参贝北瓜膏联合丙酸氟替卡松治疗小儿哮喘合并过敏性鼻炎的临床研究

目的探讨参贝北瓜膏联合丙酸氟替卡松治疗小儿哮喘合并过敏性鼻炎的临床疗效及其对患儿血清炎性因子水平的动态变化的影响。方法收集2014年1月—2015年1月在宝鸡市妇幼保健院接受治疗的小儿哮喘合并过敏性鼻炎患儿86例,随机分为对照组和治疗组,每组各43例。对照组患儿吸入丙酸氟替卡松吸入气雾剂,50~100μg/次,2次/d。治疗组患儿在对照组的基础上口服参贝北瓜膏,8 g/次,3次/d。两组患儿均连续治疗12周。观察两组患儿临床疗效,检测两组患儿呼气峰流速值(PEF)、一秒用力呼气容积(FEV1)及呼气高峰流量(PEFR)等肺功能指标与血氧分压(p O2)、二氧化碳分压(p CO2)及p H值等血气指标,观察两组血清肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)和超敏C反应蛋白(hs-CRP)变化情况。结果治疗后,对照组和治疗组的总有效率分别为83.7%、90.7%,两组比较差异有统计学意义(P0.05)。治疗后,两组患儿FEV1、PEFR和PEF均显著升高(P0.05);且治疗后治疗组FEV1、PEFR和PEF均显著高于对照组,差异具有统计学意义(P0.05)。治疗后,两组患儿p O2及p H值均较治疗前明显增加,p CO2则明显降低,差异具有统计学意义(P0.05);且治疗组患儿上述血气指标改善程度均明显优于对照组(P0.05)。治疗后,对照组患者TNF-α、IL-4和hs-CRP水平从第3周开始显著降低,治疗组从第1周开始显著降低,同组治疗前后比较差异具有统计学意义(P0.05)。治疗组患者TNF-α、IL-4和hs-CRP显著低于同期(除第10周)对照组水平,两组比较差异有统计学意义(P0.05)。结论参贝北瓜膏联合丙酸氟替卡松用于小儿哮喘合并过敏性鼻炎具有显著的疗效,可更快速的改善患儿炎症情况。

Clinical study on Shenbei Beigua Liquidum combined with fluticasone propionate in treatment of childhood bronchial asthma with allegic rhinitis

Objective To explore clinical curative effect of Shenbei Beigua Liquidum combined with fluticasone propionate in treatment of childhood bronchial asthma with allegic rhinitis and its effect on the dynamic changes of serum inflammatory factors levels. Methods Children (86 cases) with childhood bronchial asthma with allegic rhinitis in Baoji Maternal and Child Health Hospital from January 2014 to January 2015 were randomly divided into control and treatment groups, and each group had 43 cases. Children in the control group were inhalation administered with Fluticasone Propionate Inhaled Aerosol, 50 — 100μg/time, twice daily. On the basis of control group, children in the treatment group were po administered with Shenbei Beigua Liquidum, 8 g/time, three times daily. Two groups were treated for 12 weeks. After treatment, the efficacy was evaluated, lung function indexes of PEF, FEV1, PEFR and blood gas indexes of pO2, pCO2, pH in two groups were detected, and the changes of TNF-α, IL-4, and hs-CRP between two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 83.7%and 90.7%, respectively, and there were differences between two groups (P < 0.05). After treatment, FEV1, PEFR, and PEF in two groups were significantly increased (P<0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, pO2 and pH in two groups were obviously increased, and pCO2 was decreased, and the difference was statistically significant in the same group (P<0.05). And these blood gas indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, TNF-α,IL-4, and hs-CRP in the control group were obviously decreased since the third week, and these in the treatment group significantly reduced since the first week, and the difference was statistically significant in the same group (P < 0.05). And TNF-α, IL-4, and hs-CRP in the treatment group were significantly lower than those in the control group in the same time of the treatment (except the tenth week), and there were differences between two groups (P < 0.05). Conclusion Shenbei Beigua Liquidum combined with fluticasone propionate has a perfect clinical effect in treatment of childhood bronchial asthma with allegic rhinitis, and can rapidly improve inflammation.