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Article(id=1322924050661647069, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.06.042, 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=1793339272417, onlineDateStr=2026-10-30, pubDate=1749484800000, pubDateStr=2025-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339272417, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339272417, creator=13701087609, updateTime=1793339272417, updator=13701087609, issue=Issue{id=1322923782029062261, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='6', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1749484800000', pubDateStr='2025-06-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339208371, creator='13701087609', updateTime=1793340556755, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929437859258468, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929437859258469, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=204, endPage=208, ext={EN=ArticleExt(id=1322924050854585054, articleId=1322924050661647069, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Effect of Kechuan Zhending Decoction（咳喘镇定汤）in Treatment of Children with Cough Variant Asthma and Its Influence on EOS and IL-23/Th17 Axis, columnId=1256183365644968140, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Platform of Provincial Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To observe the effect of Kechuan Zhending Decoction（咳喘镇定汤）in the treatment of children with cough variant asthma and the effect on eosinophil count（EOS）and interleukin-23（IL-23）/Helper T cells17（Th17）axis.

Methods

A total of 104 cases of paediatric cough variant asthma admitted from August 2020 to February 2023 were selected and divided into two groups by simple random method.The conventional group was given the conventional treatment of relieving cough，resolving phlegm，anti-inflammatory，relieving asthma，etc.，and the Kechuan Zhending Decoction group was given the auxiliary treatment of Kechuan Zhending Decoction on the basis of the conventional group.T-lymphocyte subpopulations，EOS，macrophage inflammatory protein-1α（MIP-1α），Clara cell secreted protein 16（CC-16），eosinophil-activated chemokine（Eotaxin），IL-23/Th17 axis and small airway function were detected between and within the groups.Differences in cough symptom scores and TCM symptom scores were assessed between and within groups.The efficacy and adverse reactions were analyzed between groups.

Results

There was no difference in T-lymphoid subgroups，CC-16 or Eotaxin before treatment（P>0.05）.The levels of CD+8，EOS，MIP-1αand Eotaxin decreased and the levels of CC-16，CD+4 and CD+4/CD+8 increased after treatment in both groups，and the levels of CD+8，EOS，MIP-1αand Eotaxin in the Kechuan Zhending Decoction group were lower than those in the conventional group，and the levels of CC-16，CD+4 and CD+4/CD+8 in the Kechuan Zhending Decoction group were higher than those in the conventional group after treatment（P<0.05）.There was no difference in IL-23/Th17 axis comparing that before treatment（P>0.05）.The levels of IL-23，Th17 and interleukin-17（IL-17）decreased after treatment in both groups，and the IL-23/Th17 axis was lower in the Kechuan Zhending Decoction group than that in the conventional group after treatment（P<0.05）.There was no difference in the relevant scores before treatment（P>0.05）.Cough symptom scores and TCM symptom scores decreased after treatment in both groups，and cough symptom scores and TCM symptom scores were lower in the Kechuan Zhending Decoction group than those in the conventional group after treatment（P<0.05）.There was no difference in small airway function before treatment（P>0.05）.Small airway function was elevated after treatment in both groups，and the small airway function was higher in the Kechuan Zhending Decoction group than that in the conventional group（P<0.05）.In the Kechuan Zhending Decoction group，there were 13 cases cured，with a total of 35 cases showing significant effective results.The total effective rate was 92.31%，significantly higher than that in the conventional group（P<0.05）.

Conclusion

Kechuan Zhending Decoction can improve T-lymphoid subsets and small airway function by regulating IL-23/Th17 axis in children with cough variant asthma，reduce the cough symptoms and improve the curative effect.

, authors=Tingting HAN, Zhezhe WANG, Meng GAO, Dezhi LI, authorsList=Tingting HAN, Zhezhe WANG, Meng GAO, Dezhi LI, authorCompany=null, correspAuthors=Dezhi LI, 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=1322924058765042419, articleId=1322924050661647069, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=咳喘镇定汤在小儿咳嗽变异性哮喘治疗中的作用及对EOS、IL-23/Th17轴的影响, columnId=1256183369033965799, journalTitle=中华中医药学刊, columnName=省级项目平台, runingTitle=null, highlight=null, articleAbstract=
目的

观察咳喘镇定汤在小儿咳嗽变异性哮喘治疗中的作用及对患儿嗜酸性粒细胞计数（eosinophil count，EOS）、白介素-23（interleukin-23，IL-23）/辅助性T细胞17（helper T cells17，Th17）轴的影响。

方法

选取2020年8月—2023年2月收治的小儿咳嗽变异性哮喘患儿104例，将患儿采用简单随机法分为两组。常规组给予止咳化痰、抗炎、平喘等常规治疗，咳喘镇定汤组在常规组基础上采用咳喘镇定汤辅助治疗。检测组间及组内T淋巴亚群、EOS、巨噬细胞炎症蛋白-1α（macrophage inflammatory protein-1α，MIP-1α）、Clara细胞分泌蛋白16（clara cell secreted protein 16，CC-16）、嗜酸细胞活化趋化因子（Eotaxin）、IL-23/Th17轴、小气道功能水平。评估组间及组内咳嗽症状评分、中医证候评分差异。统计组间疗效和不良反应。

