Article(id=1322923563799421182, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.05.010, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339156341, onlineDateStr=2026-10-30, pubDate=1746806400000, pubDateStr=2025-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339156341, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339156341, creator=13701087609, updateTime=1793339156341, updator=13701087609, issue=Issue{id=1322923490592043032, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='5', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1746806400000', pubDateStr='2025-05-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339138887, creator='13701087609', updateTime=1793340572227, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929502539612595, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929502539612596, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=44, endPage=47, ext={EN=ArticleExt(id=1322923564025913599, articleId=1322923563799421182, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Effect of Huaiqihuang Granule(槐杞黄颗粒)Combined with Xiaoqinglong Decoction(小青龙汤)on Immune Function and Prognosis of Qi Deficiency of Lung and Spleen Syndrome in Remission Stage of Asthma, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the effect of Huaiqihuang Granule(槐杞黄颗粒)combined with Xiaoqinglong Decoction(小青龙汤)on immune function and prognosis of children with Qideficiency of lung and spleen syndrome in remission stage of asthma.

Methods

One hundred and six children with asthmawith deficiency of lung and spleen in remission stage admitted to the hospital from January 2021 to June 2022 were random ly divided into the combined group(53 cases)and the control group(53 cases). Both groupswere given long-term asthma control drugs and Huaiqihuang Granule and the combined group added Xiaoqinglong Decoction for onemonth. The changes of humoral immunity,inflammatory factors,lung function,Chinese version of children asthma control questionnaire(Ch-CACT),TCM syndrome score and other indicators before and after treatmentwere compared between the two groups,and the clinical efficacy of the two groupswas compared.

Results

After onemonth of treatment,the levels of immunoglobulin A(IgA),immunoglobulin G(IgG)and immunoglobulin M(IgM)in both groupswere higher than those before treatment,while immunoglobulin E(IgE)was lower than that before treatment. After onemonth's treatment,the levels of IgA,IgG and IgM in the combined group were higher than those in the control group,and the IgE was lower than that in the control group(P<0.05). After onemonth of treatment,the levels of interferon-γ(IFN-γ)increased and the level sof eosinophil(EOS)and interleukin-4(IL-4)decreased in both groups. The level of IFN-γin the combined group was higher than that in the control group,and the levels of EOS and IL-4 were lower than those in the control group(P<0.05). The values of forced expiratory volume in one second(FEV1%)and peak expiratory flow(PEF)in both groups increased after onemonth of treatment. And the values of FEV1% and PEF in the combined group were higher than those in the control group(P<0.05). After onemonth of treatment,the Ch-CACT scores of the two groupswere higher than those before treatment,and the TCM syndrome scoreswere lower than those before treatment. The Ch-CACT score of the combined group was higher than that of the control group,and the TCM syndrome scorewas lower than thatof the control group(P<0.05). After onemonth of treatment,the total effective rate of the combined group was 88.68%(47/53),which was higher than that of the control group(71.70%,38/53)(P<0.05).

Conclusion

On the basis of routine westernmedicine treatment of Huaiqihuang Granule,Modified Xiaoqinglong Decoction is helpful to improve the immune function,inflammatory factors and lung function of children with asthmawith Qideficiency of lung and spleen in remission stage,thus alleviating clinical symptoms,improving clinical efficacy and the quality of prognosis of children.

, authors=Yanchun QU, Guichang LIU, authorsList=Yanchun QU, Guichang LIU, authorCompany=null, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322923565842047248, articleId=1322923563799421182, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=槐杞黄颗粒联合小青龙汤对哮喘缓解期肺脾气虚证患儿免疫功能及预后的影响分析, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

