目的 探討玉屏風(fēng)顆粒聯(lián)合硫酸沙丁胺醇治療小兒支氣管哮喘的臨床療效。方法 選取2014年8月—2015年8月錦州市中心醫(yī)院收治的小兒支氣管哮喘患者82例,依據(jù)不同的治療方法分成治療組和對(duì)照組,每組各41例。所有患者均給予止咳、化痰及抗感染等常規(guī)治療。對(duì)照組在此基礎(chǔ)上霧化吸入吸入用硫酸沙丁胺醇溶液0.5 mL,用0.9%生理鹽水稀釋到2.5 mL,3~5min/次,3次/d。治療組在對(duì)照組用藥基礎(chǔ)上口服玉屏風(fēng)顆粒,1袋/次,3次/d。兩組患者均連續(xù)治療2周。比較兩組臨床療效、肺功能變化、動(dòng)脈血?dú)庵笜?biāo)、臨床癥狀及體征消失時(shí)間以及腫瘤壞死因子α(TNF-α)、白介素-6(IL-6)和免疫球蛋白E(IgE)表達(dá)水平。結(jié)果 治療后,對(duì)照組和治療組總有效率分別為75.61%和92.68%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組一秒用力呼氣容積(FEV1)、最大呼氣流量(PEF)均較同組治療前顯著升高,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療后,治療組這些觀察指標(biāo)顯著高于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組氧分壓(PO₂)、血氧飽和度(SpO₂)和二氧化碳分壓(PCO₂)均好于同組治療前,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療后,治療組這些觀察指標(biāo)顯著高于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,治療組患兒咳嗽、喘憋和肺部哮鳴音的消失時(shí)間少于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組TNF-α、IL-6和IgE表達(dá)水平均降低,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療后,治療組這些觀察指標(biāo)顯著低于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 玉屏風(fēng)顆粒聯(lián)合硫酸沙丁胺醇治療小兒支氣管哮喘具有較好的臨床療效,可以明顯改善患兒肺功能,抑制炎性因子表達(dá),具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To observe the clinical effect of clinical study on Yupingfeng Granules combined with salbutamol sulfate in treatment of children with bronchial asthma. Methods Children (82 cases) with bronchial asthma in Center Hospital of Jinzhou from August 2014 to August 2015 divided into control and treatment groups based on different treatment method, and each group had 41 cases. All patients were treated with conventional treatments including antitussive, expectorant, anti-infective treatment. Patients in control group were aerosol inhalation administered with Salbutamol Sulfate Solution for inhalation diluted to 2.5 mL with 0.9% normal saline on the basis of conventional treatment, 3—5 min/time, 3 time/d. Patients in treatment group were po administered with Yupingfeng Granules on the basis of control group, 1 bag/time, 3 time/d. The patients in two groups were treated for 2 week. After treatment, the efficacy was evaluated, and pulmonary function changes, arterial blood gas indexs, disappeared time of clinical symptoms and signs, tumor necrosis factor α (TNF-α), interleukin-6 (IL-6) and immunoglobulin E (IgE) in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 75.61% and 92.68%, respectively, and there were differences between two groups (P< 0.05). After treatment, forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) in two groups were significantly increased, and the difference was statistically significant in the same group (P< 0.05). After treatment, 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, partial pressure of oxygen (PO₂), oxygen saturation (SpO₂) and partial pressure of carbon dioxide (PCO₂) in two groups were significantly improved, and the difference was statistically significant in the same group (P< 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P< 0.05). After treatment, disappeared time of cough, shortness of breath and wheezing of children in treatment group were lower than those in the control group, with significant difference between two groups (P< 0.05). After treatment, IL-6, TNF-α and IgE in two groups were significantly increased, and the difference was statistically significant in the same group (P< 0.05). After treatment, the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P< 0.05). Conclusion Yupingfeng Granules combined with salbutamol sulfate has clinical curative effect in the treatment of children with bronchial asthma, and can significantly improve lung function of children, inhibit the expression of inflammatory factors, which has a certain clinical application value.