结果

治疗前T淋巴亚群、CC-16、Eotaxin等差异无统计学意义（P>0.05）。两组治疗后CD8+、EOS、MIP-1α、Eotaxin降低，CC-16、CD4+、CD4+/CD8+ 升高，咳喘镇定汤组治疗后CD8+、EOS、MIP-1α、Eotaxin低于常规组，CC-16、CD4+、CD4+/CD8+ 高于常规组（P<0.05）。治疗前比较IL-23/Th17轴差异无统计学意义（P>0.05）。两组治疗后IL-23、Th17、白介素-17（interleukin-17，IL-17）降低，咳喘镇定汤组治疗后IL-23/Th17轴低于常规组（P<0.05）。治疗前相关评分无差异（P>0.05）。两组治疗后咳嗽症状评分、中医证候评分降低，咳喘镇定汤组治疗后咳嗽症状评分、中医症候评分低于常规组（P<0.05）。治疗前小气道功能无差异（P>0.05）。两组治疗后小气道功能升高，咳喘镇定汤组治疗后小气道功能高于常规组（P<0.05）。咳喘镇定汤组治愈13例，显效和有效共35例，总有效率92.31%高于常规组，差异有统计学意义（P<0.05）。

结论

咳喘镇定汤可通过调控小儿咳嗽变异性哮喘患儿IL-23/Th17轴，改善T淋巴亚群和小气道功能，减轻咳嗽症状，提高疗效。

, authors=韩亭亭, 王哲哲, 高萌, 李得志, authorsList=韩亭亭, 王哲哲, 高萌, 李得志, authorCompany=null, correspAuthors=李得志, authorNote=

韩亭亭（1988-），女，山东滨州人，主治医师，硕士，研究方向：儿科学。

, correspAuthorsNote=
李得志（1982-），男，山东滨州人，副主任医师，硕士，研究方向：儿科学。E-mail：。
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韩亭亭（1988-），女，山东滨州人，主治医师，硕士，研究方向：儿科学。

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韩亭亭（1988-），女，山东滨州人，主治医师，硕士，研究方向：儿科学。

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journalName=实用医院临床杂志, refType=null, unstructuredReference=易爽，庞侯旭，袁程远，等. 肥胖型支气管哮喘患儿血Clara细胞分泌蛋白及补体C3和C4水平与病情严重程度的相关性分析［J］. 实用医院临床杂志，2021，18（3）：146-149., articleTitle=肥胖型支气管哮喘患儿血Clara细胞分泌蛋白及补体C3和C4水平与病情严重程度的相关性分析, refAbstract=null), Reference(id=1322924076964127552, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924050661647069, doi=null, pmid=null, pmcid=null, year=2022, volume=54, issue=10, pageStart=61, pageEnd=65, url=null, language=null, rfNumber=［25］, rfOrder=24, authorNames=李慧娇, 王一萍, 何薇, journalName=新中医, refType=null, unstructuredReference=李慧娇，王一萍，何薇，等. 定喘汤配合常规西药治疗咳嗽变异性哮喘疗效观察及对血清ICAM-1、Eotaxin水平的影响［J］. 新中医，2022，54（10）：61-65., articleTitle=定喘汤配合常规西药治疗咳嗽变异性哮喘疗效观察及对血清ICAM-1、Eotaxin水平的影响, refAbstract=null)], funds=[Fund(id=1322924069347271463, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924050661647069, awardId=2021M028, language=CN, fundingSource=山东省中医药科技项目(2021M028), fundOrder=null, country=null)], 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language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数性别/［例（%）］年龄/（岁）病程/（年）诱发因素//［例（%）］
男女冷空气运动过敏原其他
常规组5230（57.69）22（42.31）8.16±1.591.27±0.3422（42.31）15（28.85）11（21.15）4（7.69）
咳喘镇定汤组5227（51.92）25（48.08）8.24±1.671.24±0.3125（48.08）13（25.00）9（17.31）5（9.62）
χ2值0.3490.2500.4700.646
P值0.5540.8030.6390.886
), ArticleFig(id=1322924064528016154, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924050661647069, language=CN, label=表1, caption=