分析槐杞黄颗粒联合小青龙汤对哮喘缓解期肺脾气虚证患儿免疫功能及预后的影响。

方法

纳入2021年1月—2022年6月收治的106例缓解期肺脾气虚证哮喘患儿,使用简单随机法分别纳入联合组和对照组各53例,两组均给予哮喘长期控制药物及槐杞黄颗粒,联合组加用小青龙汤加减,持续1个月。对比两组患儿治疗前后体液免疫、炎性因子、肺功能、中文版儿童哮喘控制测试问卷(Chinese-childhood asthma control test,Ch-CACT)、中医证候积分等指标变化,并比较两组临床疗效。

结果

两组治疗1个月后免疫球蛋白A(Immunoglobulin A,IgA)、免疫球蛋白G(Immunoglobulin G,IgG)、免疫球蛋白M(Immunoglobulin M,IgM)均较治疗前升高,免疫球蛋白E(Immunoglobulin E,IgE)均较治疗前下降;联合组治疗1个月后IgA、IgG、IgM均高于对照组,其IgE低于对照组(P<0.05)。两组治疗1个月后干扰素-γ(Interferon-γ,IFN-γ)均较治疗前升高,嗜酸性粒细胞计数(Eosinophil,EOS)、白细胞介素-4(Interleukin-4,IL-4)均较治疗前下降;联合组治疗1个月后IFN-γ高于对照组,其EOS、IL-4低于对照组(P<0.05)。两组治疗1个月后第1 s用力呼气容积(Forced expiratory volume in one second,FEV1)%、呼气流量峰值(Peak expiratory flow,PEF)均较治疗前升高;联合组治疗1个月后FEV1%、PEF均高于对照组(P<0.05)。两组治疗1个月后Ch-CACT评分均较治疗前升高,中医证候积分均较治疗前下降;联合组治疗1个月后Ch-CACT评分高于对照组,其中医证候积分低于对照组(P<0.05)。治疗1个月后,联合组总有效率为88.68%(47/53),较对照组的71.70%(38/53)更高(P<0.05)。

结论

在常规西医治疗及槐杞黄颗粒的基础上,给予小青龙汤加减有助于缓解期肺脾气虚证哮喘患儿免疫功能、炎性因子及肺功能的改善,从而缓解临床症状,提高临床疗效,有助于患儿预后生活质量的提高。

, authors=曲艳春, 刘贵昌, authorsList=曲艳春, 刘贵昌, authorCompany=null, correspAuthors=null, authorNote=

曲艳春(1976-),女,山西忻州人,副主任药师,研究方向:药理。

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曲艳春(1976-),女,山西忻州人,副主任药师,研究方向:药理。

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曲艳春(1976-),女,山西忻州人,副主任药师,研究方向:药理。

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awardId=2019ZX6922, language=CN, fundingSource=国家中医药管理局中医药科学技术研究专项(2019ZX6922), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1322923566072733969, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923563799421182, xref=null, ext=[AuthorCompanyExt(id=1322923566081122578, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923563799421182, companyId=1322923566072733969, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Shanxi Children's Hospital,Taiyuan 030013,Shanxi,China), AuthorCompanyExt(id=1322923566093705491, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923563799421182, companyId=1322923566072733969, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=山西省儿童医院,山西 太原 030013)])], figs=[ArticleFig(id=1322923569759527210, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923563799421182, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数年龄/(岁,±s)病程/(年,±s)性别/[例(%)]过敏性疾病史/[例(%)]
男女湿疹过敏性鼻炎
联合组538.25±1.441.71±0.3636(67.92)17(32.08)39(73.58)24(45.28)
对照组538.36±1.511.65±0.2832(60.38)21(39.62)37(69.81)27(50.94)
t/χ2值0.3840.9580.6560.1860.340
P值0.7020.3400.4180.6660.560
), ArticleFig(id=1322923569835024683, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923563799421182, language=CN, label=表1, caption=

