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Article(id=1322923841105830082, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.06.016, 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=1793339222455, onlineDateStr=2026-10-30, pubDate=1749484800000, pubDateStr=2025-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339222455, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339222455, creator=13701087609, updateTime=1793339222455, 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=89, endPage=92, ext={EN=ArticleExt(id=1322923841315545283, articleId=1322923841105830082, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Effect Analysis of Feipingxiao Decoction（肺平哮汤）Combined with Respiratory Rehabilitation on Lung Function and Immune Function in Children with Bronchial 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 Feipingxiao Decoction（肺平哮汤）combined with respiratory rehabilitation on pulmonary function and immune function in children with bronchial asthma.

Methods

A total of 150 children with bronchial asthma admitted to the hospital were selected and randomly divided into control group and observation group，75 cases in each group.The control group was treated with inhaled glucocorticoids，and the observation group was given Feipingxiao Decoction combined with respiratory rehabilitation on this basis，and both groups were treated for 7 days.After treatment，the clinical treatment effect，symptom disappearance time，lung function，inflammatory factors and immune function were compared between the two groups.

Results

The total effective rate of the treatment observation group was 90.67%，which was significantly higher than that of the control group（73.33%）（P<0.05）.After treatment，the disappearance time of wheezing，rales，asthma and cough symptoms in the observation group was significantly shorter than that of the control group（P<0.05）.The levels of forced expiratory volume in 1 second（FEV1），forced vital capacity（FVC）and FEV1/FVC in both groups were significantly improved after treatment（P<0.05）.The improvement of each index in the observation group was significantly better than that in the control group（P<0.05）.The levels of C-reactive protein（CRP）and transforming growth factorβ1（TGF-β1），tumor necrosis factor-α（TNF-α）and interleukin-4（IL-4）were significantly lower than those before treatment（P<0.05）.The improvement of the indicators in the observation group was significantly better than that in the control group（P<0.05）.After treatment，the levels of immunoglobulin G（IgG），immunoglobulin A（IgA）and immunoglobulin M（IgM）were significantly higher than those before treatment（P<0.05），and the improvement of various indicators in the observation group was significantly better than that in the control group（P<0.05）.

Conclusion

Feipingxiao Decoction combined with respiratory rehabilitation can significantly improve the clinical treatment effect of children with bronchial asthma，promote the improvement of clinical symptoms，reduce the levels of inflammatory factors，and improve the pulmonary function and immune function of children.

, authors=Yan MENG1, 2, Su XIE3, authorsList=Yan MENG, Su XIE, authorCompany=null, correspAuthors=Su XIE, 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=1322923843895042252, articleId=1322923841105830082, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=肺平哮汤联合呼吸康复对支气管哮喘患儿肺功能和免疫功能的影响研究, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

肺平哮汤联合呼吸康复对支气管哮喘患儿肺功能及免疫功能的影响分析。

方法

选取医院收治的支气管哮喘患儿150例，将其随机分为对照组和观察组，各75例。对照组均给予吸入用糖皮质激素治疗，观察组在此基础上给予肺平哮汤联合呼吸康复，两组均治疗7 d。治疗后对比两组临床治疗效果、症状消失时间、肺功能、炎性因子、免疫功能。

结果

治疗观察组总有效率为90.67%，显著高于对照组的73.33%（P<0.05）；观察组治疗后哮鸣音、啰音、喘憋及咳嗽症状的消失时间均显著少于对照组（P<0.05）；两组患儿经治疗后强迫呼气一秒量（Forced Expiratory Volume in 1 second，FEV1）、用力肺活量（Forced Vital Capacity，FVC）及FEV1/FVC水平均显著提升（P<0.05），观察组各指标改善情况显著优于对照组（P<0.05）；两组患儿经治疗后C-反应蛋白（C-reactive protein，CRP）、转化生长因子β1（Transforming Growth Factor Beta 1，TGF-β1）、肿瘤坏死因子α（Tumor Necrosis Factor-alpha，TNF-α）、白细胞介素-4（Interleukin-4，IL-4）水平均较治疗前降低显著（P<0.05），观察组各项指标改善情况显著优于对照组（P<0.05）；两组患儿经治疗后免疫球蛋白G（Immunoglobulin G，IgG）、免疫球蛋白A（Immunoglobulin A，IgA）、免疫球蛋白M（Immunoglobulin M，IgM）水平均较治疗前显著升高（P<0.05），观察组各项指标改善显著优于对照组（P<0.05）。

