热毒宁联合穴位贴敷对毛细支气管炎儿童肺功能及免疫功能的影响

目的：分析热毒宁联合穴位贴敷对毛细支气管炎儿童免疫功能的影响，探索热毒宁联合穴位贴敷的临床应用价值。方法：将2012年10月至2014年8月在河南省中医院接受治疗的64例毛细支气管炎儿童患者随机分为2组：对照组给予扣背排痰、吸氧、止咳化痰、抗炎、退热、平喘雾化吸入等常规性治疗；观察组在对照组的治疗方案基础上，给予药热毒宁注射液药物治疗和如意金黄散穴位贴敷治疗。观察2组的临床疗效、肺功能及免疫功能恢复情况。结果：①观察组患者的喘憋减轻时间，喘憋、咳嗽、退热、干啰音、湿啰音消失时间和住院天数均小于对照组，组间差异具有统计学意义（t=4.346、5.301、4.445、2.238、4.116、3.733、3.681，P<0.05）。②治疗前，2组患者的呼吸频率（RR）、潮气量（VT）、功能残气量（FRC）、达峰容积比（VPEF/VE）、达峰时间比（tPTEF/tE）、有效呼吸道阻力（Reff）均无显著性差异（P>0.05）；治疗后，2组患者的RR、VT、VPEF/VE、tPTEF/tE较治疗前明显升高，FRC和Reff较治疗前的明显降低（P<0.05）；观察组治疗后RR、VT、VPEF/VE、tPTEF/tE较对照组高，FRC和Reff较对照组低，且有显著性差异（P<0.05）。③治疗前，2组患者的T淋巴细胞亚群：CD3⁺、CD4⁺、CD8⁺细胞水平均无显著性差异（P>0.05）；治疗后，2组患者的CD3⁺、CD4⁺较治疗前高，CD8⁺较治疗前低，且有显著性差异（P<0.05）；观察组患者治疗后的CD3⁺、CD4⁺较对照组高，CD8⁺较对照组低，组间差异显著（P<0.05）。④治疗前，2组患者的免疫球蛋白IgM、IgG、IgA、IgE、胰岛素样生长因子I（IGF-I）均无显著性差异（P>0.05）；2组治疗后的IgG、IgA、IgM、IGF-I较治疗前高，IgE较治疗前低，且有显著性差异（P<0.05）；观察组治疗后的IgG、IgA、IgM、IGF-I较对照组高，IgE较对照组低，组间差异显著（P<0.05）。结论：在常规西药治疗的基础上，加用热毒宁联合穴位贴敷能改善毛细支气管炎儿童临床症状，改善肺功能，提高患儿免疫功能。

Influence on Pulmonary Function and Immune Function in Children with Capillary Bronchitis by Re-Du-Ning Injection Combined with Acupoint Sticking

This study was aimed to observe the influence on immune function in children with capillary bronchitis by Re-Du-Ning (RDN) injection combined with acupoint sticking, in order to explore the clinical application value of RDN injection combined with acupoint sticking. A total of 64 children with capillary bronchitis treated in the Henan Province Hospital of Traditional Chinese Medicine from October 2012 to August 2014 were randomly divided into two groups. In the control group, conventional treatment, including sputum excretion, oxygen therapy, cough-relieving and phlegm-dissolving, anti-inflammation, antifebrile, panting-relieving and atomization inhalation, was used. In the observation group, RDN injection combined with acupoint sticking of Ru-Yi Jin-Huang (RYJH) powder was used on the basis of treatment of the control group. Observations were made on the clinical therapeutic effects as well as the recovery condition of pulmonary function and immune function in both groups. The results showed that the asthmatic suffocating relieving time, asthmatic suffocating, cough, antifebrile, dry rale and wet rale disappearing time, hospitalization days of the observation group were less than those of the control group with significant inter-group difference (t = 4.346, 5.301, 4.445, 2.238, 4.116, 3.733, 3.681, P < 0.05). However, there were no significant differences in both groups (P > 0.05). There were no statistical differences on the pretreatment RR, VT, FRC, VPEF/VE, tPTEF/tE, Reff in both groups (P > 0.05); the posttreatment RR, VT, VPEF/VE, tPTEF/tE were obviously higher than those of the pretreatment; FRC and Reff were obviously decreased compared with those of the pretreatment (P < 0.05). The posttreatment RR, VT, VPEF/VE, tPTEF/tE in the observation group were higher than those of the control group; FRC and Reff were lower than those of the control group with significant difference (P > 0.05). There were no significant differences on the pretreatment T lymphocyte subsets, which included CD3+, CD4+ and CD8+ T lymphocyte (P > 0.05). The posttreatment CD3+ and CD4+ were higher than those of pretreatment; CD8+ was lower than that of pretreatment in both groups with significant difference (P < 0.05). In the observation group, the postreatment CD3⁺ and CD4⁺ were higher than those of the control group; CD8⁺ was lower than that of the control group with significant inter-group difference (P < 0.05). There were no significant differences on IgM, IgG, IgA, IgE and insulin-like growth factor 1 (IGF-1) before treatment in both groups (P > 0.05). The posttreatment IgG, IgA, IgM and IGF-1 were higher than those of the pretreatment; IgE was lower than that of the pretreatment with significant difference (P < 0.05). The posttreatment IgG, IgA, IgM and IGF-1 of the observation group were higher than those of the control group; IgE was lower than that of the control group with significant inter-group difference (P < 0.05). It was concluded that on the basis of conventional modern medicine treatment, the RDN injection combined with acupoint sticking can improve the clinical symptoms and pulmonary function, boost immune function in children with capillary bronchitis.