两组缓解期肺脾气虚证哮喘患儿一般临床资料比较(±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数年龄/(岁,±s)病程/(年,±s)性别/[例(%)]过敏性疾病史/[例(%)]
男女湿疹过敏性鼻炎
联合组538.25±1.441.71±0.3636(67.92)17(32.08)39(73.58)24(45.28)
对照组538.36±1.511.65±0.2832(60.38)21(39.62)37(69.81)27(50.94)
t/χ2值0.3840.9580.6560.1860.340
P值0.7020.3400.4180.6660.560
), ArticleFig(id=1322923569923105068, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923563799421182, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时期IgA/(g/L)IgG/(g/L)IgM/(g/L)IgE/(U/mL)
联合组53治疗前1.46±0.155.63±0.591.29±0.11297.54±37.85
治疗1个月后1.81±0.26*6.75±0.64*1.53±0.19*122.08±16.97*
对照组53治疗前1.45±0.175.68±0.541.27±0.13291.87±36.95
治疗1个月后1.67±0.22*#6.29±0.60*#1.42±0.15*#154.59±15.25*#
), ArticleFig(id=1322923569990213933, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923563799421182, language=CN, label=表2, caption=

两组缓解期肺脾气虚证哮喘患儿体液免疫指标变化比较(±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时期IgA/(g/L)IgG/(g/L)IgM/(g/L)IgE/(U/mL)
联合组53治疗前1.46±0.155.63±0.591.29±0.11297.54±37.85
治疗1个月后1.81±0.26*6.75±0.64*1.53±0.19*122.08±16.97*
对照组53治疗前1.45±0.175.68±0.541.27±0.13291.87±36.95
治疗1个月后1.67±0.22*#6.29±0.60*#1.42±0.15*#154.59±15.25*#
), ArticleFig(id=1322923570065711406, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923563799421182, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时期EOS/(×109/L)IFN-γ/(ng/L)IL-4/(ng/L)
联合组53治疗前1.07±0.1196.25±7.91226.81±14.29
治疗1个月后0.52±0.08*122.54±15.36*180.83±12.16*
对照组53治疗前1.10±0.1295.98±7.74227.09±14.37
治疗1个月后0.69±0.10*#110.83±14.25*#191.65±12.44*#
), ArticleFig(id=1322923570153791791, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923563799421182, language=CN, label=表3, caption=

两组缓解期肺脾气虚证哮喘患儿炎性因子变化比较(±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时期EOS/(×109/L)IFN-γ/(ng/L)IL-4/(ng/L)
联合组53治疗前1.07±0.1196.25±7.91226.81±14.29
治疗1个月后0.52±0.08*122.54±15.36*180.83±12.16*
对照组53治疗前1.10±0.1295.98±7.74227.09±14.37
治疗1个月后0.69±0.10*#110.83±14.25*#191.65±12.44*#
), ArticleFig(id=1322923570225094960, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923563799421182, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时期FEV1%/(%)PEF/(L/s)
联合组53治疗前74.29±10.156.25±0.37
治疗1个月后96.88±3.52*8.43±0.59*
对照组53治疗前74.31±10.266.23±0.41
治疗1个月后91.17±4.06*#7.91±0.50*#
), ArticleFig(id=1322923570300592433, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923563799421182, language=CN, label=表4, caption=

两组缓解期肺脾气虚证哮喘患儿肺功能指标变化比较(±s)

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组别例数时期FEV1%/(%)PEF/(L/s)
联合组53治疗前74.29±10.156.25±0.37
治疗1个月后96.88±3.52*8.43±0.59*
对照组53治疗前74.31±10.266.23±0.41
治疗1个月后91.17±4.06*#7.91±0.50*#
), ArticleFig(id=1322923570367701298, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923563799421182, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时期Ch-CACT中医证候积分
联合组53治疗前17.29±2.8515.71±2.36
治疗1个月后25.44±1.35*5.08±0.88*
对照组53治疗前17.33±2.7615.66±2.25
治疗1个月后23.08±1.46*#7.14±0.75*#
), ArticleFig(id=1322923570434810163, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923563799421182, language=CN, label=表5, caption=

两组缓解期肺脾气虚证哮喘患儿Ch-CACT评分及中医证候积分变化比较(±s)

