD8⁺高于对照组，CD8⁺低于对照组（P＜0.05）。治疗后，两组免疫球蛋白（Ig）E、IgA、IgG均升高（P＜0.05），且治疗组免疫球蛋白高于对照组（P＜0.05）。结论 清咳平喘颗粒联合丙酸氟替卡松吸入气雾剂治疗咳嗽变异性哮喘患儿可有效改善患儿的肺功能，提高机体免疫功能，调节炎性因子水平。

Objective To observe the clinical efficacy of Qingke Pingchuan Granules combine with Fluticasone Propionate Inhalation Aerosol in treatment of cough variant asthma in children. Methods A total of 136 children with cough variant asthma who were treated in Zigong First People’s Hospital from May 2021 to January 2023 were selected and divided into the control group (68 cases) and the treatment group (68 cases) according to random number method. Children in the control group were given Fluticasone Propionate Inhalation Aerosol, 50—100 μg/time, twice daily. Children in the treatment group were given Qingke Pingchuan Granules with boiling water on the basis of the control group, 5—8 years old, 6 g/times, 9—14 years old, 8 g/times, 3 times daily. Children in both groups were treated continuously for 4 weeks. The clinical efficacy, pulmonary function index, inflammatory factor index, T lymphocyte subgroup index, and immunoglobulin index were compared between two groups. Results After treatment, the clinical control rate of the treatment group was 94.12%, which was higher than that of the control group 77.94% (P < 0.05). After treatment, FVC, FEV₁, and PEF in both groups were increased (P < 0.05), and FVC, FEV₁, and PEF in treatment group were higher than those in control group (P < 0.05). After treatment, the serum levels of IL-10 in two groups were increased, but the serum levels of IL-6 and MMP-9 in two groups were decreased (P < 0.05). The serum level of IL-10 in the treatment group was higher than that in the control group, but the serum levels of IL-6 and MMP-9 in the treatment group were lower than those in the control group (P < 0.05). After treatment, CD3⁺, CD4⁺, and CD4⁺/CD8⁺in two groups were increased, but CD8⁺ were decreased (P < 0.05), and CD3⁺, CD4⁺, and CD4⁺/CD8⁺in the treatment group was higher than that in the control group, but CD8⁺ in the treatment was lower than that in the control group (P < 0.05). After treatment, IgE, IgA, and IgG in the two groups were increased (P < 0.05), and the immunoglobulin in the treatment group was higher than that in the control group (P < 0.05). Conclusion Qingke Pingchuan Granules combined with Fluticasone Propionate Inhalation Aerosol in treatment of cough variant asthma in children can effectively improve the lung function, improve the immune function, and regulate the level of inflammatory factors.

R974

四川省卫生健康适宜技术推广立项项目(20PJ0273)