李原 苏俊颖 梁玉颖

摘要  目的：分析宣肺平喘湯联合孟鲁司特钠治疗小儿喘息性支气管炎的临床价值。方法：选取2018年1月至2020年1月玉林市中医医院收治的喘息性支气管炎患儿200例临床资料并进行回顾性分析，根据治疗方案不同分为对照组和观察组，每组100例。对照组采用孟鲁司特等对常规治疗，观察组采用宣肺平喘汤联合孟鲁司特等治疗。治疗2周后比较2组患儿临床疗效、肺功能、炎性反应递质、免疫指标及不良反应。结果：观察组治疗临床有效率（95.00%）显著高于对照组临床有效率（79.00%），临床症状消失及住院时间均短于对照组，差异有统计学意义（ P <0.05）;2组治疗后肺功能、免疫功能均较前改善、炎性反应递质水平均较前降低，但治疗后观察组患儿呼出最大呼气峰流速（PEF）、肺功能第1秒钟用力呼气容积占预计值百分比（FEV1%）及FEV1与用力肺活量比值（FEV1/FVC）以及CD4+以及CD4+/CD8+水平均显著高于对照组，而IgE、CD8+水平显著低于对照组，差异有统计学意义（ P <0.05），2组患儿在治疗过程中均未见明显不良反应。结论：宣肺平喘汤联合孟鲁司特钠治疗小儿喘息性支气管炎临床有效率更高，可有效抑制炎性反应，更有利于改善患儿临床症状、肺功能和免疫功能，具有一定安全性。

关键词  宣肺平喘汤;孟鲁司特钠;小儿;喘息性支气管炎;临床疗效;肺功能;炎性反应递质;免疫功能

Clinical Observation of Xuanfei Pingchuan Decoction in the Treatment of Asthmatic Bronchitis in Children

LI Yuan， SU Junying LIANG Yuying

（Department of Pediatrics， Traditional Chinese Medicine Hospital of Yulin of Guangxi Zhuang Autonomous Region， Yulin 537000， China）

Abstract Objective： To analyze the clinical value of Xuanfei Pingchuan Decoction combined with montelukast sodium in the treatment of asthmatic bronchitis in children.  Methods： A total of 200 children with asthmatic bronchitis who were treated in the Traditional Chinese Medicine Hospital of Yulin from January 2018 to January 2020 were retrospectively analyzed. According to different therapeutic schedule， they were divided into a control group（conventional treatment such as Montelukast）and an observation group（Xuanfei Pingchuan Decoction combined with montelukast and other treatment）， with 100 cases in each group. The therapeutic effects， lung function， inflammatory factors， immune indicators and adverse reactions of patients were compared between the 2 groups after 2 weeks of treatment.  Results： The total clinical effects of the observation group（95.00%）was significantly higher than that of the control group（79.00%）. The time of disappearance of clinical symptoms and the hospital stay were shorter than those in the control group（ P <0.05）. After treatment， the lung function and immune function were improved and the levels of inflammatory factors were lower. However， after treatment， the levels of PEF， FEV1， FEV1/FVC， and CD4+， and CD4+/CD8+ in the observation group were significantly higher than those in the control group， while the levels of IgE and CD8+ were significantly lower than those in the control group（ P <0.05）. There were no obvious adverse reactions in the 2 groups in the treatment.  Conclusion： Xuanfei Pingchuan Decoction combined with montelukast sodium is more effective in the treatment of asthmatic bronchitis in children， and it can effectively suppress the inflammatory response， be more conducive to improving the clinical symptoms， lung function and immune function of children. It is safe and is worthy of clinical promotion and use in clinics.

Keywords  Xuanfei Pingchuan Decoction; Montelukast sodium; Children; Asthmatic bronchitis; Therapeutic effects; Lung function; Inflammatory factors; Immune function

中图分类号：R289.5;R562 文献标识码：A  doi： 10.3969/j.issn.1673-7202.2020.14.025

喘息性支气管炎是呼吸科常见疾病，尤其是婴幼儿最常见的下呼吸道感染性疾病之一[1]。病毒感染是诱发喘息性支气管炎的主要病因，气道炎症为其发病根本，主要是气道炎性反应递质等多因素介导的炎性反应，以咳嗽、喘息以及呼吸困难为主要临床表现，倘若治疗未及时或不当甚至可危及患儿生命安全，甚至有部分患儿治疗不彻底反复迁徙后进展成为支气管哮喘，严重影响患儿健康和生命质量[2-4]。药物治疗是喘息性支气管炎的首要措施，但目前，临床上关于喘息性支气管肺炎尚未有特效药，抗感染、平喘、拍背吸痰、吸氧等常规疗法为主要手段，而关于孟鲁司特治疗喘息性支气管炎的临床价值也曾有报道[5-6]。……