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组别例数时期Ch-CACT中医证候积分
联合组53治疗前17.29±2.8515.71±2.36
治疗1个月后25.44±1.35*5.08±0.88*
对照组53治疗前17.33±2.7615.66±2.25
治疗1个月后23.08±1.46*#7.14±0.75*#
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组别例数临床控制显效好转无效总有效
联合组5310(18.87)19(35.85)18(33.96)6(11.32)47(88.68)
对照组536(11.32)17(32.08)15(28.30)15(28.30)38(71.70)
χ2值4.810
P值0.028
), ArticleFig(id=1322923572246749493, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923563799421182, language=CN, label=表6, caption=

两组缓解期肺脾气虚证哮喘患儿治疗后临床疗效比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数临床控制显效好转无效总有效
联合组5310(18.87)19(35.85)18(33.96)6(11.32)47(88.68)
对照组536(11.32)17(32.08)15(28.30)15(28.30)38(71.70)
χ2值4.810
P值0.028
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槐杞黄颗粒联合小青龙汤对哮喘缓解期肺脾气虚证患儿免疫功能及预后的影响分析
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曲艳春 , 刘贵昌
中华中医药学刊 | 国家项目点击 2025,43(5): 44-47
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中华中医药学刊 |国家项目点击 2025 , 43 (5) : 44 -47
槐杞黄颗粒联合小青龙汤对哮喘缓解期肺脾气虚证患儿免疫功能及预后的影响分析
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曲艳春(1976-),女,山西忻州人,副主任药师,研究方向:药理。

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曲艳春(1976-),女,山西忻州人,副主任药师,研究方向:药理。

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曲艳春, 刘贵昌
作者信息
  • 山西省儿童医院,山西 太原 030013
作者简介:

曲艳春(1976-),女,山西忻州人,副主任药师,研究方向:药理。

Effect of Huaiqihuang Granule(槐杞黄颗粒)Combined with Xiaoqinglong Decoction(小青龙汤)on Immune Function and Prognosis of Qi Deficiency of Lung and Spleen Syndrome in Remission Stage of Asthma
Yanchun QU, Guichang LIU
Affiliations
  • Shanxi Children's Hospital,Taiyuan 030013,Shanxi,China
出版时间: 2025-05-10 doi: 10.13193/j.issn.1673-7717.2025.05.010
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目的

分析槐杞黄颗粒联合小青龙汤对哮喘缓解期肺脾气虚证患儿免疫功能及预后的影响。

方法

纳入2021年1月—2022年6月收治的106例缓解期肺脾气虚证哮喘患儿,使用简单随机法分别纳入联合组和对照组各53例,两组均给予哮喘长期控制药物及槐杞黄颗粒,联合组加用小青龙汤加减,持续1个月。对比两组患儿治疗前后体液免疫、炎性因子、肺功能、中文版儿童哮喘控制测试问卷(Chinese-childhood asthma control test,Ch-CACT)、中医证候积分等指标变化,并比较两组临床疗效。

结果

两组治疗1个月后免疫球蛋白A(Immunoglobulin A,IgA)、免疫球蛋白G(Immunoglobulin G,IgG)、免疫球蛋白M(Immunoglobulin M,IgM)均较治疗前升高,免疫球蛋白E(Immunoglobulin E,IgE)均较治疗前下降;联合组治疗1个月后IgA、IgG、IgM均高于对照组,其IgE低于对照组(P<0.05)。两组治疗1个月后干扰素-γ(Interferon-γ,IFN-γ)均较治疗前升高,嗜酸性粒细胞计数(Eosinophil,EOS)、白细胞介素-4(Interleukin-4,IL-4)均较治疗前下降;联合组治疗1个月后IFN-γ高于对照组,其EOS、IL-4低于对照组(P<0.05)。两组治疗1个月后第1 s用力呼气容积(Forced expiratory volume in one second,FEV1)%、呼气流量峰值(Peak expiratory flow,PEF)均较治疗前升高;联合组治疗1个月后FEV1%、PEF均高于对照组(P<0.05)。两组治疗1个月后Ch-CACT评分均较治疗前升高,中医证候积分均较治疗前下降;联合组治疗1个月后Ch-CACT评分高于对照组,其中医证候积分低于对照组(P<0.05)。治疗1个月后,联合组总有效率为88.68%(47/53),较对照组的71.70%(38/53)更高(P<0.05)。

