摘要
目的:探讨麻龙止咳方治疗对小儿咳嗽变异性哮喘(CVA)患儿的治疗效果,并分析其对气道功能、外周血髓样树突状细胞(mDCs)和浆细胞样树突状细胞(pDCs)水平的影响。方法:将152例咳嗽变异性哮喘患儿为观察对象,以随机数字表法将其分为对照组(孟鲁司特钠治疗,n=76)和观察组(孟鲁司特钠治疗+麻龙止咳方,n=76)。比较两组临床疗效、症状评分(日间、夜间)、中医证候评分、小气道功能指标[最大呼气中段流量(MMEF)、50%用力肺活量呼气流速(FEF50%)和75%用力肺活量呼气流速(FEF75%)]及外周血树突状细胞mDCs和pDCs水平差异,并统计不良反应发生率。结果:观察组治疗有效率高于对照组(96.05%与84.21%)(P<0.05),不良反应总发生率低于对照组(5.26%与9.21%),但组间比较,差异无统计学意义(P>0.05)。与对照组比较,观察组治疗后日间症状、夜间症状及中医证候评分更低(P<0.05),MMEF、FEF50%和FEF75%较高(P<0.05)。两组治疗前及治疗后1周、2周、3周、4周外周血mDCs比例比较,差异均无统计学意义(P>0.05)。两组治疗后外周血pDCs比例均较治疗前持续降低,其中观察组治疗后2周、3周及4周的外周血pDCs比例更低(P<0.05)。与治疗前比较,两组治疗后2周、3周及4周的mDCs/pDCs比值均明显升高,其中观察组高于对照组(P<0.05)。结论:麻龙止咳方治疗CVA患儿具有确切的临床疗效,能显著改善气道功能,调节外周血树突状细胞亚群比例,值得临床应用。
Objective:To investigate the therapeutic effects of Malong Zhike formula on children with cough variant asthma(CVA)and analyze its impact on airway function,as well as the levels of myeloid dendritic cells(mDCs)and plasmacytoid dendritic cells(pDCs)in peripheral blood.Methods:A total of 152 children with CVA were selected as the study subjects.They were randomly divided into a control group(Montelukast Sodium treatment,n=76)and an observation group(Montelukast Sodium treatment+Malong Zhike formula,n=76).The clinical efficacy,symptom scores(daytime,nighttime),TCM syndrome scores,small airway function indicators[maximum mid-expiratory flow(MMEF),forced expiratory flow at 50%of vital capacity(FEF50%),and forced expiratory flow at 75%of vital capacity(FEF75%)],and the levels of mDCs and pDCs in peripheral blood were compared between the two groups.The incidence of adverse reactions was also recorded.Results:The treatment efficacy in the observation group was higher than that in the control group(96.05%vs.84.21%)(P<0.05),and the total incidence of adverse reactions was lower in the observation group(5.26%vs.9.21%),although the difference was not statistically significant(P>0.05).Compared to the control group,the observation group had lower daytime and nighttime symptom scores and TCM syndrome scores after treatment(P<0.05),and higher MMEF,FEF50%,and FEF75%values(P<0.05).There were no significant differences in the proportion of mDCs in peripheral blood before treatment and at 1,2,3,and 4 weeks after treatment between the two groups(P>0.05).The proportion of pDCs in peripheral blood decreased continuously after treatment in both groups,with the observation group showing lower pDCs proportions at 2,3,and 4 weeks after treatment(P<0.05).Compared to before treatment,the mDCs/pDCs ratio increased significantly at 2,3,and 4 weeks after treatment in both groups,with the observation group having a higher ratio than the control group(P<0.05).Conclusion:Malong Zhike formula has definite clinical effect in treating CVA children,which can significantly improve airway function and adjust the proportion of dendritic cell subsets in peripheral blood,and is worthy of clinical reference.
作者
项刘婷
庄承
XIANG Liuting;ZHUANG Cheng(Department of Paediatrics,The Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China)
出处
《陕西中医》
2025年第9期1209-1213,共5页
Shaanxi Journal of Traditional Chinese Medicine
基金
上海市卫生健康委员会临床研究专项课题(20224Y0297)
上海市浦东新区卫生健康委员会重点亚专科中医小儿哮喘专科(PWZY2020-10)
上海市浦东新区卫生健康委员会医学人才培养项目(PWRQ2023-46)。