两组咳嗽变异性哮喘患儿一般资料比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数性别/［例（%）］年龄/（岁）病程/（年）诱发因素//［例（%）］
男女冷空气运动过敏原其他
常规组5230（57.69）22（42.31）8.16±1.591.27±0.3422（42.31）15（28.85）11（21.15）4（7.69）
咳喘镇定汤组5227（51.92）25（48.08）8.24±1.671.24±0.3125（48.08）13（25.00）9（17.31）5（9.62）
χ2值0.3490.2500.4700.646
P值0.5540.8030.6390.886
), ArticleFig(id=1322924064595125019, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924050661647069, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数
治疗前治疗后治疗前治疗后治疗前治疗后
常规组5225.47±4.4632.97±5.01*33.25±4.8926.41±4.12*0.78±0.241.25±0.31*
咳喘镇定汤组5226.01±4.3338.77±4.45*33.12±5.1722.53±3.65*0.79±0.211.72±0.36*
t值0.6266.2420.1325.0830.2267.134
P值0.5320.0000.8950.0000.8220.000
), ArticleFig(id=1322924064666428188, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924050661647069, language=CN, label=表2, caption=

两组咳嗽变异性哮喘患儿T淋巴亚群差异比较（±s）

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组别例数
治疗前治疗后治疗前治疗后治疗前治疗后
常规组5225.47±4.4632.97±5.01*33.25±4.8926.41±4.12*0.78±0.241.25±0.31*
咳喘镇定汤组5226.01±4.3338.77±4.45*33.12±5.1722.53±3.65*0.79±0.211.72±0.36*
t值0.6266.2420.1325.0830.2267.134
P值0.5320.0000.8950.0000.8220.000
), ArticleFig(id=1322924064733537053, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924050661647069, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数EOS（×109/L）MIP-1α/（ng/L）CC-16/（ng/mL）Eotaxin/（ng/L）
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
常规组520.65±0.140.45±0.12*321.56±38.45211.47±26.16*12.85±3.0618.96±4.15*198.56±37.45165.23±28.05*
咳喘镇定汤组520.63±0.160.36±0.11*315.89±41.89170.42±22.28*12.78±2.7925.75±4.66*193.22±40.52141.33±24.56*
t值0.6783.9870.7198.6150.1227.8470.6984.623
P值0.4990.0000.4740.0000.9030.0000.4870.000
), ArticleFig(id=1322924064804840222, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924050661647069, language=CN, label=表3, caption=

两组咳嗽变异性哮喘患儿EOS、MIP-1α、CC-16、Eotaxin差异比较（±s）

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组别例数EOS（×109/L）MIP-1α/（ng/L）CC-16/（ng/mL）Eotaxin/（ng/L）
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
常规组520.65±0.140.45±0.12*321.56±38.45211.47±26.16*12.85±3.0618.96±4.15*198.56±37.45165.23±28.05*
咳喘镇定汤组520.63±0.160.36±0.11*315.89±41.89170.42±22.28*12.78±2.7925.75±4.66*193.22±40.52141.33±24.56*
t值0.6783.9870.7198.6150.1227.8470.6984.623
P值0.4990.0000.4740.0000.9030.0000.4870.000
), ArticleFig(id=1322924064880337695, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924050661647069, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数IL-23/（ng/L）Th17/（%）IL-17/（ng/L）
治疗前治疗后治疗前治疗后治疗前治疗后
常规组5216.97±3.1513.69±2.61*2.31±0.331.54±0.24*20.66±3.7915.03±3.11*
咳喘镇定汤组5217.08±3.2210.14±2.05*2.28±0.341.21±0.21*20.49±3.8312.46±2.64*
t值0.1767.7130.4577.4620.2284.543
P值0.8610.0000.6490.0000.8200.000
), ArticleFig(id=1322924066591613728, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924050661647069, language=CN, label=表4, caption=

两组咳嗽变异性哮喘患儿IL-23/Th17轴差异比较（±s）

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组别例数IL-23/（ng/L）Th17/（%）IL-17/（ng/L）
治疗前治疗后治疗前治疗后治疗前治疗后
常规组5216.97±3.1513.69±2.61*2.31±0.331.54±0.24*20.66±3.7915.03±3.11*
咳喘镇定汤组5217.08±3.2210.14±2.05*2.28±0.341.21±0.21*20.49±3.8312.46±2.64*
t值0.1767.7130.4577.4620.2284.543
P值0.8610.0000.6490.0000.8200.000
), ArticleFig(id=1322924066709054241, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924050661647069, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数日间症状评分夜间症状评分中医症候评分
治疗前治疗后治疗前治疗后治疗前治疗后
常规组522.31±0.521.10±0.26*2.24±0.491.20±0.29*15.14±3.237.55±1.13*
咳喘镇定汤组522.33±0.460.73±0.21*2.21±0.440.74±0.25*15.09±3.425.17±0.66*
t值0.2087.9830.3288.6630.07713.115
P值0.8360.0000.7430.0000.9390.000
), ArticleFig(id=1322924067006849826, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924050661647069, language=CN, label=表5, caption=