结论

在常规西医治疗及槐杞黄颗粒的基础上,给予小青龙汤加减有助于缓解期肺脾气虚证哮喘患儿免疫功能、炎性因子及肺功能的改善,从而缓解临床症状,提高临床疗效,有助于患儿预后生活质量的提高。

槐杞黄颗粒  /  小青龙汤  /  哮喘  /  肺脾气虚  /  免疫功能  /  预后
Objective

To analyze the effect of Huaiqihuang Granule(槐杞黄颗粒)combined with Xiaoqinglong Decoction(小青龙汤)on immune function and prognosis of children with Qideficiency of lung and spleen syndrome in remission stage of asthma.

Methods

One hundred and six children with asthmawith deficiency of lung and spleen in remission stage admitted to the hospital from January 2021 to June 2022 were random ly divided into the combined group(53 cases)and the control group(53 cases). Both groupswere given long-term asthma control drugs and Huaiqihuang Granule and the combined group added Xiaoqinglong Decoction for onemonth. The changes of humoral immunity,inflammatory factors,lung function,Chinese version of children asthma control questionnaire(Ch-CACT),TCM syndrome score and other indicators before and after treatmentwere compared between the two groups,and the clinical efficacy of the two groupswas compared.

Results

After onemonth of treatment,the levels of immunoglobulin A(IgA),immunoglobulin G(IgG)and immunoglobulin M(IgM)in both groupswere higher than those before treatment,while immunoglobulin E(IgE)was lower than that before treatment. After onemonth's treatment,the levels of IgA,IgG and IgM in the combined group were higher than those in the control group,and the IgE was lower than that in the control group(P<0.05). After onemonth of treatment,the levels of interferon-γ(IFN-γ)increased and the level sof eosinophil(EOS)and interleukin-4(IL-4)decreased in both groups. The level of IFN-γin the combined group was higher than that in the control group,and the levels of EOS and IL-4 were lower than those in the control group(P<0.05). The values of forced expiratory volume in one second(FEV1%)and peak expiratory flow(PEF)in both groups increased after onemonth of treatment. And the values of FEV1% and PEF in the combined group were higher than those in the control group(P<0.05). After onemonth of treatment,the Ch-CACT scores of the two groupswere higher than those before treatment,and the TCM syndrome scoreswere lower than those before treatment. The Ch-CACT score of the combined group was higher than that of the control group,and the TCM syndrome scorewas lower than thatof the control group(P<0.05). After onemonth of treatment,the total effective rate of the combined group was 88.68%(47/53),which was higher than that of the control group(71.70%,38/53)(P<0.05).

Conclusion

On the basis of routine westernmedicine treatment of Huaiqihuang Granule,Modified Xiaoqinglong Decoction is helpful to improve the immune function,inflammatory factors and lung function of children with asthmawith Qideficiency of lung and spleen in remission stage,thus alleviating clinical symptoms,improving clinical efficacy and the quality of prognosis of children.

