[1]项刘婷,庄承.麻龙止咳方治疗小儿咳嗽变异性哮喘疗效及对患儿气道功能、外周血树突状细胞mDCs和pDCs水平的影响[J].陕西中医,2025,46(9):1209-1213.[doi:DOI:10.3969/j.issn.1000-7369.2025.09.011]
 XIANG Liuting,ZHUANG Cheng.Effect of Malong Zhike formula on children with cough variant asthma and its influence on airway function and the levels of mDCs and pDCs in peripheral blood dendritic cells[J].,2025,46(9):1209-1213.[doi:DOI:10.3969/j.issn.1000-7369.2025.09.011]
点击复制

麻龙止咳方治疗小儿咳嗽变异性哮喘疗效及对患儿气道功能、外周血树突状细胞mDCs和pDCs水平的影响

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年9期
页码:
1209-1213
栏目:
临床研究
出版日期:
2025-09-05

文章信息/Info

Title:
Effect of Malong Zhike formula on children with cough variant asthma and its influence on airway function and the levels of mDCs and pDCs in peripheral blood dendritic cells
作者:
项刘婷庄承
(上海中医药大学附属第七人民医院儿科,上海 200137)
Author(s):
XIANG LiutingZHUANG Cheng
(Department of Paediatrics,The Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China)
关键词:
小儿咳嗽变异性哮喘麻龙止咳方气道功能外周血髓样树突状细胞浆细胞样树突状细胞
Keywords:
Pediatric cough variant asthmaMalong Zhike formulaAirway functionMyeloid dendritic cellsPlasmacytoid dendritic cells
分类号:
R 725.6
DOI:
DOI:10.3969/j.issn.1000-7369.2025.09.011
文献标志码:
A
摘要:
目的:探讨麻龙止咳方治疗对小儿咳嗽变异性哮喘(CVA)患儿的治疗效果,并分析其对气道功能、外周血髓样树突状细胞(mDCs)和浆细胞样树突状细胞(pDCs)水平的影响。方法:将152例咳嗽变异性哮喘患儿为观察对象,以随机数字表法将其分为对照组(孟鲁司特钠治疗,n=76)和观察组(孟鲁司特钠治疗+麻龙止咳方,n=76)。比较两组临床疗效、症状评分(日间、夜间)、中医证候评分、小气道功能指标[最大呼气中段流量(MMEF)、50%用力肺活量呼气流速(FEF50%)和75%用力肺活量呼气流速(FEF75%)]及外周血树突状细胞mDCs和pDCs水平差异,并统计不良反应发生率。结果:观察组治疗有效率高于对照组(96.05%与 84.21%)(P<0.05),不良反应总发生率低于对照组(5.26%与9.21%),但组间比较,差异无统计学意义(P>0.05)。与对照组比较,观察组治疗后日间症状、夜间症状及中医证候评分更低(P<0.05),MMEF、FEF50%和FEF75%较高(P<0.05)。两组治疗前及治疗后1周、2周、3周、4周外周血mDCs比例比较,差异均无统计学意义(P>0.05)。两组治疗后外周血pDCs比例均较治疗前持续降低,其中观察组治疗后2周、3周及4周的外周血pDCs比例更低(P<0.05)。与治疗前比较,两组治疗后2周、3周及4周的mDCs/pDCs比值均明显升高,其中观察组高于对照组(P<0.05)。结论:麻龙止咳方治疗CVA患儿具有确切的临床疗效,能显著改善气道功能,调节外周血树突状细胞亚群比例,值得临床应用。
Abstract:
Objective:To investigate the therapeutic effects of Malong Zhike formula on children with cough variant asthma (CVA) and analyze its impact on airway function,as well as the levels of myeloid dendritic cells (mDCs) and plasmacytoid dendritic cells (pDCs) in peripheral blood.Methods:A total of 152 children with CVA were selected as the study subjects.They were randomly divided into a control group (Montelukast Sodium treatment,n=76) and an observation group (Montelukast Sodium treatment + Malong Zhike formula,n=76).The clinical efficacy,symptom scores (daytime,nighttime),TCM syndrome scores,small airway function indicators [maximum mid-expiratory flow (MMEF),forced expiratory flow at 50% of vital capacity (FEF50%),and forced expiratory flow at 75% of vital capacity (FEF75%)],and the levels of mDCs and pDCs in peripheral blood were compared between the two groups.The incidence of adverse reactions was also recorded.Results:The treatment efficacy in the observation group was higher than that in the control group (96.05% vs.84.21%)(P<0.05),and the total incidence of adverse reactions was lower in the observation group (5.26% vs.9.21%),although the difference was not statistically significant (P>0.05).Compared to the control group,the observation group had lower daytime and nighttime symptom scores and TCM syndrome scores after treatment (P<0.05),and higher MMEF,FEF50%,and FEF75% values (P<0.05).There were no significant differences in the proportion of mDCs in peripheral blood before treatment and at 1,2,3,and 4 weeks after treatment between the two groups (P>0.05).The proportion of pDCs in peripheral blood decreased continuously after treatment in both groups,with the observation group showing lower pDCs proportions at 2,3,and 4 weeks after treatment (P<0.05).Compared to before treatment,the mDCs/pDCs ratio increased significantly at 2,3,and 4 weeks after treatment in both groups,with the observation group having a higher ratio than the control group (P<0.05).Conclusion:Malong Zhike formula has definite clinical effect in treating CVA children,which can significantly improve airway function and adjust the proportion of dendritic cell subsets in peripheral blood,and is worthy of clinical reference.

