小青龙汤联合糖皮质激素对支气管哮喘患儿气道重塑 及相关炎症因子的影响

摘 要 目的:探讨小青龙汤加糖皮质激素治疗支气管哮喘（BA）患儿的疗效及对气道重塑、相关炎症因子的影响。方法:选择BA患儿86例,随机分为对照组和观察组各43例。对照组给予布地奈德福莫特罗粉吸入剂治疗，观察组在对照组基础上给予自拟小青龙汤治疗。比较两组治疗前后气道重塑指标（MFB、TRBM）、TGF-β1、MMP-9变化及临床疗效。结果: 治疗后观察组中医症状积分比对照组更低（P＜0.05）；治疗后1、2、4周，两组C-ACT评分均提高，且观察组比对照组降更明显（P＜0.05）。治疗后，观察组的咳嗽、咳痰、喘息以及肺部啰音消失时间均明显低于对照组（P<0.05）。治疗后，观察组肺功能恢复比对照组快，肺功能指标明显优于对照组（P<0.05）。治疗后，两组各指标水平均降低（P<0.05），观察组MFB、TRBM、MMP-9及TGF-β1水平降低幅度均大于对照组（P<0.05）；观察组总有效率为97.67%（42/43）明显高于对照组86.05%（37/43）（P<0.05）。结论:自拟小青龙汤加糖皮质激素可抑制BA患儿气道重塑，降低血清MMP-9及TGF-β1水平，疗效显著，用药较安全。

Effects of Xiaoqinglong decoction combined with glucocorticoid on airway remodeling and related inflammatory factors in children with bronchial asthma

Objective:To investigate the effect of Xiaoqinglong decoction combined with glucocorticoid on airway remodeling and related inflammatory factors in children with bronchial asthma.Methods:86 children with bronchial asthma were selected.They were randomly divided into control group(43 cases)and observation group(43 cases).The control group was treated with budesonide formoterol powder inhalation,while the observation group was treated with Xiaoqinglong decoction on the basis of the control group.The changes of airway remodeling index(MFB,TRBM),TGF-beta 1,MMP-9 and clinical efficacy were compared between the two groups before and after treatment.Results:After 1,2,4 weeks of treatment,the C-ACT scores of both groups increased,and the observation group decreased more significantly than the control group(P<0.05).After treatment,the disappearance time of cough,sputum,wheezing and lung rale in the observation group was significantly lower than that in the control group(P<0.05).After treatment,the pulmonary function of the observation group recovered faster than that of the control group,and the pulmonary function index was significantly better than that of the control group(P<0.05).After treatment,the levels of MFB,TRBM,MMP-9 and TGF-beta 1 in the observation group were lower than those in the control group(P<0.05).The total effective rate in the observation group was 97.67%(42/43)significantly higher than that in the control group(86.05%,P<0.05).Conclusion:Xiaoqinglong decoction combined with glucocorticoid can inhibit airway remodeling and reduce serum levels of MMP-9 and TGF-beta-1 in children with bronchial asthma.