疏风益气汤联合沙美特罗替卡松治疗咳嗽变异性哮喘疗效研究及对肺功能、气道炎症反应及复发率的影响

Research on clinical efficacy of Shufeng Yiqi Decoction combined with salmeterol fluticasone on lung function, airway inflammation and cough variant asthma and influence on recurrence rate

关键词:  咳嗽变异性哮喘  中药  疏风益气汤  沙美特罗替卡松

Key words:  cough variant asthma  Chinese medicine  Shufeng Yiqi Decoction  salmeterol fluticasone

摘要:

[目的] 探讨中药疏风益气汤联合沙美特罗替卡松治疗咳嗽变异性哮喘（CVA）的临床疗效和对患者肺功能、气道炎症反应及复发率的影响。[方法] 选择石家庄市第二医院2018年3月—2020年3月收治的CVA患者120例，按照随机数字表法将120例患者分为两组，每组60例。对照组予以沙美特罗替卡松粉吸入剂，每次1揿，每日2次；观察组在对照组基础上予以中药疏风益气汤口服，两组疗程均为8周。比较两组治疗前后咳嗽评分、中医证候（次证）评分、第1秒用力呼气容积（FEV1）、最大呼气流量（PEF）、FEV1占用力肺活量的百分比（FEV1/FVC）；并比较两组气道炎症指标：包括外周血嗜酸性粒细胞百分比（BER）、血清白细胞介素-5（IL-5）、嗜酸性粒细胞阳离子蛋白（ECP）水平和痰液黏蛋白5AC（MUC5AC）含量；比较两组临床疗效和复发率。[结果] 治疗后观察组咳嗽频率、咳嗽程度评分均低于对照组（P<0.01）；咳痰、乏力、气短、自汗评分均低于对照组（P<0.01）；FEV1、PEF、FEV1/FVC均高于对照组（P<0.01）；BER、IL-5、ECP、MUC5AC均低于对照组（P<0.01）；临床疗效优于对照组（P<0.05），治疗后6个月复发率低于对照组（P<0.05），差异均有统计学意义。[结论] 疏风益气汤联合沙美特罗替卡可有效缓解症状，改善肺功能，抑制气道炎症反应，降低复发率，治疗CVA效果显著。

Abstract:

[Objective] To investigate the clinical efficacy of Shufeng Yiqi Decoction combined with salmeterol fluticasone in the treatment of cough variant asthma(CVA) and its influence on lung function, airway inflammation and recurrence rate. [Methods] The 120 patients with CVA in our hospital from March, 2018 to March, 2020 were selected and randomly divided into two groups, with 60 cases in each group. The control group were given salmeterol fluticasone powder inhalation, once press each time, twice a day. The observation group were given Shufeng Yiqi Decoction on the basis of the treatment of the control group, and the course of treatment of both groups was for 8 weeks. The cough score, traditional Chinese medicine(TCM) syndrome score, forced expiratory volume on first second(FEV1), Maximum expiratory flow(PEF), and percentage of forced vital capacity(FEV1/FVC) were compared betweentwo groups before and after treatment, and the airway inflammation indexes including peripheral blood eosinophil percentage(BER), serum interleukin-5(IL-5), eosinophil cationic protein were compared betweentwo groups. The ECP level and MUC5AC content in sputum were compared betweentwo groups. The clinical efficiency and recurrence rate were compared betweentwo groups. [Results] After treatment, the scores of cough frequency and cough degree of the observation group were lower than those of the control group(P<0.01). The scores of expectoration, fatigue, shortness of breath and spontaneous sweating of the observation group were lower than those of the control group(P<0.01). FEV1, PEF, FEV1/FVC of the observation group were higher than those of the control group(P<0.01). BER, IL-5, ECP, MUC5AC of the observation group were lower than those of the control group(P<0.05), and the recurrence rate in 6 months after treatment was lower than that of the control group(P<0.05). The difference was statistically significant. [Conclusion] Shufeng Yiqi Decoction combined with salmeterol fluticasone can effectively relieve symptoms, improve lung function, inhibit airway inflammation, reduce recurrence rate, and it has a significant effect in the treatment of CVA.