摘要
目的评价定喘汤与吸入用布地奈德联合治疗痰热内蕴型咳嗽变异性哮喘(CVA)的效果。方法选取2017年1-2018年12月在北京丰台中西医结合医院肺病科门诊就诊的80例痰热内蕴型CVA患者作为研究对象,采用随机数字表法将其随机分为对照组和观察组,每组40例。对照组患者在常规治疗基础上给予布地奈德雾化吸入治疗,观察组患者同时联合服用定喘汤治疗,比较二组疗效。结果 (1)观察组治疗4周总有效率为100.00%,显著高于对照组(80.00%)(P<0.05);(2)治疗后二组患者的呼气峰流量(PEF)、第1秒钟用力呼气容积(FEV1)、第1秒用力呼气容积/用力肺活量(FEV1/FVC)、FEV1%下降20%时吸入的乙酰甲胆碱累积剂量(PD20)较治疗前均显著升高,呼出气一氧化氮(FeNO)较治疗前则显著降低(P <0.05),且观察组患者肺功能指标和FeNO与对照组比较差异也具有统计学意义(P<0.05);(3)治疗后二组患者的血清肿瘤坏死因子-α(TNF-α)、白细胞介素-13(IL-13)、痰EOS均显著降低,IL-10较治疗前明显升高,且观察组上述细胞因子水平和痰EOS与对照组相比差异有统计学意义(P<0.05);(4)二组不良反应发生率比较差异无统计学意义(P>0.05)。结论对痰热内蕴型CVA患者在吸入布地奈德治疗的基础上联合中药定喘汤治疗效果确切,其可有效缓解咳嗽症状,避免肺功能受损,可有效降低TNF-α、IL-13等相关炎症细胞因子及外周血嗜酸细胞计数水平,改善机体免疫功能,从而降低气道高反应性和气道炎症反应。
Objective To evaluate the therapeutic effect of of asthma-reliving decoction combined with inhalation budesonide in the treatment of cough variant asthma(CVA) of phlegm heat accumulation type.Methods Eighty cases with phlegm-heat intrinsic CVA who were treated in the outpatient department of pulmonary disease of Fengtai Integrated Hospital of Traditional Chinese and Western Medicine from January 2017 to December 2018 were randomly divided into control group and observation group with 40 cases in each group.Patients in the control group were given budesonide inhalation treatment,and the patients in the experiment group were treated with the combination of asthma-reliving decoction,The clinical treatment effects were compared.Results(1) The total effective rate after 4 weeks of treatment of the experimental group was 100%,significantly higher than that of the control group(80%)(P<0.05).(2) After treatment,the PEF,FEV1,FEV1/FVC,and PD20 were significantly higher than those before treatment,FeNO was significantly lower than before treatment(P<0.05),and the pulmonary function index and FeNO of the experimental group after treatment were significantly different from those of the control group(P<0.05).(3) After treatment,the serum TNF-α,IL-13,IgE and phlegm EOS decreased significantly in the two groups,IL-10 were significantly higher than before the treatment,and the levels of cytokines and phlegm EOS in the experimentalgroup were significantly different from those in the control group(P<0.05).(4)There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion On the basis of inhaling budesonide and asthma-reliving decoction,the treatment of phlegm-heat intrinsic type CVA patients is effective.It can effectively alleviate cough symptoms,avoid impaired lung function,effectively reduce the levels of inflammatory cytokines such as TNF-α,IL-13 and peripheral blood eosinophil count,improve the immune function of the body,and reduce airway hyperresponsiveness and airway inf
作者
赵小鹏
乔树斌
Zhao Xiaopeng;Qiao Shubin(Department of Respiratory and Critical Care Medicine,Fengtai Hospital of Integrated Traditional Chinese and Western Medicine,Beijing 100072,China)
出处
《中国煤炭工业医学杂志》
2019年第6期654-658,共5页
Chinese Journal of Coal Industry Medicine
基金
北京中医药科技发展资金项目(编号:QN2016-08)
关键词
咳嗽变异性哮喘
痰热内蕴型
吸入用布地奈德
定喘汤
Cough variant asthma
Phlegm heat accumulation
Inhalation budesonide
Asthma-reliving decoction
Therapeutic effect