两组咳嗽变异性哮喘患儿咳嗽症状评分、中医证候评分差异比较（±s）

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组别例数日间症状评分夜间症状评分中医症候评分
治疗前治疗后治疗前治疗后治疗前治疗后
常规组522.31±0.521.10±0.26*2.24±0.491.20±0.29*15.14±3.237.55±1.13*
咳喘镇定汤组522.33±0.460.73±0.21*2.21±0.440.74±0.25*15.09±3.425.17±0.66*
t值0.2087.9830.3288.6630.07713.115
P值0.8360.0000.7430.0000.9390.000
), ArticleFig(id=1322924067073958691, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924050661647069, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数FEF25%FEF50%FEF75%FEF25%~75%
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
常规组5267.85±5.8579.85±6.01*52.36±5.1481.45±5.96*34.56±4.5253.98±5.07*35.05±5.6568.57±6.94*
咳喘镇定汤组5268.04±5.4784.57±6.23*51.75±4.9985.08±6.31*35.01±4.4762.14±5.85*34.47±5.1674.45±7.08*
t值0.1713.9320.6143.0160.5107.6010.5474.277
P值0.8650.0000.5410.0030.6110.0000.5860.000
), ArticleFig(id=1322924067153650468, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924050661647069, language=CN, label=表6, caption=

两组咳嗽变异性哮喘患儿小气道功能差异比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数FEF25%FEF50%FEF75%FEF25%~75%
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
常规组5267.85±5.8579.85±6.01*52.36±5.1481.45±5.96*34.56±4.5253.98±5.07*35.05±5.6568.57±6.94*
咳喘镇定汤组5268.04±5.4784.57±6.23*51.75±4.9985.08±6.31*35.01±4.4762.14±5.85*34.47±5.1674.45±7.08*
t值0.1713.9320.6143.0160.5107.6010.5474.277
P值0.8650.0000.5410.0030.6110.0000.5860.000
), ArticleFig(id=1322924069154333477, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924050661647069, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治愈显效有效无效总有效
常规组527（13.46）18（34.62）15（28.85）12（23.08）40（76.92）
咳喘镇定汤组5213（25.00）24（46.15）11（21.15）4（7.69）48（92.31）
χ2值4.727
P值0.030
), ArticleFig(id=1322924069229830950, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322924050661647069, language=CN, label=表7, caption=

两组咳嗽变异性哮喘患儿疗效差异比较

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组别例数治愈显效有效无效总有效
常规组527（13.46）18（34.62）15（28.85）12（23.08）40（76.92）
咳喘镇定汤组5213（25.00）24（46.15）11（21.15）4（7.69）48（92.31）
χ2值4.727
P值0.030
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咳喘镇定汤在小儿咳嗽变异性哮喘治疗中的作用及对EOS、IL-23/Th17轴的影响
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韩亭亭 , 王哲哲 , 高萌 , 李得志
中华中医药学刊 | 省级项目平台 2025,43(6): 204-208
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中华中医药学刊 |省级项目平台 2025 , 43 (6) : 204 -208
咳喘镇定汤在小儿咳嗽变异性哮喘治疗中的作用及对EOS、IL-23/Th17轴的影响
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韩亭亭, 王哲哲, 高萌, 李得志
作者信息
  • 滨州医学院附属医院，山东 滨州 256600
通讯作者:
李得志（1982-），男，山东滨州人，副主任医师，硕士，研究方向：儿科学。E-mail：。
作者简介:

韩亭亭（1988-），女，山东滨州人，主治医师，硕士，研究方向：儿科学。

Effect of Kechuan Zhending Decoction（咳喘镇定汤）in Treatment of Children with Cough Variant Asthma and Its Influence on EOS and IL-23/Th17 Axis
Tingting HAN, Zhezhe WANG, Meng GAO, Dezhi LI
Affiliations
  • Children's Respiratory Department，The Affiliated Hospital of Binzhou Medical College，Binzhou 256600，Shandong，China
出版时间: 2025-06-10 doi: 10.13193/j.issn.1673-7717.2025.06.042
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摘要
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目的

观察咳喘镇定汤在小儿咳嗽变异性哮喘治疗中的作用及对患儿嗜酸性粒细胞计数（eosinophil count，EOS）、白介素-23（interleukin-23，IL-23）/辅助性T细胞17（helper T cells17，Th17）轴的影响。

方法

选取2020年8月—2023年2月收治的小儿咳嗽变异性哮喘患儿104例，将患儿采用简单随机法分为两组。常规组给予止咳化痰、抗炎、平喘等常规治疗，咳喘镇定汤组在常规组基础上采用咳喘镇定汤辅助治疗。检测组间及组内T淋巴亚群、EOS、巨噬细胞炎症蛋白-1α（macrophage inflammatory protein-1α，MIP-1α）、Clara细胞分泌蛋白16（clara cell secreted protein 16，CC-16）、嗜酸细胞活化趋化因子（Eotaxin）、IL-23/Th17轴、小气道功能水平。评估组间及组内咳嗽症状评分、中医证候评分差异。统计组间疗效和不良反应。