Huaiqihuang Granule(槐杞黄颗粒)  /  Xiaoqinglong Decoction(小青龙汤)  /  asthma  /  Qi deficiency of lung and spleen  /  immune function  /  prognosis
曲艳春, 刘贵昌. 槐杞黄颗粒联合小青龙汤对哮喘缓解期肺脾气虚证患儿免疫功能及预后的影响分析. 中华中医药学刊, 2025 , 43 (5) : 44 -47 . DOI: 10.13193/j.issn.1673-7717.2025.05.010
Yanchun QU, Guichang LIU. Effect of Huaiqihuang Granule(槐杞黄颗粒)Combined with Xiaoqinglong Decoction(小青龙汤)on Immune Function and Prognosis of Qi Deficiency of Lung and Spleen Syndrome in Remission Stage of Asthma[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (5) : 44 -47 . DOI: 10.13193/j.issn.1673-7717.2025.05.010
支气管哮喘简称哮喘,是一种反复发作的哮鸣、气喘型呼吸道变态反应性疾病,以儿童时期常见,患儿临床表现包括反复发作性喘息、呼吸困难等。据报道,全球哮喘患者数量约1.6亿,而这一数字将在2025年达到4亿[1]。针对儿童哮喘,急性期治疗以解痉、平喘、吸氧、抗感染为主,但吸入性糖皮质激素常引发骨质流失、生长发育迟缓,且对患儿免疫功能存在负面影响[2]。而对于缓解期患儿而言,有效控制症状、预防哮喘复发至关重要,但支气管扩张剂、白三烯调节剂等常用药物的防治效果存在明显局限性[3]。中医认为,儿童哮喘缓解期以肺脾气虚证多见,故有学者将槐杞黄颗粒应用于患儿的治疗,在改善患儿中医证候积分、预防哮喘复发方面获得了显著成效[4]。小青龙汤具有温肺、行水、下气功效,近年来在哮喘的治疗中受到了越来越多的关注[5]。此次研究尝试将槐杞黄颗粒与小青龙汤联合应用于缓解期肺脾气虚证哮喘患儿,并就其对患儿免疫功能、预后的影响进行了分析,现报道如下。
以我院2021年1月—2022年6月收治的106例缓解期肺脾气虚证哮喘患儿为研究对象,开展前瞻性对照研究。纳入标准:(1)参照《儿童支气管哮喘诊断与防治指南》明确儿童哮喘诊断[6]:①反复发作的喘息、咳嗽、气促、胸闷或咳嗽症状;②发作时双肺可闻及散在或弥漫性哮鸣音,呼气相延长;③经治疗或休息后上述症状可缓解;④除外其他疾病所致症状;⑤临床表现不典型者,支气管激发试验或运动试验阳性、支气管舒张试验阳性、最大呼气流量(Peak expiratory flow,PEF)每日或昼夜变异率≥20%亦可明确诊断;(2)符合中医肺脾气虚证判断标准[7]:反复感冒,气短自汗,咳嗽无力,形体消瘦,神疲懒言,面白少华或萎黄,纳差、便溏,舌质淡胖、苔薄白,脉细软;(3)处于临床缓解期[8]:临床症状或体征基本消失,第1 s用力呼气容积(Forced expiratory volume in one second,FEV1)%或PEF≥80%预计值,持续≥4周;(4)拟接受缓解期治疗。排除标准:(1)入组前3个月内有影响免疫功能药物使用史;(2)可能存在药物过敏;(3)合并其他慢性疾病;(4)合并先天性疾病。在征得患儿监护人知情同意后,使用简单随机法将患儿分别纳入联合组和对照组各53例。两组年龄、病程、过敏性疾病史等基线资料对比,差异无统计学意义(P>0.05),具有可比性。本临床研究经本院医学伦理委员会审核通过,见表1。
