射干麻黄汤联合布地奈德在毛细支气管炎患儿中的应用

目的 探究射干麻黄汤联合布地奈德、异丙托溴雾化吸入治疗对毛细支气管炎患者的肺功能、免疫功能及Th1/Th2细胞平衡的影响。方法 选取2020年3月至2022年3月于温州市中西医结合医院就诊的毛细支气管炎患儿90例，采用随机数字表法将其分为观察组（n=45）及对照组（n=45）。对照组给予布地奈德联合异丙托溴雾化吸入治疗，观察组在对照组的基础上加用射干麻黄汤治疗。观察两组患儿的总有效率、不良反应发生情况；比较干预前后患儿的呼吸频率（respiratory rate，RR）、呼吸时间比（inspiratory to expiratory ratio，Ti/Te）、潮气量（tidal volume，VT）、T淋巴细胞亚群水平（CD4+、CD8+）、Th1、Th2。结果 观察组患儿的总有效率（95.56%）显著高于对照组患儿（82.22%），总不良反应率（6.67%）显著低于对照组（24.44%），差异有统计学意义（P<0.05）。干预后，两组患儿的Th1水平、VT、CD4+水平较治疗前增高，Ti/Te、RR、CD8+、Th2水平较治疗前明显下降，与对照组相比，观察组患儿上述指标改善幅度更大，差异有统计学意义（P<0.05）。结论 射干麻黄汤联合布地奈德、异丙托溴雾化吸入治疗，对毛细支气管炎具有确切疗效，可明显改善患儿的肺功能，提高免疫功能，可促进Th1/Th2细胞平衡，不良反应少，临床安全有效。

Application of shegan mahuang decoction combined with budesonide in children with capillary bronchitis

Objective To investigate the effects of shegan mahuang decoction combined with budesonide and ipratropium bromide by nebulised inhalation therapy on lung function, immune function and Th1/Th2 cell balance in patients with capillary bronchitis. Methods A total of 90 children with capillary bronchiolitis treated in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from March 2020 to March 2022 were selected and divided into the observation group and the control group according to the random number table method, with 45 cases in each group. The control group was given budesonide combined with ipratropium bromide by nebulised inhalation treatment, and the observation group was treated with shegan mahuang decoction on the basis of the control group. Observe the total response rate and adverse effects of the two groups and compared the respiratory rate (RR), breathing time ratio (Ti/Te), tidal volume (VT), T lymphocyte subset levels (CD4+, CD8+), Th1, Th2 before and after the intervention. Results The total response rate (95.56%) was significantly higher than that in the control group (82.22%), the total adverse response rate (6.67%) was significantly lower than that in the control group (24.44%) (P<0.05). After the prognosis, the children in both groups showed an increase in Th1 level, VT and CD4+ level, and a significant decrease in Ti/Te, RR, CD8+ and Th2 level compared to the pre-treatment period, and the children in the observation group showed a greater improvement in the above indicators compared to the control group, and the differences were statistically significant (P<0.05).Conclusion The combination of shegan mahuang decoction with budesonide and ipratropium bromide by nebulised inhalation therapy has definite efficacy in capillary bronchitis, can significantly improve the lung function of children, enhance immune function, can promote Th1/Th2 cell balance, has few adverse effects, and is clinically safe and effective.