结果

治疗前T淋巴亚群、CC-16、Eotaxin等差异无统计学意义（P>0.05）。两组治疗后CD8+、EOS、MIP-1α、Eotaxin降低，CC-16、CD4+、CD4+/CD8+ 升高，咳喘镇定汤组治疗后CD8+、EOS、MIP-1α、Eotaxin低于常规组，CC-16、CD4+、CD4+/CD8+ 高于常规组（P<0.05）。治疗前比较IL-23/Th17轴差异无统计学意义（P>0.05）。两组治疗后IL-23、Th17、白介素-17（interleukin-17，IL-17）降低，咳喘镇定汤组治疗后IL-23/Th17轴低于常规组（P<0.05）。治疗前相关评分无差异（P>0.05）。两组治疗后咳嗽症状评分、中医证候评分降低，咳喘镇定汤组治疗后咳嗽症状评分、中医症候评分低于常规组（P<0.05）。治疗前小气道功能无差异（P>0.05）。两组治疗后小气道功能升高，咳喘镇定汤组治疗后小气道功能高于常规组（P<0.05）。咳喘镇定汤组治愈13例，显效和有效共35例，总有效率92.31%高于常规组，差异有统计学意义（P<0.05）。

结论

咳喘镇定汤可通过调控小儿咳嗽变异性哮喘患儿IL-23/Th17轴，改善T淋巴亚群和小气道功能，减轻咳嗽症状，提高疗效。

咳喘镇定汤  /  小儿咳嗽变异性哮喘  /  IL-23/Th17轴  /  小气道功能  /  疗效  /  咳嗽  /  T淋巴亚群
Objective

To observe the effect of Kechuan Zhending Decoction（咳喘镇定汤）in the treatment of children with cough variant asthma and the effect on eosinophil count（EOS）and interleukin-23（IL-23）/Helper T cells17（Th17）axis.

Methods

A total of 104 cases of paediatric cough variant asthma admitted from August 2020 to February 2023 were selected and divided into two groups by simple random method.The conventional group was given the conventional treatment of relieving cough，resolving phlegm，anti-inflammatory，relieving asthma，etc.，and the Kechuan Zhending Decoction group was given the auxiliary treatment of Kechuan Zhending Decoction on the basis of the conventional group.T-lymphocyte subpopulations，EOS，macrophage inflammatory protein-1α（MIP-1α），Clara cell secreted protein 16（CC-16），eosinophil-activated chemokine（Eotaxin），IL-23/Th17 axis and small airway function were detected between and within the groups.Differences in cough symptom scores and TCM symptom scores were assessed between and within groups.The efficacy and adverse reactions were analyzed between groups.

Results

There was no difference in T-lymphoid subgroups，CC-16 or Eotaxin before treatment（P>0.05）.The levels of CD+8，EOS，MIP-1αand Eotaxin decreased and the levels of CC-16，CD+4 and CD+4/CD+8 increased after treatment in both groups，and the levels of CD+8，EOS，MIP-1αand Eotaxin in the Kechuan Zhending Decoction group were lower than those in the conventional group，and the levels of CC-16，CD+4 and CD+4/CD+8 in the Kechuan Zhending Decoction group were higher than those in the conventional group after treatment（P<0.05）.There was no difference in IL-23/Th17 axis comparing that before treatment（P>0.05）.The levels of IL-23，Th17 and interleukin-17（IL-17）decreased after treatment in both groups，and the IL-23/Th17 axis was lower in the Kechuan Zhending Decoction group than that in the conventional group after treatment（P<0.05）.There was no difference in the relevant scores before treatment（P>0.05）.Cough symptom scores and TCM symptom scores decreased after treatment in both groups，and cough symptom scores and TCM symptom scores were lower in the Kechuan Zhending Decoction group than those in the conventional group after treatment（P<0.05）.There was no difference in small airway function before treatment（P>0.05）.Small airway function was elevated after treatment in both groups，and the small airway function was higher in the Kechuan Zhending Decoction group than that in the conventional group（P<0.05）.In the Kechuan Zhending Decoction group，there were 13 cases cured，with a total of 35 cases showing significant effective results.The total effective rate was 92.31%，significantly higher than that in the conventional group（P<0.05）.

Conclusion

Kechuan Zhending Decoction can improve T-lymphoid subsets and small airway function by regulating IL-23/Th17 axis in children with cough variant asthma，reduce the cough symptoms and improve the curative effect.