两组患儿均接受哮喘缓解期常规综合治疗:沙美特罗替卡松(商品名舒利迭,Glaxo Wellcome Production,批准文号H20150324,规格50/250μg)雾化吸入,1次/d,1吸/次,每次吸入后使用温盐水漱口;孟鲁司特钠咀嚼片(商品名顺尔宁,杭州默沙东制药有限公司,国药准字J20130054,规格5 mg×5片)口服,1次/d,5 mg/次,睡前服用。同时给予槐杞黄颗粒(商品名还尔金,启东盖天力药业有限公司,国药准字B20020074,规格10 g×6袋)口服,1~3岁2次/d,5 g/次,3~12岁2次/d,10 g/次。两组治疗均持续1个月。
联合组在对照组治疗方案的基础上给予小青龙汤加减。组方:苦杏仁10 g,法半夏10 g,陈皮6 g,款冬花6 g,紫苏子6 g,炙麻黄5 g,桂枝3 g,干姜3 g,炙甘草3 g,细辛2 g,白芍2 g;多痰者加瓜蒌皮,鼻塞流涕者加白芷。1剂/d,500mL水煎1 h后过滤,滤液蒸干浓缩为20 mL,116℃灭菌40 min,1~3岁2次/d,5 mL/次,3~12岁2次/d,10 mL/次,持续1个月。
对比两组患儿治疗前后体液免疫、炎性因子、肺功能、中文版儿童哮喘控制测试问卷(Chinese-childhood asthma control test,Ch-CACT)、中医证候积分等指标变化,并比较两组临床疗效。(1)体液免疫:包括免疫球蛋白A(Immunoglobulin A,IgA)、免疫球蛋白G(Immunoglobulin G,IgG)、免疫球蛋白M(Immunoglobulin M,IgM)及免疫球蛋白E(Immunoglobulin E,IgE)。(2)炎性因子:包括嗜酸性粒细胞计数(Eosinophil,EOS)、干扰素-γ(Interferon-γ,IFN-γ)及白细胞介素-4(Interleukin-4,IL-4)。(3)肺功能:包括FEV1占预计值百分比及PEF。(4)Ch-CACT:包括7个问题,患儿回答问题1~4,监护人回答问题5~7,问卷总分27分,评分越高则哮喘症状控制越佳[9]。(5)中医证候积分:包括呼吸急促、喘息、哮鸣音共3个主症,以及咳嗽、痰液、舌脉等共10个次症,按照无、轻度、中度、重度分别计0、2、4、6分,评分越高则症状越严重[10]。(6)临床疗效[11]:临床症状消失,双肺哮鸣音消失,FEV1或PEF增加>35%,或FEV1或PEF>80%预计值,判定为临床控制;临床症状缓解,双肺哮鸣音消失或偶见,FEV1或PEF增加>25% ~35%,或FEV1或PEF>60% ~80%预计值,判定为显效;临床症状好转,双肺哮鸣音减少,FEV1或PEF增加>15%~25%,判定为好转;未达到上述标准判定为无效。总有效率=(临床控制+显效+好转)/总例数×100%。
使用SPSS 22.0统计学软件分析本研究相关数据,计数资料以例(%)表示,并采用卡方检验(χ2检验),计量资料均符合正态分布,以平均数±标准差()表示,采用双侧t检验,当P<0.05时,认为差异存在统计学意义。
两组治疗1个月后IgA、IgG、IgM均较治疗前升高,IgE均较治疗前下降;联合组治疗1个月后IgA、IgG、IgM均高于对照组,其IgE低于对照组(P<0.05)。见表2。
两组治疗1个月后IFN-γ均较治疗前升高,EOS、IL-4均较治疗前下降;联合组治疗1个月后IFN-γ高于对照组,其EOS、IL-4低于对照组(P<0.05)。见表3。
两组治疗1个月后FEV1%、PEF均较治疗前升高;联合组治疗1个月后FEV1%、PEF均高于对照组(P<0.05)。见表4。
两组治疗1个月后Ch-CACT评分均较治疗前升高,中医证候积分均较治疗前下降;联合组治疗1个月后Ch-CACT评分高于对照组,其中医证候积分低于对照组(P<0.05)。见表5。
治疗1个月后,联合组总有效率为88.68%,较对照组的71.70%更高(P<0.05)。见表6。
目前我国儿童哮喘患病率约0.5% ~5.0%,且集中于沿海地区,男女比例达到1.43∶1,同时,近年来我国哮喘患病率也呈上升趋势[12]。呼吸道感染、烟尘吸入、花粉等因素均可引发机体变态反应,导致哮喘反复发作,直接影响着患儿生长发育质量及生活质量,故哮喘缓解期的治疗目标在于通过抗炎、降低气道高反应性等手段长期控制症状、预防哮喘复发。
