目的 探討宣肺止嗽合劑聯(lián)合吸入沙美特羅替卡松治療咳嗽性變異性哮喘的臨床療效。方法 選取2019年1月—2019年12月在天津市泰達(dá)醫(yī)院治療的哮喘患者282例，隨機(jī)分為對(duì)照組（141例）和治療組（141例）。對(duì)照組吸入沙美特羅替卡松吸入粉霧劑，50 μg/次，2次/d。治療組在對(duì)照組基礎(chǔ)上口服宣肺止嗽合劑，20 mL/次，3次/d。兩組連用7 d。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者第1秒用力呼氣量（FEV1）、第1秒用力呼氣容積占預(yù)計(jì)百分比（FEV1% pred）和FEV1/最大呼吸量（FVC），外周血調(diào)節(jié)性T細(xì)胞（Treg）、輔助性T細(xì)胞17（Th17）百分比和Treg/Th17，ACT評(píng)分和mMRC評(píng)分，及呼出氣一氧化氮（FeNO）和嗜酸性粒細(xì)胞計(jì)數(shù)。結(jié)果 治療后，對(duì)照組臨床有效率為74.47%，顯著低于治療組的95.74%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組FEV1、FEV1% pred和FEV1/FVC明顯增加（P<0.05），且治療組較對(duì)照組顯著上升（P<0.05）。治療后，兩組Treg細(xì)胞百分比顯著升高（P<0.05），Th17百分比及Treg/Th17比值明顯降低（P<0.05），且治療組Treg細(xì)胞百分比、Th17百分比和Treg/Th17比值明顯好于對(duì)照組（P<0.05）。治療后，兩組患者ACT評(píng)分顯著升高（P<0.05），mMRC評(píng)分明顯降低（P<0.05），且治療組ACT評(píng)分和mMRC評(píng)分明顯好于同期對(duì)照組（P<0.05）。治療后，兩組FeNO和嗜酸性粒細(xì)胞計(jì)數(shù)顯著降低（P<0.05），且治療組FeNO和嗜酸性粒細(xì)胞計(jì)數(shù)較對(duì)照組明顯下降（P<0.05）。結(jié)論 宣肺止嗽合劑聯(lián)合沙美特羅替卡松治療咳嗽變異性哮喘療效顯著，能夠有效的改善肺部功能，調(diào)節(jié)免疫能力，降低FeNO和炎癥水平。

Objective To explore the clinical effect of Xuanfei Zhisou Mixture combined with salmeterol and fluticasone in treatment of cough variant asthma. Methods Patients (282 cases) with cough variant asthma in Tianjin TEDA Hospital from January 2019 to December 2019 were randomly divided into control (141 cases) and treatment (141 cases) groups. Patients in the control group were inhalation administered with Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation, 50 μg/time, twice daily. Patients in the treatment group were po administered with Xuanfei Zhisou Mixture on the basis of the control group, 20 mL/time, three times daily. Two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and the FEV1, FEV1%pred, FEV1/FVC, Treg, Th17% and Treg/Th17 of peripheral blood, ACT and mMRC scores, FeNO and eosinophil count in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 74.47%, which was significantly lower than 95.74% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the FEV1, FEV1%pred and FEV1/FVC in two groups were significantly increased (P<0.05), and which in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, the Treg% in two groups was significantly increased (P<0.05), but the Th17% and Treg/Th17 were significantly decreased (P<0.05), and the Treg%, Th17% and Treg/Th17 in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the ACT scores in two groups were significantly increased (P<0.05), but the mMRC scores were significantly decreased (P<0.05), and these scores in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the FeNO and eosinophil count 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 Xuanfei Zhisou Mixture combined with salmeterol and fluticasone in treatment of cough variant asthma has certain effectiveness, can effectively improve lung function, regulate immune function, and reduce FeNO and inflammation levels.

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