苏黄止咳胶囊联合沙美特罗/丙酸氟替卡松治疗咳嗽变异性哮喘的临床观察

摘要

目的 探讨苏黄止咳胶囊联合沙美特罗/丙酸氟替卡松对成人咳嗽变异性哮喘(CVA)的临床疗效.方法 选择2015年12月～2017年8月在浙江省湖州市第一人民医院确诊的60例CVA患者,随机分为两组,观察组30例采用沙美特罗50 μg/丙酸氟替卡松250 μg联合苏黄止咳胶囊治疗;对照组30例单用沙美特罗50 μg/丙酸氟替卡松250μg治疗,两组均治疗4周.连续药物治疗2周后,观察两组患者咳嗽症状评分,4周后对两组患者采用哮喘控制测试(ACT)问卷进行评价,并检测血清总免疫球蛋白E(IgE)、肿瘤坏死因子(TNF-α)、白介素(IL)-4及IL-6水平,诱导痰嗜酸性粒细胞百分比.结果 观察组总有效率(93.33％)高于对照组(73.33％),差异有统计学意义(P＜0.05);治疗后,两组咳嗽症状评分均较治疗前显著降低,且观察组明显低于对照组(P＜0.05).观察组ACT评分明显高于对照组,差异有统计学意义(P＜0.05).治疗后两组患者诱导痰嗜酸性粒细胞百分比、血清IgE、TNF-α水平均较治疗前降低,且观察组明显低于对照组(P＜0.05).结论 苏黄止咳胶囊联合沙美特罗/丙酸氟替卡松能降低成人CVA患者血清中IgE、TNF-α水平及诱导痰嗜酸性粒细胞百分比,降低气道炎症,改善咳嗽症状,从而达到提高治疗效果的目的.%Objective To explore the clinical effect of Suhuang Cough Capsules combined with Salmeterol/Fluticasone Propionate in the treatment of cough variant asthma (CVA).Methods Sixty patients diagnosed with CVA from December 2015 to August 2017 in First People's Hospital of Huzhou were selected and randomly divided into two groups,with 30 cases in each group.Patients in the observation group were treated with Salmeterol 50 μg/Fluticasone Propionate 250 μg inhalation combined with Suhuang Cough Capsules.Patients in the control group were treated with Salmeterol 50 μg/Fluticasone Propionate 250 μg inhalation,both groups were treated for 4 weeks.After two weeks of continuous drug treatment,the cough symptom score was observed in both groups.After 4 weeks,patients of the two groups were evaluated by the asthma control test (ACT) questionnaire,and the levels of total serum IgE,TNF-α,IL-4 and IL-6 were measured and the percentage of sputum eosinophils was induced.Results The total efficiency of the observation group (93.33％) was higher than that of the control group (73.33％),the difference was statistically significant (P ＜ 0.05).After treatment,the scores of both groups were significantly lower than those before treatment,and the observation group was significantly lower than the control group (P ＜ 0.05).The ACT score of the observation group was significantly higher than that of the control group,and the difference was statistically significant (P ＜ 0.05).After treatment,the sputum eosinophil percentage,serum IgE,TNF-α levels in two groups were lower than those before treatment (P ＜0.05),and the observation group was significantly lower than the control group (P ＜ 0.05).Conclusion Suhuang Cough Capsules combined with Salmeterol/Fluticasone Propionate can reduce the level of serum IgE,TNF-o and the sputum eosinophil percentage in adult patients with cough variant asthma,reduce airway inflammation and improve cough symptoms,so as to improve the therapeutic effect.