世界中医药

目的:观察射干麻黄汤对咳嗽变异性哮喘的临床疗效,并探讨其对机体免疫系统的干预效应。方法:选取2014年1月至2016年2月信阳职业技术学院附属医院收治的咳嗽变异性哮喘患儿80例纳入研究,随机分为对照组和观察组,每组40例。对照组孟鲁司特口服及沙丁胺醇气雾剂喷吸,观察组在上述治疗基础上加用射干麻黄汤,1剂/d。2组均以12周为1个疗程,疗程结束后比较2组患者哮喘控制测试(C-ACT)评分、急性症状发作次数、肺功能以及免疫学指标的变化。结果:1)治疗后2组患者C-ACT均较治疗前明显提高,其中观察组增加的分数较对照组多,差异有统计学意义(P<0.05);2)经过治疗2组患者症状急性发作次数明显下降,其中观察组急性症状发作次数较对照组减少(P<0.05);3)2组肺功能指标均有明显改善,其中观察组各指标优于对照组(P<0.05);4)观察组中CD8+的表达水平明显低于对照组(P<0.05),而CD4+和CD4+/CD8+的表达情况与之相反,高于对照组的表达情况(P<0.05)。结论:射干麻黄汤可有效缓解咳嗽变异性哮喘临床症状,改善患者肺功能,其作用机制可能与介导患者免疫系统有关。

English Summary:

To observe the curative effects of Shegan Mahuang Decoction on treating cough variant asthma and its intervention effect on immune system.Methods:A total of 80 children with cough variant asthma admitted in the pneumology department in Affiliated Hospital of Xinyang Vocational and Technical College from January 2014 to February 2016 were included in the research,and were randomly divided into the observation group and the control group,with 40 cases in each group.The control group had oral administration of montelukast and inhaled albuterol aerosol,and the observation group had Shegan Mahuang Decoction 1 dose in a day on the basis of the treatment above.Both group accepted treatment for 12 weeks as a course.After treatment,asthma control test (C-ACT) score,number of acute onset of symptoms,pulmonary function and the change of immunological index of patients were compared between the two groups.Results:1) After treatment,C-ACT scores of the patients in the two groups were obviously improved,and the increasing scores of the observation group were more than those of the control group,and the differences were statistically significant (P<0.05); 2) after treatment,the number of acute onset of patients in the two groups decreased obviously,and the number of the observation group were less than that of the control group (P<0.05); 3) pulmonary function index improved significantly in both groups,and each index in the observation group was better than that of the control group (P<0.05); 4) the expression of CD8+ in the observation group was significantly lower than that of the control group (P<0.05),while the expression of CD4+ and CD4+/CD8+ in the observation group was higher than that of the control group (P<0.05).Conclusion:Shegan Mahuang Decoction can effectively relieve clinical symptoms of cough variant asthma,improve pulmonary function,and its mechanism may relate to the mediation of patients' immune system.

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