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作者	单位
冯爱民	陕西中医药大学附属医院新生儿科陕西咸阳 712000
李晓娟	陕西中医药大学第二附属医院新生儿科陕西咸阳 712000
杨会侠	陕西中医药大学第二附属医院新生儿科陕西咸阳 712000
何平	陕西中医药大学第二附属医院新生儿科陕西咸阳 712000
谢秀春	陕西中医药大学第一附属医院儿科陕西咸阳 712000

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中文摘要:

摘要目的：研究布地奈德联合槐杞黄颗粒治疗小儿哮喘的临床疗效及对患儿血清白细胞三烯D4(LTD4)、神经生长因子(NGF)、基质金属蛋白酶抑制剂-1(TIMP-1)水平的影响。方法：选取2014年3月至2015年3月我院接诊的支气管哮喘患儿90例作为本次研究对象，按照随机数表法分为观察组和对照组。每组45例。两组患儿均在入院后给予支气管解痉剂、吸氧、抗生素、糖皮质激素等常规治疗，对照组患儿在此基础上采用雾化吸入布地奈德混悬液治疗，每次0.5 mg，加入3 mL生理盐水进行持续吸入，每天两次。观察组患儿在对照组的基础上加用槐杞黄颗粒治疗，每天两次。治疗12周后，观察和比较两组患儿的治疗疗效，喘憋、咳嗽、肺部湿罗音、肺部哮鸣音等临床症状消失时间，肺功能用力肺活量(FVC)、一秒用力呼气容积(FEV1)，血清LTD4、NGF、TIMP-1水平及T淋巴亚群CD3⁺、CD4⁺、CD8⁺。结果：治疗后，观察组总有效率显著高于对照组[93.33%(42/45)vs77.77%(35/45)](P＜0.05)；喘憋消失、咳嗽缓解、肺部湿罗音、肺部哮鸣音消失时间显著短于对照组[(4.32±1.03)d vs(6.08±1.24)d，(5.60±1.12)d vs(7.21±1.30)d，(3.19±0.98)d vs(4.98±1.02)d，(3.25±1.03)d vs(5.89±1.35)d](P＜0.05)；FEV1、FEV1/FVC显著高于对照组[(92.63±10.01)L/s vs(78.36±9.19)L/s，(95.37±11.72)%vs(80.19±10.23)%](P＜0.05)；血清LTD4、NGF、TIMP-1水平显著低于对照组[(7.24±0.86)ng/ml vs(12.68±1.01)ng/mL，(68.18±9.01)pg/mL vs(80.78±10.24)pg/mL，(34.16±5.06)ng/mL vs(49.76±5.47)ng/mL](P＜0.05)；CD3⁺、CD4⁺显著高于对照组[(66.15±7.20)% vs(62.03±6.85)%，(45.13±7.90)% vs(37.42±7.06)%](P＜0.05)，CD8⁺显著低于对照组[(34.16±5.06)% vs(49.76±5.47)%](P＜0.05)。结论：布地奈德联合槐杞黄颗粒治疗小儿哮喘的疗效显著，能够增强患儿的免疫功能，改善肺功能，降低血清LTD4、NGF、TIMP-1的水平。

英文摘要:

ABSTRACT Objective: To study the curative efficacy of budesonide combined with huaiqihuang granules in the treatment of chil- dren with asthma and its effects on the serum leukotriene D4(LTD4), nerve growth factor (NGF), tissue inhibitor of metalloproteinase-1(TIMP-1) levels. Methods: 90 cases of children with asthma who were treated from March 2014 to March 2015 in our hospital were se- lected and divided into the observation group (n=45) and the control group (n=45) according to the random number table. Both groups of children were given bronchial antispasmodic agent, oxygen, antibiotics, glucocorticoid and other conventional treatment after admission, the control group was given budesonide atomization inhalation treatment on the basis of conventional treatment, 0.5 mg budesonide were add in 3ml saline for continuous inhalation, twice a day, while the observation group was treated with Huaiqihuang Granules on the basis of the control group, twice a day. After 12 weeks of treatment, the curative effect, disappearance time of wheezing, cough relief, pul- monary rales, wheezing and other symptoms, forced vital capacity(FVC), serum LTD4, NGF, TIMP-1 levels, CD3⁺, CD4⁺, CD8⁺ of both groups were compared. Results: After treatment, the total effective rate of observation group was significantly higher than that of the con- trol group[93.33%(42/45) vs 77.77%(35/45)](P＜0.05); disappearance time of breath, cough, moist rales and wheezes were significantly shorter than those of the control group[(4.32±1.03)d vs (6.08±1.24)d,(5.60±1.12)d vs (7.21±1.30)d，(3.19±0.98)d vs (4.98±1.02)d，(3.25±1.03)d vs (5.89±1.35)d](P＜0.05); the FEV1, FEV1/FVC were significantly higher than those of the control group[(92.63±10.01)L/s vs (78.36±9.19)L/s, (95.37±11.72)% vs (80.19±10.23)%](P＜0.05); the serum LTD4, NGF, TIMP-1 levels were significantly lower than those of the control group[(7.24±0.86)ng/mL vs (12.68±1.01vng/mL, (68.18±9.01)pg/mL vs(80.78±10.24)pg/mL, (34.16±5.06)ng/mL vs(49.76±5.47)ng/mL] (P＜0.05); the CD3⁺, CD4⁺ were significantly higher than those of the control group[(66.15±7.20)% vs (62.03±6.85)%, (45.13±7.90)% vs (37.42±7.06)%], CD8⁺ was significantly lower than that of the control group[(34.16±5.06)% vs (49.76±5.47)%] (P＜0.05). Conclusion: Budesonide combined with Huaiqihuang granules was effective for children with asthma, which could enhance the immune function, improve the lung function, reduce the serum levels of LTD4, NGF, TIMP-1.

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