[1]李 焱,管 磊,袁道勇,等.滋肾润肺平喘汤治疗哮喘缓解期疗效及对儿童Th17/Treg影响研究[J].陕西中医,2021,(2):204-208.[doi:DOI:10.3969/j.issn.1000-7369.2020.02.017]
　LI Yan,GUAN Lei,YUAN Daoyong,et al.Effect of Zishen Runfei Pingchuan decoction on Th17/Treg and its clinical curative effect in children with asthma in remission stage[J].,2021,(2):204-208.[doi:DOI:10.3969/j.issn.1000-7369.2020.02.017]
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滋肾润肺平喘汤治疗哮喘缓解期疗效及对儿童Th17/Treg影响研究
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2021年2期
页码:
204-208
栏目:
临床研究
出版日期:
2021-02-05

文章信息/Info

Title:
Effect of Zishen Runfei Pingchuan decoction on Th17/Treg and its clinical curative effect in children with asthma in remission stage
作者:
李 焱1; 管 磊2; 袁道勇1; 于 静3
(1.荆州市第二人民医院儿科,湖北 荆州 434000; 2.荆州市第一人民医院儿科,湖北 荆州434100; 3.洛阳市中心医院儿科,河南 洛阳 471009)
Author(s):
LI Yan; GUAN Lei; YUAN Daoyong; YU Jing
(Department of Pediatrics,Second People's Hospital of Jingzhou,Jingzhou 434000,China)
关键词:
儿童哮喘;  缓解期;  滋肾润肺平喘汤;  辅助性T细胞17;  调节T细胞;  发作频率
Keywords:
Childhood asthma;  Remission;  Zishen Runfei Pingchuan decotion;  Helper T cells 17;  Regulatory T cells;  Frequency of attack
分类号:
R 725.6
DOI:
DOI:10.3969/j.issn.1000-7369.2020.02.017
文献标志码:
A
摘要:
目的:观察儿童哮喘缓解期口服滋肾润肺平喘汤对辅助性T细胞17/调节T细胞(Th17/Treg)及临床疗效的影响。方法:选取86例哮喘患儿纳入此项研究,按随机法划分为西药组与联合组,西药组给予布地奈德福莫特罗粉吸入治疗,联合组在西药组治疗的同时联合给予滋肾润肺平喘汤口服; 1个治疗后,评估全部患儿疗效,观察疗程前后中医症候积分、肺功能、Th17计数、Treg计数、Th17/Treg及白细胞介素-17(IL-17)、白细胞介素-10(IL-10)、转化生长因子-β(TGF-β)水平的变化; 统计治疗期间不良反应发生情况; 随访6个月,比较患儿哮喘发作频率的变化。结果:1个治疗后,两组患儿主症:喉中哮鸣音、气喘、畏寒肢冷,次症:咳嗽、咳痰、发育迟缓、面色苍白积分均较本组治疗前降低(均P<0.05),联合组均低于西药组(均P<0.05); 两组患儿FEV1、FEV1/FVC、PEF均较本组治疗前提高(均P<0.05),联合组均高于西药组(均P<0.05); 两组患儿Th17计数均有下降(P<0.05)、Treg计数均有升高(P<0.05)、Th17/Treg均较本组治疗前降低(P<0.05),联合组Th17计数高于西药组(P<0.05)、Treg计数与Th17/Treg均高于西药组(P<0.05); 两组患儿血清IL-17、TGF-β水平均较本组治疗前改善(均P<0.05),联合组均优于西药组(均P<0.05); 两组治疗期间均未见严重不良反应; 随访6个月,两组患儿哮喘发作频率与每次发作时间均较本组治疗前减少,联合组均少于西药组(均P<0.05)。结论:儿童哮喘口服滋肾润肺平喘汤可通过改善患儿Th17、Treg相关血清因子表达水平,发挥辅助调节Th17/Treg平衡,降低哮喘发作频率的作用。
Abstract:
Objective:To observe the effect of Zishen Runfei Pingchuan decoction on the T cells 17/ Regulatory T cells(Th17/Treg)and its clinical curative effect in children with asthma in remission stage.Methods:The objects of study were 86 children with asthma,and enrolled children were divided into western medicine group and combined group according to the randomization method.Children in western medicine group were given Budesonide and formoterol powder for inhalation,and those in the combined group were provided with Zishen Runfei Pingchuan decoction simultaneously on the basis of therapeutic approach in western medicine group.After 1 course of treatment,the curative effect of all the children was evaluated,and the changes of traditional Chinese medicine(TCM)syndrome score,lung function,Th17 count,Treg count,Th17/Treg and serum factors including interleukin-17(IL-17),interleukin-10(IL-10)and transforming growth factor-β(TGF-β)levels were observed before and after the treatment of all the children.Furthermore,the incidence of adverse reactions during treatment was counted.The children were followed up for 6 months to compare the frequency of asthma attacks.Results:After one course of treatment,the main symptoms of the children in the two groups were wheezing rales in the throat,asthma,chilly sensation and the cold limbs,while the secondary symptoms included cough,expectoration,growth retardation,pale complexion; all the above scores were lower than those before the course of treatment in the two groups(all P<0.05),and scores in the combined group were all lower than the western medicine group(all P<0.05).FEV1,FEV1/FVC and PEF of the two groups were all improved compared with those before treatment during intra-group comparison(all P<0.05),and those of the combined group were higher than those of the western medicine group(all P<0.05).Th17 count in both groups were decreased(all P<0.05)while Treg count increased(P<0.05)in both groups,and Th17/Treg count were both decreased(all P<0.05)compared with that before treatment during intra-group comparison.Furthermore,Th17 count in the combined group was higher than that in the western medicine group(P<0.05),while Treg count and Th17/Treg count were both higher than that in the western medicine group(all P<0.05).The serum levels of IL-17 and TGF-β within both groups were improved after treatment compared with those before treatment(all P<0.05),and the combined group was superior to the western medicine group(all P<0.05).No serious adverse reactions were observed during treatment in both groups.Follow-up for 6 months showed that the frequency and duration of asthma attacks in the two groups were both lower than that before the course of treatment during intra-group comparison,and the combined group was lower than that in the western medicine group(P<0.05).Conclusion:Zishen Runfei Pingchuan decoction can help to improve the expression levels of Th17 and Treg-related serum factors in children with asthma,which plays a role in assisting the regulation of Th17/Treg balance and reducing the frequency of asthma attacks.

