小青龙汤加味联合布地奈德雾化吸入治疗小儿毛细支气管炎(风寒闭肺证)临床研究

摘要

Objective:To explore clinical effect of variant Xiaoqinglong Decoction combined with budesonide inhalation in treatment of children with capillary bronchitis of wind cold closed lung type.Methods:110 cases of children with capillary bronchitis of wind cold closed lung type were selected as the study objects,and were divided into the observation group and the control group according to random number table method,55 cases in each group.All the two groups were given oxygen,cough,fever,phlegm and other symptomatic treatment.The control group were given budesonide inhalation therapy on the basis of that,and the observation group were combined with variant Xiaoqinglong Decoction on the basis of the control group.Clinical effect,symptom scores,cough,fever,wheezing,pulmonary rales,wheezing disappearance time were observed in the two groups.Tumor necrosis factor-α (TNF-α),high sensitivity C reactive protein (hs-CRP),and procalcitonin (PCT) levels were examined,and meanwhile,CD4+,CD8+,CD4+/CD8+ subgroups levels were tested.Results:The total effective rate of the observation group was 94.55％,significantly higher than that of the control group (81.82％),with statistically significant difference (P＜ 0.05).After treatment,TCM symptom scores were significantly lower than that before treatment in the two groups (P＜ 0.05),and the observation group were significantly lower than the control group (P ＜ 0.05).Cough,fever,wheezing,pulmonary rales,wheeze disappeared time in the observation group were significantly lower than those in the control group,with statistically significant difference (P＜ 0.05).After treatment,the levels of TNF-α,hs-CRP and PCT in the two groups were significantly lower than those before treatment(P＜ 0.05),and the observation group were significantly lower than the control group (P ＜ 0.05).After treatment,the levels of CD4+ and CD4+/CD8+ in the two groups were significantly higher than those before treatment (P＜ 0.05),and the observation group were significantly higher than the control group (P＜ 0.05).The level of CD8+ subgroup in the two groups was significantly lower than that before treatment (P＜0.05),and the observation group was significantly lower than the control group (P ＜ 0.05).Conclusion:Variant Xiaoqinglong Decoction combined with budesonide inhalation can effectively relieve clinical symptoms of children with wind cold closed pulmonary capillary bronchitis,and improve the levels of serum inflammatory cytokines and T cell subsets.It can improve clinical effect.%目的 观察小青龙汤加味联合布地奈德雾化吸入治疗小儿毛细支气管炎(风寒闭肺证)临床效果并探讨其机制.方法 选取本院收治的毛细支气管炎(风寒闭肺证)患儿110例作为研究对象,按照随机数字表法分为观察组和对照组各55例,两组均给予吸氧、止咳、退热、化痰等对症治疗,对照组另予布地奈德雾化吸入治疗,观察组在对照组基础上联合小青龙汤加味治疗.比较两组临床疗效、中医证候积分、咳嗽、发热、喘憋、肺部湿啰音以及哮鸣音消失时间,同时检测血清肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、降钙素原(PCT)水平,并检测CD4+、CD8+、CD47CD8+亚群水平.结果 观察组总有效率94.55％,显著高于对照组81.82％,差异具有统计学意义(P＜0.05);治疗后两组中医证候积分显著低于治疗前(P＜0.05),且观察组显著低于对照组(P＜0.05);观察组咳嗽、发热、喘憋、肺部湿啰音以及哮鸣音消失时间显著短于对照组,差异具有统计学意义(P＜0.05);冶疗后两组TNF-α、hs-CRP、PCT水平显著低于治疗前(P＜0.05),且观察组显著低于对照组(P＜0.05);治疗后两组CD4+ 、CD47CD8+亚群水平显著高于治疗前(P＜0.05),且观察组显著高于对照组(P＜0.05),两组CD8+亚群水平显著低于治疗前(P＜0.05),且观察组显著低于对照组(P＜0.05).结论 采用小青龙汤加味联合布地奈德雾化吸入能够有效缓解毛细支气管炎(风寒闭肺证)患儿临床症状,改善血清炎性因子和T细胞亚群水平,提高临床疗效.