Kechuan Zhending Decoction（咳喘镇定汤）  /  infantile cough variant asthma  /  IL-23/Th17 axis  /  small airway function  /  curative effect  /  cough  /  T lymphoid subgroup
韩亭亭, 王哲哲, 高萌, 李得志. 咳喘镇定汤在小儿咳嗽变异性哮喘治疗中的作用及对EOS、IL-23/Th17轴的影响. 中华中医药学刊, 2025 , 43 (6) : 204 -208 . DOI: 10.13193/j.issn.1673-7717.2025.06.042
Tingting HAN, Zhezhe WANG, Meng GAO, Dezhi LI. Effect of Kechuan Zhending Decoction（咳喘镇定汤）in Treatment of Children with Cough Variant Asthma and Its Influence on EOS and IL-23/Th17 Axis[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (6) : 204 -208 . DOI: 10.13193/j.issn.1673-7717.2025.06.042
正文
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咳嗽变异性哮喘是哮喘的一种特殊类型，临床表现为持续或反复咳嗽，夜间或凌晨加重，本病好发于小儿，是引起小儿慢性咳嗽的常见病因之一[1]。嗜酸性粒细胞计数（eosinophil count，EOS）、白介素-23（interleukin-23，IL-23）/辅助性T细胞17（helper T cells17，Th17）轴紊乱在其病程中发挥重要作用[2]。目前西医临床治疗咳嗽变异性哮喘的药物以吸入性糖皮质激素、β2受体激动剂、白三烯受体拮抗剂、抗胆碱药物、抗过敏药物等为主，短期疗效肯定，但停药后病情易反复，而长期用药可引起耐药性及不良反应，部分患儿疗效欠佳，可进展为典型哮喘[3]。
中医学理论将咳嗽变异性哮喘归纳于“喘嗽”之范畴，小儿脏腑未实、形气未充，易感受外邪，其病位在肺，外邪侵袭肺络，肺失宣降、肺气上逆是其基本病机，治则以宣肺平喘、镇咳化痰为法[4]。咳喘镇定汤是本院治疗小儿咳嗽变异性哮喘的经验方，其疗效已得到临床验证，但其对患儿免疫功能炎症状态的影响尚未见报道。本研究观察咳喘镇定汤在小儿咳嗽变异性哮喘治疗中的作用及对患儿EOS、IL-23/Th17轴的影响。
1　资料与方法
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1.1　样本量估算
N＝Z2×［P×（1-P））/E2］，z为置信度（取1.96），E为误差值（取0.003），P为概率值（取0.5），进行测算得到每组样本量为52例。本研究经过伦理审查委员会的批准（批号：Lw202007016）。
1.2　诊断标准
西医参考《儿童支气管哮喘诊断与防治指南》[5]制定，①咳嗽（干咳为主）病程>4周，夜间和清晨加重（发作）；②临床上无感染征象；③支气管激发试验（bronchial provocation test，BPT）呈阳性；④排除其他疾病引起的咳嗽，且应用抗哮喘药物有效；⑤病儿或家族有哮喘史。
中医参考《中医儿科临床诊疗指南·小儿咳嗽变异性哮喘》[6]中风寒袭肺证标准：①舌淡红，苔薄白，脉浮紧；②少/无痰，咽痒，流清涕；③咳嗽，阵发性呛咳，晨起夜卧明显。
1.3　纳入与排除标准
1.3.1　纳入标准
①西医符合小儿咳嗽变异性哮喘标准；②中医辨证均为风寒袭肺证；③年龄5～14岁；④患儿直系家属签署同意书。
1.3.2　排除标准
①其他原因导致的慢性咳嗽；②入组前接受糖皮质激素、免疫抑制剂、茶碱药物等相关药物治疗；③长期激素治疗；④合并其他肺系疾病；⑤严重肝、肾、血液原发性疾病；⑥2周内有呼吸道感染史。
1.3.3　剔除标准
①出现严重过敏反应；②未按规定用药，影响评价疗效；③试验期间，自行使用其他药物治疗。
1.4　一般资料
选取2020年8月—2023年2月医院收治的小儿咳嗽变异性哮喘患儿104例，男童57例、女童47例；最小4岁，最大14岁；病程最短0.5年，最长3年。将患儿采用简单随机法分为两组。两组基线资料比较，具有可比性（P>0.05）。见表1。
1.5　治疗方法
1.5.1　常规组
给予止咳化痰、抗炎、平喘等常规治疗。
1.5.2　咳喘镇定汤组
在常规组基础上采用咳喘镇定汤辅助治疗。咳喘镇定汤：炙麻黄、五味子3 g，川芎6 g，甘草6 g，杏仁6 g，桂枝9 g，紫菀、苏子6 g，防风6 g，荆芥10 g。痰多壅盛者加清半夏6 g，蜜百部9 g；咽痒较甚者加射干6 g，桔梗9 g；流涕较甚者加辛夷6 g，苍耳子9 g。上药1剂/d，水煎煮，取汁共100 mL左右，早晚各温服50 mL。两组均连续治疗4周。