参考文献/References:

[1]DIAB N,PATEL M,O’BYRNE P,et al.Narrative review of the mechanisms and treatment of cough in asthma,cough variant asthma,and non-asthmatic eosinophilic bronchitis[J].Lung,2022,200(6):707-716.
[2]王雪红,张延峰,陈丹,等.LXA4、SAA、ECP水平预测咳嗽变异性哮喘患儿预后的价值[J].保健医学研究与实践,2024,21(6):80-84.
[3]CORTESELLI E,ALEXIS N.Cough-variant asthma:The asthma phenotype no one coughs about[J].Am J Respir Cell Mol Biol,2025,72(3):231-232.
[4]张莉婷.儿童咳嗽变异性哮喘发病因素及中医体质分布特点研究[D].上海:上海中医药大学,2021.
[5]HU Y,ZHENG S,CHEN Z,et al.Validity of fractional exhaled nitric oxide and small airway lung function measured by IOS in the diagnosis of cough variant asthma in preschool children with chronic cough[J].Allergy Asthma Clin Immunol,2023,19(1):83.
[6]WEN L,ZHANG T,CHEN F,et al.Modified Dingchuan decoction treats cough-variant asthma by suppressing lung inflammation and regulating the lung microbiota[J].J Ethnopharmacol,2023,306:116171.
[7]ZHENG J,ZHANG R,LIU C,et al.The TLR4/NF-κB signaling pathway-mediated type 2 skewing of T helper cell in cough variant asthma was counteracted by ethanol extract of Anacyclus pyrethrum root[J].Immunobiology,2023,228(3):152379.
[8]赵淑萍.穴位敷贴联合宣肺平嗽汤治疗小儿咳嗽变异性哮喘风邪犯肺证的效果及对患者炎症因子、免疫功能的影响[J].陕西中医,2019,40(7):954-956.
[9]岳永琴,宋文萍.布地奈德混悬液雾化及万托林雾化吸入治疗小儿咳嗽变异性哮喘临床研究[J].陕西医学杂志,2017,46(12):1763-1764.
[10]陈华侨,王宝珍.射干麻黄汤治疗小儿咳嗽变异性哮喘的疗效及对血清IgE、IL-4、TNF-α水平的影响[J].陕西中医,2017,38(10):1358-1360.
[11]中华医学会.支气管哮喘基层诊疗指南(实践版·2018)[J].中华全科医师杂志,2018,17(10):763-769.
[12]冯晓纯,段晓征,孙丽平,等.中医儿科临床诊疗指南·小儿咳嗽变异性哮喘(制订)[J].中医儿科杂志,2016,12(5):4.
[13]国家食品药品监督管理局.中药新药临床研究指导原则:试行[M].北京:中国医药科技出版社,2002:112-114.
[14]王杨,张琳,刘铭泽,等.经方辨治小儿咳嗽变异性哮喘研究进展[J].中医学报,2024,39(10):2133-2138.
[15]李红,陈常青,李艳英,等.疏风止咳汤联合糖皮质激素治疗咳嗽变异性哮喘疗效研究[J].陕西中医,2023,44(3):312-315.
[16]丁子超,任献青,苏杭,等.基于《素问·咳论》与子午流注理论辨治小儿咳嗽[J].中医学报,2023,38(10):2075-2079.
[17]刘圣康,崔红生,王成鑫,等.从风与湿论治咳嗽变异性哮喘[J].环球中医药,2020,13(4):663-665.
[18]董高威,刘建秋.刘建秋教授六经辨治咳嗽变异性哮喘[J].长春中医药大学学报,2017,33(5):738-740.
[19]范慧慧,任玉梅,田新磊,等.麻黄碱调控TGF-β1/Smads通路对支气管哮喘小鼠气道重塑的影响[J].安徽医科大学学报,2024,59(8):1398-1404.
[20]韩兆鹏,薛征.从瘀论述蚓激酶疗效的研究进展[J].世界中医药,2022,17(10):1481-1484.
[21]吴旖,江仁望,赵斌.百部新碱与罗汉果皂苷Ⅴ联用对小鼠的镇咳、祛痰作用研究[J].中国药房,2017,28(13):1755-1757.
[22]税丕先,孙琴,庄元春,等.HPLC测定止嗽定喘片中苦杏仁苷的含量[J].中成药,2007,29(12):1870-1872.
[23]张琪,陈忻.黄芩苷的药动学研究进展[J].中南药学,2011,9(3):209-212.
[24]赵莹莹,阎力君.秦皮药理作用研究进展[J].特产研究,2022,44(1):98-103.
[25]陶钧宇,袁晓云.孟鲁司特钠联合小儿咳喘灵颗粒对咳嗽变异性哮喘患儿外周血mDCs和pDCs及疗效的影响[J].贵州医科大学学报,2023,48(1):119-124.
[26]许诺,高明利.莱菔及莱菔子的药理作用及临床应用研究进展[J].辽宁中医药大学学报,2024,26(7):60-67.
[27]李燕华,李仲昆,李丛元,等.车前草粗多糖对人巨噬细胞免疫功能的调节作用及其机制研究[J].中药材,2020,43(11):2795-2798.

备注/Memo

备注/Memo:
上海市卫生健康委员会临床研究专项课题(20224Y0297);上海市浦东新区卫生健康委员会重点亚专科中医小儿哮喘专科(PWZY2020-10);上海市浦东新区卫生健康委员会医学人才培养项目(PWRQ2023-46)
更新日期/Last Update: 2025-09-08