结论

肺平哮汤联合呼吸康复显著提高小儿支气管哮喘临床治疗效果，促进患儿临床症状的改善，降低炎性因子水平，改善患儿肺功能及免疫功能。

, authors=蒙艳1, 2, 谢甦3, authorsList=蒙艳, 谢甦, authorCompany=null, correspAuthors=谢甦, authorNote=

蒙艳（1974-），女，贵州织金人，主任医师，硕士，研究方向：中医药在儿童康复治疗领域的基础及临床。

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谢甦（1969-），女，贵州贵阳人，主任医师，硕士研究生导师，博士，研究方向：中医药在儿童康复治疗领域的基础及临床。E-mail：。
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蒙艳（1974-），女，贵州织金人，主任医师，硕士，研究方向：中医药在儿童康复治疗领域的基础及临床。

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蒙艳（1974-），女，贵州织金人，主任医师，硕士，研究方向：中医药在儿童康复治疗领域的基础及临床。

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组别例数痊愈显效有效无效总有效
对照组7516（21.33）20（26.67）19（25.33）20（26.67）55（73.33）
观察组7528（37.33）23（30.67）17（22.67）7（9.33）68（90.67）
χ2值7.633 2
P值0.005 7
), ArticleFig(id=1322923845690204396, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923841105830082, language=CN, label=表1, caption=

两组支气管哮喘患儿临床疗效比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数痊愈显效有效无效总有效
对照组7516（21.33）20（26.67）19（25.33）20（26.67）55（73.33）
观察组7528（37.33）23（30.67）17（22.67）7（9.33）68（90.67）
χ2值7.633 2
P值0.005 7
), ArticleFig(id=1322923845765701869, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923841105830082, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数哮鸣音消失时间啰音消失时间憋喘消失时间咳嗽消失时间
对照组755.21±1.024.68±1.275.40±1.126.01±0.91
观察组753.12±0.54*3.20±0.35*3.08±0.29*4.25±0.84*
), ArticleFig(id=1322923845837005038, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923841105830082, language=CN, label=表2, caption=

两组支气管哮喘患儿症状消失时间比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数哮鸣音消失时间啰音消失时间憋喘消失时间咳嗽消失时间
对照组755.21±1.024.68±1.275.40±1.126.01±0.91
观察组753.12±0.54*3.20±0.35*3.08±0.29*4.25±0.84*
), ArticleFig(id=1322923845908308207, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923841105830082, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间FEV1/（L）FVC/（L）FEV1/FVC
对照组75治疗前1.49±0.352.21±0.1050.32±4.37
治疗后2.45±0.40*3.32±0.15*70.14±5.41*
观察组75治疗前1.45±0.342.60±0.1250.23±4.36
治疗后3.52±0.41*#4.04±0.18*#80.44±5.23*#
), ArticleFig(id=1322923845971222768, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923841105830082, language=CN, label=表3, caption=

两组支气管哮喘患儿治疗前后肺功能比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间FEV1/（L）FVC/（L）FEV1/FVC
对照组75治疗前1.49±0.352.21±0.1050.32±4.37
治疗后2.45±0.40*3.32±0.15*70.14±5.41*
观察组75治疗前1.45±0.342.60±0.1250.23±4.36
治疗后3.52±0.41*#4.04±0.18*#80.44±5.23*#
), ArticleFig(id=1322923846055108849, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923841105830082, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间CRP/（ng/L）TGF-β1/（ng/mL）TNF-α/（ng/mL）IL-4/（ng/L）
对照组75治疗前37.34±3.4053.35±6.75166.65±15.66194.22±13.56
治疗后9.33±1.40*48.76±5.33*96.44±10.50*137.26±10.41*
观察组75治疗前37.75±3.3153.40±6.22166.86±16.12193.35±14.21
治疗后3.38±1.02*#42.15±5.03*#72.09±9.23*#90.42±9.42*#
), ArticleFig(id=1322923847711858930, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923841105830082, language=CN, label=表4, caption=

