目的 研究寒喘祖帕颗粒联合孟鲁司特钠治疗咳嗽变异性哮喘患儿的效果。方法 选取2017年1月-2019年12月唐山市丰润区人民医院收治的200例咳嗽变异性哮喘患儿作为研究对象，根据就诊顺序将患儿分别纳入对照组与观察组，各100例。对照组睡前口服孟鲁司特钠咀嚼片，5 mg/次，1次/d。观察组在对照组的基础上口服寒喘祖帕颗粒，6 g/次，2次/d。两组患儿疗程均为4周。观察两组患者的临床疗效，同时比较两组治疗前后的咳嗽症状评分、中医证候积分、生活质量评分（LCQ）、血清中嗜酸性粒细胞阳离子蛋白（ECP）、白细胞介素（IL）-2、IL-4、IL-13、巨噬细胞炎性蛋白-1α（MIP-1α）、白三烯B4（LTB4）和免疫球蛋白E（IgE）水平。结果 治疗后，观察组总有效率为91.00%，显著高于对照组的74.00%，差异有统计学意义（P<0.05）。治疗后，两组日间与夜间咳嗽评分均显著降低（P<0.05）；且观察组显著低于对照组（P<0.05）。治疗后，两组各项中医证候积分与总分均显著降低（P<0.05）；且观察组显著低于对照组（P<0.05）。治疗后，两组生理积分、心理积分、社会积分与总分均显著升高（P<0.05）；治疗后，观察组生理积分、心理积分、社会积分与总分均显著高于对照组（P<0.05）。治疗后，两组血清ECP、IL-4、IL-13、MIP-1α、IgE和LTB4水平均显著降低，IL-2水平显著升高（P<0.05）；且观察组血清ECP、IL-2、IL-4、IL-13、MIP-1α、IgE和LTB4水平显著优于对照组（P<0.05）。结论 采用寒喘祖帕颗粒联合孟鲁司特钠治疗咳嗽变异性哮喘，疗效值得肯定，能够有效改善患儿咳嗽症状，提高生活质量，并可抑制气道炎症，降低血清IgE、LTB4水平，具有较好临床应用价值。

Objective Study the effect of Hanchuan Zupa Granules combined with montelukast sodium in treatment of children with cough variant asthma. Methods A total of 200 children with cough variant asthma treated in Tangshan Fengrun People's Hospital from January 2017 to December 2019 were selected as the research subjects. According to the order of treatment, the children were included in the control group and the observation group, with 100 cases in each group. Patients in the control group were po administered with Montelukast Sodium Tablets, 5 mg/time, once daily. Patients in the observation group were po administered with Hanchuan Zupa Granules on the basis of control group, 6 g/time, twice daily. The course of treatment for both groups was four weeks. The clinical efficacy of two groups was observed. The cough symptom score, TCM syndrome score, LCQ score, serum levels of ECP, IL-2, IL-4, IL-13, MIP-1α, LTB4, and IgE before and after treatment between two groups were compared. Results After treatment, the total effective rate of the observation group was 91.00%, which was significantly higher than 74.00% of the control group, the difference being statistically significant (P<0.05). After treatment, the cough scores in day and night in two groups were significantly decreased (P<0.05). The observation group was significantly lower than the control group (P<0.05). After treatment, the TCM syndrome scores and total scores in two groups were significantly decreased (P<0.05), and observation group was significantly lower than control group (P<0.05). After treatment, physiological scores, psychological scores, social scores, and total scores in two groups were significantly increased (P<0.05). After treatment, the physiological scores, psychological scores, social scores and total scores of observation group were significantly higher than those of control group (P<0.05). After treatment, the serum levels of ECP, IL-4, IL-13, MIP-1α, IgE and LTB4 in two groups were significantly decreased, while the level of IL-2 was significantly increased (P<0.05). The levels of ECP, IL-2, IL-4, IL-13, MIP-1α, IgE and LTB4 in the observation group were significantly better than those in the control group (P<0.05). Conclusion The curative effect of Hanchuan Zupa Granules combined with Montelukast sodium in treatment of cough variable asthma is worthy of affirmability. It can effectively improve cough symptoms and improve life quality, inhibit airway inflammation, reduce serum IgE and LTB4 levels, and has good clinical application value.

R974

河北省中医药管理局科研计划项目（2020404）