目的 觀察清咳平喘顆粒聯(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2021年5月—2023年1月在自貢市第一人民醫(yī)院就診的136例咳嗽變異性哮喘患兒，采用隨機(jī)數(shù)字法分為對照組（68例）和治療組（68例）。對照組給予丙酸氟替卡松吸入氣霧劑，50～100 μg/次，2次/d。治療組在對照組基礎(chǔ)上開水沖服清咳平喘顆粒，5歲≤年齡≤8歲，6 g/次，8歲＜年齡≤14歲，8 g/次，3次/d。兩組患兒均連續(xù)治療4周。比較兩組患兒的臨床療效、肺功能指標(biāo)、炎癥因子指標(biāo)、T淋巴細(xì)胞亞群指標(biāo)、免疫球蛋白指標(biāo)。結(jié)果 治療后，治療組的臨床控制率為94.12%，高于對照組的臨床控制率77.94%（P＜0.05）。治療后，兩組用力肺活量（FVC）、一秒用力呼氣容積（FEV₁）和最大呼氣流量（PEF）均升高（P＜0.05），且治療組FVC、FEV₁、PEF高于對照組（P＜0.05）。治療后，兩組血清白細(xì)胞介素（IL）-10水平升高，血清IL-6、基質(zhì)金屬蛋白酶-9（MMP-9）水平均下降（P＜0.05），且治療組血清IL-10水平高于對照組，血清IL-6、MMP-9水平低于對照組（P＜0.05）。治療后，兩組CD3⁺、CD4⁺、CD4⁺/CD8⁺升高，CD8⁺下降（P＜0.05），且治療組CD3⁺、CD4⁺、CD4⁺/CD8⁺高于對照組，CD8⁺低于對照組（P＜0.05）。治療后，兩組免疫球蛋白（Ig）E、IgA、IgG均升高（P＜0.05），且治療組免疫球蛋白高于對照組（P＜0.05）。結(jié)論 清咳平喘顆粒聯(lián)合丙酸氟替卡松吸入氣霧劑治療咳嗽變異性哮喘患兒可有效改善患兒的肺功能，提高機(jī)體免疫功能，調(diào)節(jié)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

四川省衛(wèi)生健康適宜技術(shù)推廣立項項目(20PJ0273)