两组支气管哮喘患儿治疗前后炎性因子水平比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间CRP/（ng/L）TGF-β1/（ng/mL）TNF-α/（ng/mL）IL-4/（ng/L）
对照组75治疗前37.34±3.4053.35±6.75166.65±15.66194.22±13.56
治疗后9.33±1.40*48.76±5.33*96.44±10.50*137.26±10.41*
观察组75治疗前37.75±3.3153.40±6.22166.86±16.12193.35±14.21
治疗后3.38±1.02*#42.15±5.03*#72.09±9.23*#90.42±9.42*#
), ArticleFig(id=1322923847795745011, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923841105830082, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间IgGIgAIgM
对照组75治疗前5.54±1.431.14±0.320.96±0.54
治疗后7.44±1.90*1.48±0.41*1.45±0.53*
观察组75治疗前5.57±1.461.15±0.450.84±0.78
治疗后9.91±1.45*#1.97±0.60*#1.99±0.63*#
), ArticleFig(id=1322923847871242484, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923841105830082, language=CN, label=表5, caption=

两组支气管哮喘患儿治疗前后免疫功能比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间IgGIgAIgM
对照组75治疗前5.54±1.431.14±0.320.96±0.54
治疗后7.44±1.90*1.48±0.41*1.45±0.53*
观察组75治疗前5.57±1.461.15±0.450.84±0.78
治疗后9.91±1.45*#1.97±0.60*#1.99±0.63*#
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肺平哮汤联合呼吸康复对支气管哮喘患儿肺功能和免疫功能的影响研究
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蒙艳 1, 2 , 谢甦 3
中华中医药学刊 | 国家项目点击 2025,43(6): 89-92
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中华中医药学刊 |国家项目点击 2025 , 43 (6) : 89 -92
肺平哮汤联合呼吸康复对支气管哮喘患儿肺功能和免疫功能的影响研究
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蒙艳（1974-），女，贵州织金人，主任医师，硕士，研究方向：中医药在儿童康复治疗领域的基础及临床。

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蒙艳（1974-），女，贵州织金人，主任医师，硕士，研究方向：中医药在儿童康复治疗领域的基础及临床。

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蒙艳1, 2, 谢甦3
作者信息
  • 1.贵州医科大学，贵州 贵阳 550004
  • 2.六盘水市妇幼保健院，贵州 六盘水 553001
  • 3.贵州医科大学附属医院，贵州 贵阳 550004
通讯作者:
谢甦（1969-），女，贵州贵阳人，主任医师，硕士研究生导师，博士，研究方向：中医药在儿童康复治疗领域的基础及临床。E-mail：。
作者简介:

蒙艳（1974-），女，贵州织金人，主任医师，硕士，研究方向：中医药在儿童康复治疗领域的基础及临床。

Effect Analysis of Feipingxiao Decoction（肺平哮汤）Combined with Respiratory Rehabilitation on Lung Function and Immune Function in Children with Bronchial Asthma
Yan MENG1, 2, Su XIE3
Affiliations
  • 1.Guizhou Medical University，Guiyang 550004，Guizhou，China
  • 2.Liupanshui Maternal and Child Health Hospital，Liupanshui 553001，Guizhou，China
  • 3.Guizhou Medical University Affiliated Hospital，Guiyang 550004，Guizhou，China
出版时间: 2025-06-10 doi: 10.13193/j.issn.1673-7717.2025.06.016
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摘要
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目的

肺平哮汤联合呼吸康复对支气管哮喘患儿肺功能及免疫功能的影响分析。

方法

选取医院收治的支气管哮喘患儿150例，将其随机分为对照组和观察组，各75例。对照组均给予吸入用糖皮质激素治疗，观察组在此基础上给予肺平哮汤联合呼吸康复，两组均治疗7 d。治疗后对比两组临床治疗效果、症状消失时间、肺功能、炎性因子、免疫功能。

