目的 探讨人参五味子汤加减治疗肺脾气虚证支气管哮喘患儿的疗效及对其气道炎症、免疫功能的影响.方法 选取2020年1月-2021年3月期间安徽省六安市中医院收治的肺脾气虚证哮证的患儿108例,按随机数字表法分为对照组和观察组,每组各54例.对照组患儿给予布地奈德混悬液雾化治疗,观察组在对照组基础上给予人参五味子汤加减,两组患儿均治疗1周.观察比较两组患儿临床疗效,治疗前后血气状态[血氧分压(Partial Pressure of Oxygen in Arterial Blood,PaO2)、二氧化碳分压(Partial Pressure of Carbon Dioxide in Arterial Blood,PaCO2)、血氧饱和度(Oxygen Saturation of Arterial Blood,SaO2)]、气道炎症因子[血清中转化生长因子β1(Transforming Growth Factor-β1,TGF-β1)、单核细胞趋化蛋白-1(Monocyte Chemoattractant Protein-1,MCP-1)、嗜酸细胞阳离子蛋白(Eosinophil Cationic Protein,ECP)]、免疫功能[IgA、IgG、IgM]、中医证候、肺功能[肺功能第一秒用力呼气量(Forced Expiratory Volume in 1 second,FEV1)、用力肺活量(Forced Vital Capacity,FVC)及第一秒用力呼气量与用力肺活量比率(Forced Expiratory Volume in 1 second/Forced Vital Capacity,FEVl/FVC)].结果 治疗后观察组总有效率94.44％(51/54)明显高于对照组81.48％(44/54),差异有统计学意义(P＜0.05).治疗后两组患儿气道炎症因子TGF-β1、MCP-1、ECP水平均明显低于治疗前,差异有统计学意义(P＜0.05);且观察组气道炎症因子TGF-β1、MCP-1、ECP水平均明显低于对照组,差异有统计学意义(P＜0.05).治疗后两组患儿免疫功能IgG、IgA、IgM水平均较治疗前升高,差异有统计学意义(P＜0.05);且观察组免疫功能IgG、IgA、IgM水平均明显高于对照组,差异有统计学意义(P＜0.05).治疗后两组患儿主症、次症、体征及总积分均较治疗前明显降低,差异有统计学意义(P＜0.05);且观察组主症、次症、体征及总积分均明显低于对照组,差异有统计学意义(P＜0.05).治疗后两组患儿肺功能FEV1、FVC及FEV1/FVC水平均较治疗前升高,差异有统计学意义(P＜0.05);且观察组肺功能FEV1、FVC及FEV1/FVC水平均明显高于对照组,差异有统计学意义(P＜0.05).治疗后两组患儿血气指标PaO2、SaO2水平均较治疗前升高,PaCO2水平均较治疗前降低,差异有统计学意义(P＜0.05);且观察组血气指标PaO2、SaO2水平均明显高于对照组,PaCO2水平明显低于对照组,差异有统计学意义(P＜0.05).结论 人参五味子汤加减能显著提高肺脾气虚证支气管哮喘患儿的临床治疗效果,改善临床证候,减轻炎性反应,提升其免疫功能并改善患儿肺功能.
Curative Effect of Renshen Wuweizi Decoction on Children with Bronchial Asthma Due to Lung-spleen qi Deficiency Syndrome and its Influence on Airway Inflamma-tion and Immune Function
Objective To explore the efficacy of modified Renshen Wuweizi Decoction in treating children with bronchial asthma due to lung-spleen qi deficiency syndrome,as well as its effects on airway inflammation and immune function.Methods A total of 108 children diagnosed with asthma due to lung-spleen qi deficiency syndrome from Janu-ary 2020 to March 2021 were selected at the Traditional Chinese Hospital of LuAn in Anhui Province.They were randomly divided into a control group and an observation group,with 54 cases in each group.Children in the control group were trea-ted with nebulized budesonide suspension,while those in the observation group received modified Renshen Wuweizi Decoc-tion in addition to the treatment in the control group.Both groups were treated for 1 weeks.The clinical efficacy,blood gas parameters[partial pressure of oxygen(PaO2),partial pressure of carbon dioxide(PaCO2),and oxygen saturation(SaO2)],airway inflammation factors[serum transforming growth factor-β1(TGF-β1),monocyte chemoattractant pro-tein-1(MCP-1),and eosinophil cationic protein(ECP)],immune function(IgA,IgG,and IgM),traditional Chinese medicine(TCM)syndrome,and lung function[forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),and FEV1/FVC ratio]were observed and compared between the two groups before and after treatment.Results The total effective rate of the observation group after treatment was 94.44％(51/54),which was significantly higher than 81.48％(44/54)in the control group(P＜0.05).After treatment,the levels of airway inflammation factors TGF-β1,MCP-1,and ECP in both groups were significantly lower than those before treatment(P＜0.05).Additionally,the levels of these factors in the observation group were significantly lower than those in the control group(P＜0.05).The levels of IgG,IgA,and IgM in both groups were significantly increased after treatment compared with those before treatment(P＜0.05).Fur-thermore,the levels of these immune function factors in the observation group were significantly higher than those in the control group(P＜0.05).The main symptoms,secondary symptoms,signs,and total scores of both groups were significantly lower after treatment compared with those before treatment(P＜0.05).Moreover,these scores in the observation group were significantly lower than those in the control group(P＜0.05).The levels of lung function parameters FEV1,FVC,and FEV1/FVC in both groups were significantly increased after treatment compared with those before treatment(P＜0.05).Additionally,these parameters in the observation group were significantly higher than those in the control group(P＜0.05).The blood gas parameters PaO2 and SaO2 were significantly increased after treatment compared with those before treatment,while PaCO2 was significantly decreased(P＜0.05)in both groups.Moreover,the levels of PaO2 and SaO2 in the observation group were significantly higher than those in the control group,while PaCO2 was significantly lower(P＜0.05).Conclusion Modified Renshen Wuweizi Decoction can significantly improve the clinical efficacy of children with bronchial asthma due to lung-spleen qi deficiency syndrome,improve clinical symptoms,alleviate inflammatory reactions,enhance immune function,and improve lung function in children.
Renshen Wuweizi DecoctionLungs-spleen Qi Deficiency SyndromeBronchial AsthmaAirway In-flammationImmune Function
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