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上海市儿童医院,上海交通大学 附属儿童医院,上海 200040
Received:22 September 2021,
Published Online:13 December 2021,
Published:05 March 2022
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于琳琳,王婧,叶智祺等.五虎汤加味治疗儿童哮喘急性发作期痰热阻肺证的临床随机对照观察[J].中国实验方剂学杂志,2022,28(05):95-101.
YU Lin-lin,WANG Jing,YE Zhi-qi,et al.Clinical Randomized Controlled Observation of Modified Wuhutang in Treatment of Acute Asthma in Children[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(05):95-101.
于琳琳,王婧,叶智祺等.五虎汤加味治疗儿童哮喘急性发作期痰热阻肺证的临床随机对照观察[J].中国实验方剂学杂志,2022,28(05):95-101. DOI: 10.13422/j.cnki.syfjx.20220425.
YU Lin-lin,WANG Jing,YE Zhi-qi,et al.Clinical Randomized Controlled Observation of Modified Wuhutang in Treatment of Acute Asthma in Children[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(05):95-101. DOI: 10.13422/j.cnki.syfjx.20220425.
目的
2
探讨五虎汤加味治疗儿童哮喘急性发作期的临床疗效。
方法
2
将130例急性发作期哮喘儿童,随机分为观察组和对照组,每组65例,观察组给予五虎汤加味治疗,对照组给予盐酸丙卡特罗治疗,疗程1周,比较治疗前后患儿的主要症状(喘息、咳嗽、气促、胸闷)评分情况;次要症状(精神、流涕、口干、舌质、舌苔、大便等)评分情况,肺功能改善情况;免疫球蛋白(Ig)E表达、嗜酸性粒细胞(EOS)计数变化情况,血清白细胞介素(IL)因子(IL-5,IL-6,IL-8,IL-1
β
)水平变化。
结果
2
该研究最终对126例患儿的数据进行统计分析。与本组治疗前比较,治疗后观察组和对照组主要症状(喘息、咳嗽、气促、胸闷),次要症状(精神、流涕、口干、舌质、舌苔、大便)评分、血清IL水平和IgE表达,EOS计数明显降低(
P
<
0.05),肺功能指标明显升高(
P
<
0.05);治疗后与对照组比较,观察组咳嗽症状与次要症状评分明显降低(
P
<
0.05);IL-1
β
表达水平降低程度不及对照组(
P
<
0.05)。肺功能指标,IgE表达,EOS计数改善情况与对照组等同。
结论
2
五虎汤加味治疗儿童哮喘急性发作期痰热阻肺证能明显减轻哮喘患儿的临床症状,改善肺功能,降低IgE,IL-5,IL-6,IL-8,IL-1
β
表达水平和EOS计数,总体临床疗效优于或等同盐酸丙卡特罗。
Objective
2
To explore the clinical effect of modified Wuhutang in the treatment of children with acute asthma.
Method
2
A total of 130 children with acute asthma were randomly divided into an observation group and a control group, with 65 cases in each group. The observation group was treated with modified Wuhutang and the control group was treated with procaterol hydrochloride for one week. The scores of primary symptoms (wheezing, cough, shortness of breath, and chest tightness) and secondary symptoms (mental status, runny nose, dry mouth, tongue texture, tongue coating, stool, etc.), lung functions, immunoglobulin E (IgE) expression, eosinophil (EOS) count, and serum inflammatory factors, including interleukin (IL)-5, IL-6, IL-8, and IL-1
β
in two groups before and after treatment were compared.
Result
2
The data of 126 children were statistically analyzed. As revealed by the results, compared with the conditions before treatment, the scores of primary symptoms and secondary symptoms, serum levels of IL, IgE expression, and EOS count were both reduced in two groups (
P
<
0.05), lung functions were increased in the two groups(
P
<
0.05). Compared with the control group after treatment, the observation group showed decreased scores of cough and secondary symptoms (
P
<
0.05), and insignificant decrease in IL-1
β
(
P
<
0.05). The improvement in lung functions, IgE expression, and EOS count in observation group was equivalent to that in control group.
Conclusion
2
Modified Wuhutang for treatment of acute asthma in children (phlegm-heat obstructing lung syndrome) can significantly relieve the clinical symptoms, improve lung functions, and reduce IgE, IL-5, IL-6, IL-8, IL-1
β
expression levels and EOS count, and its overall clinical efficacy is superior or equivalent to that of tprocaterol hydrochloride.
中华医学会儿科学分会呼吸学组《中华儿科杂志》编辑委员会 . 儿童支气管哮喘诊断与防治指南(2016年版) [J]. 中华儿科杂志 , 2016 , 54 ( 3 ): 167 - 181 .
KIM R Y , PINKERTON J W , ESSILFIE A T , et a1 . Role for NLRP3 Inflammasome- mediated, IL-l β -dependent responses in severe, steroid. Resistant asthma [J]. Am J Respir Crit Care Med , 2017 , 196 ( 3 ): 283 - 297 .
KAMER J , WAWRZYNIAK M , TANKOV S , et a1 . Increased microRNA-323-3p in IL-22/IL-17 producing T cells and asthma: a role in the regulation of the TGF- β pathway and IL-22 production [J]. Allergy , 2017 , 72 ( 1 ): 55 - 65 .