结果

治疗观察组总有效率为90.67%，显著高于对照组的73.33%（P<0.05）；观察组治疗后哮鸣音、啰音、喘憋及咳嗽症状的消失时间均显著少于对照组（P<0.05）；两组患儿经治疗后强迫呼气一秒量（Forced Expiratory Volume in 1 second，FEV1）、用力肺活量（Forced Vital Capacity，FVC）及FEV1/FVC水平均显著提升（P<0.05），观察组各指标改善情况显著优于对照组（P<0.05）；两组患儿经治疗后C-反应蛋白（C-reactive protein，CRP）、转化生长因子β1（Transforming Growth Factor Beta 1，TGF-β1）、肿瘤坏死因子α（Tumor Necrosis Factor-alpha，TNF-α）、白细胞介素-4（Interleukin-4，IL-4）水平均较治疗前降低显著（P<0.05），观察组各项指标改善情况显著优于对照组（P<0.05）；两组患儿经治疗后免疫球蛋白G（Immunoglobulin G，IgG）、免疫球蛋白A（Immunoglobulin A，IgA）、免疫球蛋白M（Immunoglobulin M，IgM）水平均较治疗前显著升高（P<0.05），观察组各项指标改善显著优于对照组（P<0.05）。

结论

肺平哮汤联合呼吸康复显著提高小儿支气管哮喘临床治疗效果，促进患儿临床症状的改善，降低炎性因子水平，改善患儿肺功能及免疫功能。

肺平哮汤  /  呼吸康复  /  支气管哮喘  /  肺功能  /  免疫功能
Objective

To analyze the effect of Feipingxiao Decoction（肺平哮汤）combined with respiratory rehabilitation on pulmonary function and immune function in children with bronchial asthma.

Methods

A total of 150 children with bronchial asthma admitted to the hospital were selected and randomly divided into control group and observation group，75 cases in each group.The control group was treated with inhaled glucocorticoids，and the observation group was given Feipingxiao Decoction combined with respiratory rehabilitation on this basis，and both groups were treated for 7 days.After treatment，the clinical treatment effect，symptom disappearance time，lung function，inflammatory factors and immune function were compared between the two groups.

Results

The total effective rate of the treatment observation group was 90.67%，which was significantly higher than that of the control group（73.33%）（P<0.05）.After treatment，the disappearance time of wheezing，rales，asthma and cough symptoms in the observation group was significantly shorter than that of the control group（P<0.05）.The levels of forced expiratory volume in 1 second（FEV1），forced vital capacity（FVC）and FEV1/FVC in both groups were significantly improved after treatment（P<0.05）.The improvement of each index in the observation group was significantly better than that in the control group（P<0.05）.The levels of C-reactive protein（CRP）and transforming growth factorβ1（TGF-β1），tumor necrosis factor-α（TNF-α）and interleukin-4（IL-4）were significantly lower than those before treatment（P<0.05）.The improvement of the indicators in the observation group was significantly better than that in the control group（P<0.05）.After treatment，the levels of immunoglobulin G（IgG），immunoglobulin A（IgA）and immunoglobulin M（IgM）were significantly higher than those before treatment（P<0.05），and the improvement of various indicators in the observation group was significantly better than that in the control group（P<0.05）.

Conclusion

Feipingxiao Decoction combined with respiratory rehabilitation can significantly improve the clinical treatment effect of children with bronchial asthma，promote the improvement of clinical symptoms，reduce the levels of inflammatory factors，and improve the pulmonary function and immune function of children.

