Objective

2

To observe the clinical efficacy of Qufeng Juanyin Decoction on bronchial asthma in children （syndrome of wind phlegm blocking lung） during the stage of attack， and the regulatory effect on T helper cell 17 （Th17）/regulatory T cell （Treg） and related factors.

Method

2

One hundred and thirty patients were randomly divided into observation group （65 cases） and control group （65 cases） by random number table. In control group， 61 cases completed the treatment， including 1 fell off or lost visit， 3 was eliminated because of breach of protocol. And in observation group， 63 patients completed the treatment， including 2 cases fell off or lost visit. Both of the groups got Budesonide suspension by atomizer， 1 mg/time， 2 times/day， and severe children were added with Terbutaline Sulfate Aerosol every morning and evening， 2 sprays/time. Patients in control group got Suhuang Zhike capsules， 2 grains/time， 3 times/day. Patients in observation group got Qufeng Juanyin Decoction， 1 dose/day. The course of treatment lasted for 7 days. Onset and mitigation times of asthma were recorded. And before and after treatment， pulmonary function was evaluated， and daily variation rate of peak expiratory flow （PEF）， first second expiratory flow as a percentage of expected （FEV

1

%） and ratio of first second forced expiratory volume （FEV

1

） and forced vital capacity （FVC） were recorded， and scores of syndrome of wind phlegm blocking lung and exhaled nitric oxide were detected. At the first week after the treatment， asthma control test in children （C-ACT） was made. Levels of Th17 cells， Treg cells， interleukin-17 （IL-17）， IL-6， IL-10， IL-22 and IL-35 were also detected. And the safety was evaluated.

Result

2

Onset and mitigation times of asthma in observation group were shorter those in control group （

P

<

0.01）. The daily variation rate of PEF in observation group was lower than that in control group （

P

<

0.01）， while levels of FEV

1

% and FEV

1

/FVC were higher than those in control group （

P

<

0.01）. Asthma control in observation group was better than that in control group （

Z

=2.106，

P

<

0.05）. FeNO and score of syndrome of wind phlegm blocking lung were lower than those in control group （

P

<

0.01）. Levels of Th17， Th17/Treg， IL-17， IL-6 and IL-22 were lower than those in control group （

P

<

0.01）， whereas levels of proportion of Treg cells， IL-10 and IL-35 were higher than those in control group （

P

<

0.01）. The total effective rate in observation group was 96.83% （61/63）， which was better than 85.25% （52/61） in control group （

χ

2

=5.141，

P

<

0.05）. And the total effective rate of traditional Chinese medicine （TCM） syndrome was 98.41% （62/63）， which was better than 86.89% （53/61） in control group （

χ

2

=4.525，

P

<

0.05）. And there was no adverse reaction caused by Qufeng Juanyin Decoction.

Conclusion

2

Qufeng Juanyin Decoction can shorten the course of disease， improve the lung function， regulate the expressions of Th17/Treg cells and related factors， promote the immune balance of Th17 / Treg， reduce airway inflammation and airway hyperresponsiveness， and effectively control the attack of asthma， with a good clinical efficacy and safety on bronchial asthma in children （syndrome of wind phlegm blocking lung） during the stage of attack.