目的 探討參貝北瓜膏聯(lián)合丙酸氟替卡松治療小兒哮喘合并過敏性鼻炎的臨床療效及其對患兒血清炎性因子水平的動態(tài)變化的影響。方法 收集2014年1月-2015年1月在寶雞市婦幼保健院接受治療的小兒哮喘合并過敏性鼻炎患兒86例，隨機分為對照組和治療組，每組各43例。對照組患兒吸入丙酸氟替卡松吸入氣霧劑，50～100 μg/次，2次/d。治療組患兒在對照組的基礎(chǔ)上口服參貝北瓜膏，8 g/次，3次/d。兩組患兒均連續(xù)治療12周。觀察兩組患兒臨床療效，檢測兩組患兒呼氣峰流速值（PEF）、一秒用力呼氣容積（FEV₁）及呼氣高峰流量（PEFR）等肺功能指標(biāo)與血氧分壓（pO₂）、二氧化碳分壓（pCO₂）及pH值等血氣指標(biāo)，觀察兩組血清腫瘤壞死因子-α（TNF-α）、白細胞介素-4（IL-4）和超敏C反應(yīng)蛋白（hs-CRP）變化情況。結(jié)果 治療后，對照組和治療組的總有效率分別為83.7%、90.7%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患兒FEV₁、PEFR和PEF均顯著升高（P<0.05）；且治療后治療組FEV₁、PEFR和PEF均顯著高于對照組，差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患兒pO₂及pH值均較治療前明顯增加，pCO₂則明顯降低，差異具有統(tǒng)計學(xué)意義（P<0.05）；且治療組患兒上述血氣指標(biāo)改善程度均明顯優(yōu)于對照組（P<0.05）。治療后，對照組患者TNF-α、IL-4和hs-CRP水平從第3周開始顯著降低，治療組從第1周開始顯著降低，同組治療前后比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療組患者TNF-α、IL-4和hs-CRP顯著低于同期（除第10周）對照組水平，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 參貝北瓜膏聯(lián)合丙酸氟替卡松用于小兒哮喘合并過敏性鼻炎具有顯著的療效，可更快速的改善患兒炎癥情況。

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, 50-100 μg/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.