目的探討黃龍止咳顆粒聯(lián)合丙酸氟替卡松吸入氣霧劑治療兒童咳嗽變異性哮喘的臨床療效。方法選取2020年9月—2021年3月在開(kāi)封市兒童醫(yī)院治療的94例咳嗽變異性哮喘患兒，根據(jù)用藥的差別分為對(duì)照組和治療組，每組各47例。對(duì)照組口腔吸入丙酸氟替卡松吸入氣霧劑，100 μg/次，2次/d；治療組在對(duì)照組基礎(chǔ)上口服黃龍止咳顆粒，4~7歲患兒6 g/次，8~14歲患兒10 g/次，3次/d。兩組均經(jīng)8周治療。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀改善時(shí)間，肺功能指標(biāo)用力呼出25%肺活量時(shí)的瞬間流量（PEF25%）、PEF50%、PEF75%和第1秒用力呼氣量（FEV1），炎癥介質(zhì)超敏C反應(yīng)蛋白（hs-CRP）、白細(xì)胞介素-13（IL-13）、白細(xì)胞介素-23（IL-23）、基質(zhì)金屬蛋白酶-9（MMP-9）和白細(xì)胞介素-5（IL-5）水平。結(jié)果治療后，治療組臨床有效率明顯高于對(duì)照組（97.87% vs 82.98%，P＜0.05）。治療后，治療組在咳嗽緩解時(shí)間、咳嗽消失時(shí)間均早于對(duì)照組（P＜0.05）。經(jīng)治療，兩組PEF25%、PEF50%、PEF75%、FEV1均顯著升高（P＜0.05），且治療組肺功能水平明顯好于對(duì)照組（P＜0.05）。經(jīng)治療，兩組血清hs-CRP、IL-5、IL-13、IL-23、MMP-9水平均顯著降低（P＜0.05），且治療組明顯低于對(duì)照組（P＜0.05）。結(jié)論黃龍止咳顆粒聯(lián)合丙酸氟替卡松吸入氣霧劑治療兒童咳嗽變異性哮喘，不僅可改善患兒肺功能和臨床癥狀，還降低機(jī)體促炎因子的水平，具有一定臨床推廣應(yīng)用價(jià)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

河南省中醫(yī)藥科學(xué)研究專(zhuān)項(xiàng)課題（20-21ZY2166）