三桔咳喘口服液治疗哮喘急性发作期痰浊阻肺证的临床观察

目的:观察三桔咳喘口服液治疗哮喘急性发作期痰浊阻肺证的临床疗效及对肺功能和炎症因子的影响。方法:将117例患者按随机数字表法分为对照组57例和观察组60例。对照组采用布地奈德混悬液吸入剂,1~2 mg/次,2次/d,经雾化器给药;不能控制者,加用沙美特罗替卡松粉吸入剂,50~250μg/次,早晚各1吸。观察组在对照组治疗的基础上,口服三桔咳喘口服液,20 m L/次,3次/d。两组疗程均为连续治疗7 d。进行治疗前后哮喘急性发作时病情严重程度和痰浊阻肺证评分;记录1 s用力呼气容积(FEV1)和呼气流量峰值昼夜变异率(PEF);随访4周进行哮喘控制测试(ACT);记录治疗前后呼出气一氧化氮(Fe NO),外周血和痰液嗜酸粒细胞(Eos)百分比;检测治疗前后外周血白细胞介素-2(IL-2),IL-4,IL-5,IL-17和干扰素-γ(IFN-γ)水平。结果:观察组疗效好于对照组(Z=1.916,P<0.05);观察组哮喘急性发作时病情严重程度评分和痰浊阻肺证评分均低于对照组(P<0.01);观察组FEV1高于对照组(P<0.05),PEF低于对照组(P<0.05);观察组哮喘控制情况优于对照组(Z=2.231,P<0.01);观察组Fe NO,痰液Eos和外周血Eos水平均低于对照组(P<0.01);观察组IFN-γ和IL-2水平均高于对照组(P<0.01),IL-4,IL-5,IL-17水平均低于对照组(P<0.01)。结论:在常规西医治疗的基础上,加用三桔咳喘口服液可明显减轻哮喘急性发作期痰浊阻肺证患者病情严重程度,提高肺功能,控制哮喘发作,并可抑制气道炎症反应,临床疗效优于单纯布地奈德混悬液+沙美特罗替卡松粉治疗。

Clinical Efficacy of Sanju Kechuan Oral Liquid on Phlegm-turbid Obstruction of Lung Syndrome of Asthma at Acute Episode

Objective:To observe the clinical efficacy of Sanju Kechuan oral liquid on phlegm-turbid obstruction of lung syndrome of asthma at acute episode,in order to study its effect on pulmonary function and inflammatory factors.Method:One hundred and seventeen patients were randomly divided into control group(57 cases)and observation group(60 cases)by random number table.Patients in control group got budesonide suspension for inhalation by atomizer,1-2 mg/time,2 times/days.Patients who could not control were added with salmeterol xinafoate and fluticasone propionate powder for inhalation in every morning and evening,50-250μg/time.In addition to the therapy of control group,patients in observation group was added with Sanju Kechuan oral liquid,20 m L/time,3 times/days.The course of treatment was 7 days.And before and after treatment,the severity of asthma at acute episode and the phlegm-turbid obstruction of lung syndrome were scored.And 1-second forced expiratory volume(FEV1),diurnal variability of peak expiratory flow(PEF),fractional exhaled nitric oxide(Fe NO),peripheral blood,percentage of sputum eosinophils(Eos)were recorded,and levels of interleukin-2(IL-2),interferon-gamma(IFN-γ),IL-4,IL-5 and IL-17 were detected.Result:The clinical efficacy in observation group was better than that in control group(Z=1.916,P<0.05).Scores of severity of asthma at acute episode and phlegm-turbid obstruction of lung syndrome were lower than those in control group(P<0.01).And FEV1 was higher than that in control group(P<0.05),while PEF was lower than that in control group(P<0.05).Asthma control in observation group was better than that in control group(Z=2.231,P<0.01).And levels of Fe NO,Eos in sputum,Eos in peripheral blood,IL-4,IL-5 and IL-17 were lower than those in control group(P<0.01),whereas levels of IL-2 and IFN-γwere higher than those in control group(P<0.01).Conclusion:In addition to the therapy of routine western medicine,Sanju Kechuan oral liquid can alleviate the severity of phlegm-turbid obstruction of lung syndrome of asthma at acute episode,improve the lung function,control the attack of asthma and inhibit the airway inflammation,with a better the clinical efficacy than pure western medicine treatment.