唐静 石京花 康海燕 叶协琼

摘要 目的：探究孟魯司特联合柴朴活血止咳汤治疗肺部感染后咳嗽患者的临床疗效及作用机制，评估联合治疗对患者细胞免疫功能的影响。方法：选取2019年2月至2020年2月期间中国中医科学院望京医院感染科收治的辨证为少阳枢机不利兼痰饮瘀血证的肺部感染后咳嗽患者90例作为研究对象，按照随机数字表法分为对照组和观察组，每组45例。对照组给予孟鲁司特，观察组给予柴朴活血止咳汤联合孟鲁司特，比较2组患者治疗效果、咳嗽改善情况及治疗前细胞免疫功能、肺功能水平。结果：观察组总有效率（95.56%）高于对照组（80.00%），差异有统计学意义（P<0.05）。治疗14 d后，2组CD4+、CD4+/CD8+均较治疗前提高，CD8+较治疗前明显下降;2组FVC、FEV1及FEV1/FVC均较治疗前显著提高，差异均有统计学意义（P<0.05）。结论：孟鲁司特联合柴朴活血止咳汤治疗肺部感染后咳嗽患者，能够提高细胞免疫功能，改善肺功能，值得推广。

关键词 孟鲁司特;柴朴活血止咳汤;肺部感染;细胞免疫功能

Effects of Montelukast Combined with Chaipu Huoxue Zhike Decoction on the Cellular Immune Function of Patients with Cough after Lung Infection

TANG Jing，SHI Jinghua，KANG Haiyan，YE Xieqiong

（Infection Department，Wangjing Hospital of China Academy of Chinese Medical Sciences，Beijing 100102，China）

Abstract Objective：To investigate the clinical efficacy and mechanism of the combination of montelukast and Chaipu Huoxue Zhike Decoction，and to evaluate the effect of the combination therapy on the cellular immune function of patients with cough after lung infection and Shaoyang cardinal disadvantage and phlegm drinking stasis syndrome.Methods：A total of 90 patients with cough with the syndromes of dysfunction of Shaoyang pivot，phlegm and fluid retention，and blood stasis after a lung infection admitted to the Infection Department of Wangjing Hospital from February 2019 to February 2020 were selected as the research objects and and were divided into a control group（n=45，given Monelukast）and an observation group（n=45，given Montelukast and Chaipu Decoction）by using a randomized numerical table.The treatment effect，cough improvement，cellular immune function，and pulmonary function in the two groups were compared.Results：The total effective rate of the observation group was higher than that of the control group（95.56% vs 80.00%），and the comparison was significant（P<0.05）.After 14 d of treatment，CD4+ and CD4+/CD8+ increased in both groups，and CD8+ decreased significantly compared with the pre-treatment level.After 14 d of treatment，FVC，FEV1 and FEV1/FVC in both groups increased significantly compared with those before treatment，and the comparison between the two groups was significant（P<0.05）.Conclusion：Using Montelukast and Chaipu Huoxue Zhike Decoction for the treatment of patients with cough after lung infection can improve cellular immunity and lung function，which is worthy of be promoted.

Keywords Montelukast; Chaipu Huoxue Zhike Decoction; Pulmonary infection; Cellular immune function

中图分类号：R256.11文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.06.018

肺部感染后咳嗽是肺部感染患者常见并发症，具有刺激性干咳、咳痰、咽喉痒等症状，具有阵发性，持续时间为1～2个月[1]。对于本病，西医往往给予茶碱类、糖皮质激素、H受体拮抗剂等药物，其中孟鲁司特是白三烯受体拮抗剂，能够降低局部炎症反应，能够有效控制病情，但是难以根治病情[2]。肺部感染后咳嗽属于中医学“外感咳嗽”研究范畴，病因为少阳枢机不利，痰气交阻于肺，郁而化热，炼液为痰，气滞血瘀，痰瘀互阻，因此中医治疗以疏利少阳、下气化痰、活血化瘀为治疗原则[3-4]。为探究宣孟鲁司特联合柴朴活血止咳汤治疗肺部感染后咳嗽患者的临床疗效及作用机制，本研究选取了我院收治的90例辨证为少阳枢机不利兼痰饮瘀血证的肺部感染后咳嗽患者作为研究对象。……