参考文献/References:

[1] 王 宁,王立军,任筱郿,等.西安城区儿童哮喘患病特点调查研究[J].陕西医学杂志,2018,47(5):674-677.
[2] 蒋 俊,刘 挺.健脾化痰汤联合布地奈德治疗缓解期儿童哮喘的临床疗效及对炎症因子水平的影响[J].中华中医药学刊,2015,33(12):3056-3059.
[3] 吴 迪,杨勤军,李泽庚,等.基于数据挖掘的中医药治疗儿童哮喘缓解期的临床用药规律分析[J].时珍国医国药,2020,31(1):234-238.
[4] 姜小云,张丽珊.Th17/Treg平衡在儿童哮喘发病机制中的作用[J].中国卫生检验杂志,2019,29(12):1472-1474.
[5] 董 雷,胡 芳.防哮饮联合吸入用布地奈德治疗肺气虚证儿童哮喘缓解期的临床观察[J].中药材,2017,40(6):1461-1464.
[6] 樊 英,康淑红.抗喘利肺汤联合西药治疗小儿哮喘临床研究[J].陕西中医,2018,39(11):1602-1605.
[7] 何修宇,王海燕,熊光明,等.匹多莫德联合布地奈德雾化吸入对儿童急性哮喘伴肺炎的临床疗效及对血浆IL-17水平的影响[J].现代实用医学,2020,32(6):645-647.
[8] 邹昌文,胥亚福,蒋承勇.小青龙颗粒联合孟鲁司特钠治疗小儿支气管哮喘的临床研究[J].现代药物与临床,2019,34(7):2058-2063.
[9] 中华医学会儿科学分会呼吸学组.儿童支气管哮喘诊断与防治指南(2016年版)[J].中华儿科杂志,2016,54(3):167-181.
[10] 李艳艳.自拟平喘汤加减对肺脾两虚型支气管哮喘缓解期患儿症状改善及肺功能的影响[J].黑龙江中医药,2019,48(2):223-224.
[11] 贾 琳,李博林,魏莉瑛,等.固本通络方联合西药治疗缓解期儿童哮喘疗效及对免疫功能的影响[J].现代中西医结合杂志,2019,28(11):1150-1154.
[12] 刘树俊,王婷婷,曹世钰,等.中国儿童哮喘危险因素的Meta分析[J].中国当代儿科杂志,2018,20(3):218-223.
[13] 尉耘翠,贾露露,胡利华,等.儿童哮喘缓解期吸入性糖皮质激素用药依从性现况调查[J].中国医院药学杂志,2019,39(14):1494-1498.
[14] 甘 兵,张洪浩,邓应美,等.支气管哮喘急性发作期诱导痰中白介素-17变化临床研究[J].中国实用内科杂志,2018,38(2):157-159.
[15] 马 菁,纪文娜.玉屏风散合六君子汤加减辅助治疗小儿哮喘缓解期184例临床观察[J].中医儿科杂志,2018,14(2):32-35.
[16] 方艳丽,李 思,王建玲,等.平喘汤联合GINA阶梯方案治疗小儿支气管哮喘缓解期临床观察[J].新中医,2017,49(2):111-114.
[17] 苏丽娜,吴守业,李文琳,等.肺炎支原体感染对哮喘患儿病情急性发作影响的可能机制分析[J].中华医院感染学杂志,2019,29(23):3651-3654,3660.
[18] 周韶谷,刘玉玲,华凌云.中药补肾纳气平喘膏方治疗儿童支气管哮喘缓解期的临床研究[J].辽宁中医杂志,2015,42(6):1239-1240.
[19] 李红芬,毕玲莉,张茂华.小青龙汤联合糖皮质激素对支气管哮喘患儿气道重塑及相关炎症因子的影响[J].陕西中医,2019,40(5):631-633,654.

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备注/Memo

备注/Memo:
基金项目:河南省医学科技攻关项目(2013409834)
更新日期/Last Update: 2021-01-28