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[摘要]
目的 探讨小青龙颗粒联合孟鲁司特钠治疗小儿支气管哮喘的临床效果。方法 选取2017年1月—2019年1月阿坝藏族羌族自治州人民医院收治的86例支气管哮喘患儿,使用随机数字表法随机分成对照组和治疗组,每组各43例。对照组口服孟鲁司特钠咀嚼片,4~5岁,4 mg/次,1次/d;6~12岁,5 mg/次,1次/d;睡前服用。治疗组在对照组基础上口服小青龙颗粒,4~6岁,6 g/次,3次/d;7~12岁,13 g/次,3次/d;开水冲服。两组均连续治疗4周。观察两组的临床疗效,比较两组哮喘症状评分、儿童哮喘控制测试(C-ACT)、呼气峰流速(PEF)昼夜变异率、EOS百分比(EOS%)和血清学指标比较。结果 治疗后,对照组和治疗组的总有效率分别是76.7%、93.0%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组哮喘日间和夜间症状评分均较治疗前显著降低,而C-ACT评分显著升高,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,治疗组哮喘日间和夜间症状评分显著低于对照组,而C-ACT评分高于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组第1秒用力呼气容积(FEV1)、PEF、FEV1与用力肺活量(FVC)比值(FEV1/FVC)值均较治疗前显著增高,而PEF昼夜变异率均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,治疗组FEV1、PEF、FEV1/FVC值显著高于对照组,而PEF昼夜变异率低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组外周血嗜酸性粒细胞百分比(EOS%)及血清白介素-17(IL-17)、转化生长因子-β1(TGF-β1)、白三烯B4(LTB4)水平较治疗前均显著下降,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,治疗组外周血EOS%及血清IL-17、TGF-β1、LTB4水平显著低于对照组,两组比较差异具有统计学意义(P<0.05)。结论 小青龙颗粒联合孟鲁司特钠治疗小儿支气管哮喘具有较好的临床疗效,能有效减轻患儿症状,提高哮喘控制水平,保护肺功能,抑制机体炎症反应,具有一定的临床推广应用价值。
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[Abstract]
Objective To investigate the clinical effects of Xiaoqinglong Granules combined with montelukast sodium in treatment of bronchial asthma in children. Methods 86 Children with bronchial asthma in People's Hospital of Aba Prefecture from January 2017 to January 2019 were randomly divided into control group (43 cases) and treatment group (43 cases). Patients in the control group were po administered with Montelukast Sodium Chewable Tablets, 4-5 years old, 4 mg/time, once daily; 6-12 years old, 5 mg/time, once daily. Patients in the treatment group were po administered with Xiaoqinglong Granules on the basis of control group, 4-6 years old, 6 mg/time, three times daily; 7-12 years old, 13 mg/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the changes of asthma symptom score, C-ACT score, PEF diurnal variation rate, EOS% and serological indicators in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 76.7% and 93.0%, respectively, and there were differences between two groups (P<0.05). After treatment, asthma symptom score in two groups were significantly decreased, but C-ACT score were significantly increased, and there were differences in the same group (P<0.05). After treatment, asthma symptom score in the treatment group were lower than that in the control group, but C-ACT score was higher than that in the control group, and there were differences between two groups (P<0.05). After treatment, FEV1, PEF, and FEV1/FVC in two groups were significantly increased, but PEF diurnal variation rate was significantly decreased, and there were differences in the same group (P<0.05). After treatment, FEV1, PEF, and FEV1/FVC in the treatment group were higher than those in the control group, but PEF diurnal variation rate was lower than that in the control group, and there were differences between two groups (P<0.05). After treatment, EOS%, IL-17, TGF-β1, and LTB4 in two groups were significantly decreased, and there were differences in the same group (P<0.05). After treatment, EOS%, IL-17, TGF-β1, and LTB4 in the treatment group were lower than those in the control group, and there were differences between two groups (P<0.05). Conclusion Xiaoqinglong Granules combined with montelukast sodium has significant effect in treatment of bronchial asthma in children, and can effectively reduce the symptoms, and improve the control level of asthma, and protect lung function, and inhibit the inflammatory response of the body, which has a certain clinical application value.
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