1.6　观察指标
1.6.1　检测方法
于治疗前、治疗4周后抽取两组患儿空腹静脉血8 mL，分装于3支真空采血管，1支血标本采用美国贝克曼-库尔特公司CytoFLEX流式细胞仪检测T淋巴亚群（CD+4、CD+8、CD+4/CD+8）及Th17。1支血标本采用离心机处理，转速3000 r/min，时长10 min，取血清采用赛默飞-世尔科技公司MK3酶标仪检测巨噬细胞炎症蛋白-1α（macrophage inflammatory protein-1α，MIP-1α）、Clara细胞分泌蛋白16（clara cell secreted protein 16，CC-16）、嗜酸细胞活化趋化因子（Eotaxin）、白介素-23（interleukin-23，IL-23）、白介素-17（interleukin-17，IL-17），酶联免疫吸附法试剂盒购自上海臻科生物科技有限公司。1支血标本采用深圳迈瑞BC-3000血细胞分析仪检测嗜酸性粒细胞计数（eosinophil count，EOS）。
1.6.2　评分标准
咳嗽症状评分[7]：在日间和夜间分别评估，①日间：0、1、2、3分，对应咳嗽的无至频繁，严重影响生活的变化。②夜间：0、1、2、3分，对应咳嗽的无至咳嗽严重影响睡眠的变化。
中医证候评分：咳嗽、阵发性呛咳两项以患儿严重程度分为无、轻、中、重，计为0～6分。少痰、咽痒、流清涕3项以患儿严重程度分为无、轻、中、重，计为0～3分。
1.6.3　小气道功能
于治疗前、治疗4周后采用德国康讯公司肺功能仪检测两组患儿小气道功能（FEF25%、FEF50%、FEF75%、FEF25%～75%）。
1.6.4　疗效标准[8]
①治愈：咳嗽完全缓解，咳嗽偶发无需用药，证候积分降低≥95%；②显效：咳嗽显著减轻，咳嗽偶发用药后可缓解，证候积分降低≥70%；③有效：咳嗽好转，需用药治疗，证候积分降低≥30%；④无效：咳嗽无改善。
1.7　统计学方法
数据采用SPSS 25.0处理，已证实MIP-1α、IL-23/Th17轴、CC-16等计量资料符合正态分布，同时满足方差齐性，以（）表示，组内（治疗前后）比较用配对t检验，组间（两组同时间）比较用独立样本t检验，疾病的诱发因素、疾病患儿性别等计数资料用例（%）表示，比较用χ2 检验，以α＝0.05为标准。
2　结果
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2.1　比较T淋巴亚群差异
治疗前T淋巴亚群差异无统计学意义（P>0.05）。两组治疗后CD+8 降低，CD+4、CD+4/CD+8 升高，咳喘镇定汤组治疗后CD+8 低于常规组，CD+4、CD+4/CD+8 高于常规组（P<0.05）。见表2。
2.2　比较EOS、MIP-1α、CC-16、Eotaxin差异
治疗前EOS、MIP-1α、CC-16、Eotaxin差异无统计学意义（P>0.05）。两组治疗后EOS、MIP-1α、Eotaxin降低，CC-16升高，咳喘镇定汤组治疗后EOS、MIP-1α、Eotaxin低于常规组，CC-16高于常规组（P<0.05）。见表3。
2.3　比较IL-23/Th17轴差异
治疗前IL-23/Th17轴差异无统计学意义（P>0.05）。两组治疗后IL-23、Th17、IL-17降低，咳喘镇定汤组治疗后IL-23/Th17轴低于常规组（P<0.05）。见表4。
2.4　比较咳嗽症状评分、中医证候评分差异
治疗前相关评分差异无统计学意义（P>0.05）。两组治疗后咳嗽症状评分、中医证候评分降低，咳喘镇定汤组治疗后咳嗽症状评分、中医证候评分低于常规组（P<0.05）。见表5。
2.5　比较小气道功能差异
治疗前小气道功能差异无统计学意义（P>0.05）。两组治疗后FEF25%、50%、75%、25% ～75%升高，咳喘镇定汤组治疗后小气道功能高于常规组（P<0.05）。见表6。
2.6　比较疗效差异
咳喘镇定汤组治愈13例，显效和有效共35例，总有效率92.31%高于常规组，有统计学意义（P<0.05）。见表7。
2.7　比较安全性
未发生严重不良反应。
3　讨论
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流行病学研究发现，全球咳嗽变异性哮喘的患病率高达9.6%，占慢性咳嗽病因的42.2%左右[9]。其发病机制比较复杂，已有的研究认为与气道高反应性、气道炎症反应、气道平滑肌痉挛有关。吸入冷空气、刺激性气体、气候改变、气道感染、接触过敏原、精神心理因素等均可诱发本病，因此在冬春季节多发[10]。糖皮质激素、白三烯受体拮抗剂等是咳嗽变异性哮喘的一线治疗药物，但仍有部分患儿疗效欠佳，最终进展至典型哮喘，严重影响患儿的健康和生长发育。因此在确诊咳嗽变异性哮喘后应给予积极的治疗[11]。