吸入型糖皮质激素、长效β2受体激动剂、白三烯调节剂、缓释茶碱、肥大细胞膜稳定剂等药物是西医治疗缓解期哮喘的常用药物,但预防效果有限,故多数学者均建议在西医治疗的基础上联合中药治疗[13]。中医认为,哮喘属“喘鸣”“上气”范畴,针对儿童哮喘的描述最早源于《丹溪心法·喘论》,此后《幼幼新书·卷十六》提及,“有齁齃嗽,气急嗽速”,显示出儿童哮喘的特异性症状。同时,儿童哮喘的病因以肺脾气虚常见,脾、肺、肾脏器缺乏正气,是导致体虚及哮喘反复发作的主要原因[14]。因此,治疗当以固本扶正为要,在益气健脾、固土生金的基础上,辅以固表益肺、化痰理气,是改善脏腑机能、祛痰生津的重要环节,也是改善、抑制哮喘发作的关键所在。
既往有学者将槐杞黄颗粒应用于儿童哮喘缓解期的治疗,方中槐耳有治风、破血、益力之功,能益气强壮;枸杞子性味甘平,入肝肾经,可滋阴、润肺、补肝;黄精入肺脾肾经,可补中益气、润肺强骨。三药合用有益气、滋阴之效,故可补五脏精气,有效缓解患儿哮喘症状、预防哮喘复发[15]。此次研究在槐杞黄颗粒的基础上,将小青龙汤应用于儿童哮喘缓解期的治疗,结果显示,联合组治疗1个月后IgA、IgG、IgM均高于对照组,其IgE低于对照组,表明联合组机体体液免疫平衡有效恢复,其中,IgA的降低意味着气道高反应性缓解、防御功能提高,而IgE升高是引发哮喘发作的主要因素,故联合组治疗后进一步降低的IgE水平也与患儿更低的哮喘复发风险有关[16-18]。其次,联合组治疗1个月后IFN-γ高于对照组,其EOS、IL-4低于对照组,说明患儿气道炎症明显改善、气道重塑显著抑制,而EOS、IL-4的下降也被认为是解决哮喘迁延难愈、反复发作的关键[19-21]。随着免疫功能、炎性因子的平衡恢复,联合组患儿肺功能改善更为显著、症状评分明显降低,也获得了更为理想的临床治疗效果[22-24]。该结果表明,小青龙汤加减在肺脾气虚证哮喘患儿缓解期的治疗中,能够通过免疫功能、炎性因子的调节,达到改善肺功能及症状的目的,其优势在于:小青龙汤方中麻黄有宣肺通络之功,桂枝可温煦肺经,细辛散寒解表、干姜消除饮邪、半夏宣达阳明,辅以苦杏仁纠正咳逆上气、款冬花润肺平肝、紫苏化痰降气、陈皮健脾下气、炙甘草补中扶正之效,数药共奏可达补气固脱、健脾益肺和养血生津之功,最终实现肺脾气虚证标本兼治,进而达到调节免疫、改善预后之效[25-26]。此次研究的局限性在于随访时间有限,进一步延长随访时间将为中西医联合治疗方案对患儿远期哮喘复发的影响提供更为充足的证据,值得关注。
综上所述,在常规西医治疗及槐杞黄颗粒的基础上,给予小青龙汤加减有助于缓解期肺脾气虚证哮喘患儿免疫功能、炎性因子及肺功能的改善,从而缓解临床症状、提高临床疗效,有助于患儿预后生活质量的提高,值得推广应用。
  • 国家中医药管理局中医药科学技术研究专项(2019ZX6922)
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2025年第43卷第5期
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doi: 10.13193/j.issn.1673-7717.2025.05.010
  • 首发时间:2026-10-30
  • 出版时间:2025-05-10
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国家中医药管理局中医药科学技术研究专项(2019ZX6922)
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    山西省儿童医院,山西 太原 030013
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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