Clinical Efficacy on Erchentang Combined with Sanzi Yangqintang in Treatment of Cough Variant Asthma in Children with Phlegm Evil Accumulation Lung Syndrome

Jun WAN; Zhou YU; Meng-tian SUN; Xiang-zheng YANG

doi:10.13422/j.cnki.syfjx.20210624

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Clinical Efficacy on Erchentang Combined with Sanzi Yangqintang in Treatment of Cough Variant Asthma in Children with Phlegm Evil Accumulation Lung Syndrome

Clinic | 更新时间：2021-04-20

- Clinical Efficacy on Erchentang Combined with Sanzi Yangqintang in Treatment of Cough Variant Asthma in Children with Phlegm Evil Accumulation Lung Syndrome
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 27, Issue 10, Pages: 58-63(2021)
- 作者机构：
  
  北京中医药大学深圳医院（龙岗），广东深圳 518100
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20210624
  CLC： R22;R242;R2-031;R287
- Received：05 November 2020，
  
  Published Online：20 January 2021，
  
  Published：20 May 2021
- 稿件说明：
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万军,于宙,孙梦甜等.二陈汤合三子养亲汤加减治疗痰邪蕴肺型儿童咳嗽变异性哮喘的临床观察[J].中国实验方剂学杂志,2021,27(10):58-63.

WAN Jun,YU Zhou,SUN Meng-tian,et al.Clinical Efficacy on Erchentang Combined with Sanzi Yangqintang in Treatment of Cough Variant Asthma in Children with Phlegm Evil Accumulation Lung Syndrome[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(10):58-63.
万军,于宙,孙梦甜等.二陈汤合三子养亲汤加减治疗痰邪蕴肺型儿童咳嗽变异性哮喘的临床观察[J].中国实验方剂学杂志,2021,27(10):58-63. DOI： 10.13422/j.cnki.syfjx.20210624.

WAN Jun,YU Zhou,SUN Meng-tian,et al.Clinical Efficacy on Erchentang Combined with Sanzi Yangqintang in Treatment of Cough Variant Asthma in Children with Phlegm Evil Accumulation Lung Syndrome[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(10):58-63. DOI： 10.13422/j.cnki.syfjx.20210624.

摘要

目的

观察二陈汤合三子养亲汤加减治疗痰邪蕴肺型儿童咳嗽变异性哮喘（CVA）的临床疗效及对气道炎症和气道高反应性（AHR）的影响。

方法

将116例患儿随机分为观察组和对照组，各58例。两组均采用孟鲁司特钠咀嚼片，5 mg/次，1次/d，夜间睡前服用。观察组口服二陈汤合三子养亲汤加减配方颗粒，对照组口服二陈汤合三子养亲汤安慰剂颗粒。疗程均为6周。于治疗前及治疗后每周记录咳嗽症状积分和痰邪蕴肺证积分；记录咳嗽缓解时间、咳嗽消失时间，随访24周记录咳嗽复发情况；进行治疗前后莱切斯特咳嗽生命质量问卷（LCQ）评分检测；测量治疗前后诱导痰液嗜酸性粒细胞（EOS）比例和白细胞介素（IL）-4，IL-5，IL-12及IL-13水平；测量治疗前后呼出气一氧化氮（FeNO）和乙酰甲胆碱使用的累积剂量（PD20）；进行安全性评价。

结果

与本组治疗前比较，治疗后两组患儿治疗后不同时点咳嗽症状积分和痰邪蕴肺证积分均逐渐下降（

对照组

=5.277，

观察组

=7.636，

0.01），治疗后观察组患儿咳嗽症状积分和痰邪蕴肺证积分均低于同期对照组（

0.01）；治疗后观察组咳嗽缓解时间、咳嗽消失时间短于对照组（

0.01）；随访24周内，观察组患儿复发率为68.97%（40/58），低于对照组的84.48%（49/58）（

=3.917，

0.05），治疗后观察组患儿平均复发次数少于对照组（

0.01）；治疗后观察组患儿LCQ总分及各维度评分均高于对照组（

0.01）；治疗后观察组患儿EOS，IL-4，IL-5，IL-13低于对照组，IL-12高于对照组（

0.01）；治疗后观察组患儿FeNO低于对照组（

0.01），PD20多于对照组（

0.01）；观察组患儿临床疗效总有效率为96.55%（56/58），高于对照组的82.76%（48/58）（

=5.948，

0.05）。

结论

二陈汤合三子养亲汤加减治疗CVA痰邪蕴肺证患儿可进一步控制咳嗽症状，缩短咳嗽病程，提高生命质量，并可减轻气道炎症反应和AHR，减少复发率，临床疗效优于单纯的孟鲁司特，且安全，具有较好临床使用价值。

Abstract

Objective

To observe the clinical efficacy of Erchentang combined with Sanzi Yangqintang in the treatment of cough variant asthma （CVA） in children with phlegm-evil accumulation lung syndrome and its influence on airway inflammation and airway hyperresponsiveness （AHR）.

Method

A total of one hundred and sixteen children were randomly divided into observation group and control group 58 cases in each group. Patients in both groups took montelukast sodium chewable tablets orally， 5 mg/time， once daily， at night before bedtime. In observation group， patients took Erchentang and Sanzi Yangqintang modified granules orally. While patients in control group took Erchentang and Sanzi Yangqintang placebo granules orally. Treatment course continued six weeks for two groups. Before and after treatment， the cough symptom scores and phlegm evil accumulating lung syndrome scores were recorded every week. The cough remission time and cough disappearance time were recorded， followed up for 24 weeks to record cough recurrence. Leicester Cough quality of life questionnaire （LCQ） was scored before and after treatment. The ratio of induced sputum eosinophils （EOS） and the levels of interleukin-4 （IL-4）， IL-5， IL-12， IL-13 were measured before and after treatment. The cumulative doses of exhaled nitric oxide （FeNO） and methacholine （PD20） were measued before and after therapy. Safety evaluation was conducted.

Result

The scores of cough symptom and phlegm-evil accumulation lung syndrome at different time points were decreased gradually in two groups of children after treatment （

control group

=5.277，

observation group

=7.636，

0.01）. The scores of cough symptom and phlegm-evil accumulation in the lung syndrome of observation group were lower than those in control group （

0.01） at the same period. The durations of cough relief and cough disappearance in observation group were shorter than those in control group （

0.01）. Within 24 weeks of follow-up， the recurrence rate of children in observation group was 68.97% （40/58）， lower than 84.48% （49/58） in control group （

=3.917，

0.05）. Children in observation group had fewer relapses than those in control group （

0.01）. The total LCQ scores and scores of all dimensions in observation group were higher than those in control group （

0.01）. The EOS， IL-4， IL-5 and IL-13 levels in observation group were lower than the data in control group， and IL-12 level was higher than that in control group （

0.01）. FeNO of children in observation group was lower than that in control group （

0.01）， while PD20 was more than that of control group （

0.01）. The total effective rate of clinical curative effect of children in observation group was 96.55% （56/58）， which was higher than 82.76% （48/58） in control group （

=5.948，

0.05）.

Conclusion

Erchentang combined with Sanzi Yangqintang for children with CVA phlegm evil accumulation lung syndrome can further control the symptoms of cough， shorten the course of cough， improve the quality of life， and reduce airway inflammation and AHR， reduce the recurrence rate. The clinical efficacy is better than using montelukast only， and it is safe and has good clinical value.

关键词

Keywords

references

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