KIM R Y , HORVAT J C , PINKERTON J W , et al . MicroRNA-21 drives severe, steroid-insensitive experimental asthma by amplifying phosphoinositide 3-kinase-mediated suppression of histone deacetylase 2 [J]. J Allergy Clin Immunol , 2017 , 139 ( 2 ): 519 - 532 .
全国儿科哮喘协作组 . 中国疾病预防控制中心环境与健康相关产品安全所.第三次中国城市儿童哮喘流行病学调查 [J]. 中华儿科杂志 , 2013 , 10 ( 51 ): 729 .
全国儿科哮喘协作组 . 2000年与1990年儿童支气管哮喘患病率的调查比较 [J]. 中华结核和呼吸杂志 , 2004 , 27 ( 2 ): 112 - 116 .
全国儿科哮喘协作组 . 第三次中国城市儿童哮喘流行病学调查 [J]. 中华儿科杂志 , 2013 , 51 ( 10 ): 729 - 735 .
解玉 , 杨子珍 , 柴柏春 . 上海市哮喘儿童与 β -肾上腺素能受体基因多态性的关系 [J]. 实用儿科临床杂志 , 2008 , 23 ( 4 ): 272 - 273 .
Global Initiative for Asthma . Global Strategy for Asthma Management and Prevention, 2020 . Available from : www.ginasthma.org www.ginasthma.org .
武进华 , 贾林萍 . 加味五虎汤联合药物贴敷治疗痰热闭肺型小儿支原体肺炎 [J]. 中医学报 , 2018 , 33 ( 10 ): 1878 - 1881 .
张晶洁 . 徐荣谦教授运用五虎汤治疗小儿肺系病证经验 [J]. 中医儿科杂志 , 2011 , 7 ( 3 ): 9 - 10 .
戴岳 , 刘连华 , 寇俊平 , 等 . 五虎汤的止咳平喘作用 [J]. 中国药科大学学报 , 1996 , 27 ( 6 ): 374 - 376 .
迟天燕 , 纪雪飞 , 夏明钰 , 等 . 五虎汤6种活性成分对离体豚鼠气管平滑肌的作用 [J]. 中国实验方剂学杂志 , 2009 , 15 ( 3 ): 51 - 55 .
胡克崇 . 清热平喘汤联合西药治疗支气管哮喘急性发作期热哮证临床观察 [J]. 新中医 , 2018 , 50 ( 3 ): 64 - 66 .
中华中医药学会 . 中医儿科常见病诊疗指南 [M]. 北京 : 中国中医药出版社 , 2012 : 22 - 25 .
王东波 , 单洪武 , 王翔 . 吸入ICS联合LTRA治疗对支气管哮喘患者血清炎症因子和FeNO的影响 [J]. 北京医学 , 2018 , 40 ( 2 ): 177 - 179 .
刘芳 , 虞坚尔 , 张新光 , 等 . 中西医结合分期控制儿童支气管哮喘的临床疗效评价 [J]. 上海中医药杂志 , 2018 , 52 ( 12 ): 39 - 43 .
郑筱萸 . 中药新药临床探究指导原则 [M]. 北京 : 中国医药科技出版社 , 2002 .
RADINGER M , LÖTVALL J . Eosinophil progenitors in allergy and asthma-do they matter? [J] Pharmacol Ther , 2009 , 121 ( 2 ): 174 - 184 .
CHEUNG P F , WONG C K , HO A W , et al . Activation of human eosinophils and epidermal keratinocytes by Th2 cytokine IL-31: implication for the immunopathogenesis of atopic dermatitis [J]. Int Immunol , 2010 , 22 ( 6 ): 453 - 467 .
MARCHAND F , MECHERI S , GUILLOUX L , et al . Human serum IgE-mediated mast cell degranulation shows poor correlation to allergen specific IgE content [J]. Allergy , 2003 , 58 ( 10 ): 1037 - 1043 .
SIMON H U . Cytokine and anti-cytokine therapy for asthma [J]. Curr Allergy Asthma Rep , 2006 , 6 ( 2 ): 117 - 121 .
SCHOUTEN M , VAN DE POL M A , LEVI M , et al . Early activation of coagulation after allergen challenge in patients with allergic asthma [J]. J Thromb Haemost , 2009 , 7 ( 9 ): 1592 - 1594 .
帅云飞 , 荀春铮 , 王孟清 , 等 . 五虎汤对病毒诱发幼年哮喘大鼠肺组织初始CD4 + T细胞转录因子表达的影响 [J]. 湖南中医杂志 , 2018 , 34 ( 1 ): 148 - 150 .
赵毅涛 , 张新光 , 虞坚尔 , 等 . 平喘方对哮喘模型小鼠肺组织炎症及IFN- γ 和IL-4的影响 [J]. 中西医结合学报 , 2012 , 10 ( 7 ): 807 - 813 .
孔一卜 , 孙丽平 , 刘璐 . 益气固本胶囊调控哮喘小鼠核因子 κ B信号通路肿瘤坏死因子 α 和白细胞介素1 β 含量的实验研究 [J]. 中国中西医结合儿科学 , 2018 , 10 ( 5 ): 409 - 412 .
韦伟 , 孙军 , 帅雪芬 . 金荞麦胶囊对轻中度哮喘急性发作期患者肺通气功能及EOS、IgE水平的影响 [J]. 吉林中医药 , 2021 , 41 ( 6 ): 751 - 754 .
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