中医学理论认为，风寒袭肺是引起小儿喘嗽的重要病机，肺为娇脏，不耐寒热，易感受风寒之邪[12]。《素问玉机·真藏论篇》有云：“风者百病之长也，今风寒客于人……弗治，病入舍于肺，名曰肺痹，发咳上气”[13]。咳喘镇定汤中以炙麻黄为君药，功擅开腠发汗、宣肺平喘，尤善祛在表之寒、开闭郁之肺气。杏仁、桂枝共为臣药，杏仁善降利肺气，与麻黄一宣一降，可增强宣肺平喘之功。桂枝温通经脉、透营达卫，与麻黄相须为用，可增强发汗解表之效。佐以紫菀润肺止咳、祛痰止嗽；苏子解表散寒、降气止咳；防风、荆芥祛风解表、发散风寒；五味子敛肺止咳、善补五脏之虚，可防辛散之品过于宣散肺气。久病入络必有瘀，佐以少量川芎行气通络、化瘀活血。甘草止咳化痰，兼为使药。痰多壅盛者加清半夏、蜜百部以化痰止喘；伴咽痒者加射干、桔梗以利咽止痒；伴流涕者加辛夷、苍耳子以宣通鼻窍。诸药共奏宣肺平喘、镇咳化痰之功效[14-15]。
本研究发现，咳喘镇定汤组总有效率高于常规组；两组治疗后咳嗽症状评分、中医证候评分降低，咳喘镇定汤组治疗后咳嗽症状评分、中医证候评分低于常规组。上述结果提示，咳喘镇定汤可减轻咳嗽变异性哮喘患儿的咳嗽症状和中医证候，提高疗效。这是由于咳喘镇定汤中麻黄所含的生物碱成分可作用于支气管平滑肌的β受体，缓解支气管平滑肌痉挛而引起的咳嗽[16]。杏仁所含的苦杏仁苷经酶水解后可产生微量氢氰酸，抑制呼吸中枢而产生镇咳作用[17]。紫菀所含的萜类、黄酮类、肽类成分具有镇咳、祛痰、抗炎、抗菌、抗病毒等药理作用[18]。荆芥所含的挥发油、黄酮类成分具有抗菌、抗病毒、抗炎等药理作用，可对抗组胺引起的气管平滑肌收缩[19]。甘草所含的黄酮类成分可缓解支气管痉挛、抑制炎症反应、调节免疫功能[20]。
咳嗽变异性哮喘患儿机体处于免疫紊乱状态，T淋巴亚群比例失调，细胞免疫功能低下，IL-23/Th17轴异常活化，而IL-23/Th17轴是Th细胞活化的关键通路[21]。EOS是参与气道炎症的主要炎性细胞，在变应原刺激下EOS产生炎症因子、白三烯，引起气道炎性浸润、黏膜水肿、气道高反应[22]。MIP-1α是一种趋化因子，可将EOS、单核巨噬细胞、肥大细胞等趋化至炎症部位，加重局部炎性损伤[23]。CC-16是Clara细胞分泌的内源性抗炎因子，可抑制气道高反应[24]。Eotaxin与炎症反应有关，是活化EOS的重要因子[25]。本研究发现，两组治疗后CD+8、EOS、MIP-1α、Eotaxin、IL-23、Th17、IL-17降低，CC-16、CD+4、CD+4/CD+8 升高，咳喘镇定汤组治疗后CD+8、EOS、MIP-1α、Eotaxin、IL-23、Th17、IL-17低于常规组，CC-16、CD+4、CD+4/CD+8 高于常规组。上述结果提示，咳喘镇定汤可通过调控小儿咳嗽变异性哮喘患儿IL-23/Th17轴，改善T淋巴亚群，纠正患儿机体免疫紊乱状态。这是其治疗小儿咳嗽变异性哮喘的重要机制之一。
受炎性细胞、炎症介质的影响，咳嗽变异性哮喘患儿气道微血管通透性增加、渗出物增多，导致气道通换气功能障碍。本研究发现，两组治疗后FEF25%、50%、75%、25% ～75%升高，咳喘镇定汤组治疗后小气道功能高于常规组。这一结果提示，咳喘镇定汤可改善小儿咳嗽变异性哮喘患儿的小气道功能。这与咳喘镇定汤纠正患儿机体免疫紊乱、减轻气道免疫炎症反应等辅助作用有关。
综上所述，咳喘镇定汤可通过调控小儿咳嗽变异性哮喘患儿IL-23/Th17轴，改善T淋巴亚群和小气道功能，减轻咳嗽症状，提高疗效。
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  • 山东省中医药科技项目(2021M028)
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参考文献 引证文献
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2025年第43卷第6期
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doi: 10.13193/j.issn.1673-7717.2025.06.042
  • 首发时间：2026-10-30
  • 出版时间：2025-06-10
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山东省中医药科技项目(2021M028)
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    滨州医学院附属医院，山东 滨州 256600

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李得志（1982-），男，山东滨州人，副主任医师，硕士，研究方向：儿科学。E-mail：。
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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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