Feipingxiao Decoction（肺 平 哮 汤）  /  respiratory rehabilitation  /  bronchial asthma  /  pulmonary function  /  immune function
蒙艳, 谢甦. 肺平哮汤联合呼吸康复对支气管哮喘患儿肺功能和免疫功能的影响研究. 中华中医药学刊, 2025 , 43 (6) : 89 -92 . DOI: 10.13193/j.issn.1673-7717.2025.06.016
Yan MENG, Su XIE. Effect Analysis of Feipingxiao Decoction（肺平哮汤）Combined with Respiratory Rehabilitation on Lung Function and Immune Function in Children with Bronchial Asthma[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (6) : 89 -92 . DOI: 10.13193/j.issn.1673-7717.2025.06.016
正文
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支气管哮喘是一种常见的儿童呼吸系统慢性疾病，其患病率呈逐年上升的趋势，成为社会各界关注的公共卫生问题[1]。流行病学调查显示，小儿支气管哮喘多见于3～6岁儿童，男孩患病率高于女孩。遗传因素和环境因素相互作用被认为是其发病的主要原因[2]。小儿支气管哮喘的临床症状复杂多样，反复发作的喘息、呼吸急促、咳嗽等症状严重影响患儿的生活质量和家庭幸福[3]。气道炎症和气道重塑过程可能导致肺功能下降，影响患儿的生长发育。目前，小儿支气管哮喘的治疗主要包括救急治疗和长期控制治疗。长期使用糖皮质激素可能带来不良反应，且部分患儿对现有治疗方案反应不佳，复发和药物耐受性问题仍然存在，迫切需要更安全有效的治疗方法[4]。在这一背景下，中医药作为中国传统医学的重要组成部分，被引入治疗小儿支气管哮喘。中医药强调辨证施治，注重个体化的调理，中医药治疗可能为现有治疗方案提供有效的补充和互补，减少药物副作用，改善患儿的生活质量。本研究在常规西医治疗的基础上，使用肺平哮汤联合呼吸康复方案，旨在探究其在小儿支气管哮喘中的应用价值，现报道如下。
1　资料与方法
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1.1　一般资料
选取我院2019年6月—2022年6月收治的支气管哮喘患儿150例，按照随机数表法将纳入研究的患儿随机分为对照组及观察组，两组各75例。对照组中男39例，女36例，年龄4～9岁，平均（5.11±1.43）岁；病程1～8 d，平均（3.57±1.37）d。观察组男38例，女37例，年龄4～10岁，平均（5.67±1.23）岁；病程1～7 d，平均（3.33±1.59）d。对照组与治疗组的患儿性别、年龄、病程等一般资料的比较差异无统计学意义（P>0.05）。本研究经本院医学伦理委员会批准。
1.2　诊断标准
西医诊断参照《儿童支气管哮喘诊断与防治指南》[5]哮喘诊断标准，主要依据呼吸道症状、体征及肺功能检查，证实存在可变的呼气气流受限，并排除可引起相关症状的其他疾病。中医诊断参照《中医儿科学》[6]中寒痰阻肺证，咳嗽气喘，喉间有痰鸣音，痰多白沫，形寒肢冷，鼻流清涕，面色淡白，恶寒无汗，舌淡红，苔白滑，脉浮滑。
1.3　纳入及排除标准
1.3.1　纳入标准
①符合研究相关中西医诊断；②初始发病且处于急性发作期；③患儿年龄≤14岁；④患儿监护人对本研究相关情况知情并签署知情同意书。
1.3.2　排除标准
①不符合相关纳入标准者；②有其他呼吸系统疾病，如慢性阻塞性肺病、肺结核、肺癌等；③严重的心血管系统、肝肾功能、内分泌或免疫系统疾病，或有其他影响本研究结果的并发症；④近一个月内使用过生物制剂、免疫抑制剂或其他试验性药物治疗哮喘；⑤对本研究所使用的药物或器械有过敏史或不耐受。
1.4　方法
对照组：给予丙酸氟替卡松雾化吸入用混悬液（Glaxo-SmithKline Australia Pty Ltd，国药准字HJ2017036），雾化吸入，1 mg/次，2次/d，持续治疗7 d。观察组：在对照组基础上给予肺平哮汤：射干10 g，麻黄10 g，细辛3 g，生姜10 g，桂枝10 g，炒杏仁15 g，陈皮10 g，法半夏10 g，五味子10 g，炙甘草6 g，以上药物共水煎服，每日1剂，早晚分服，持续治疗7 d；同时采用呼吸康复法：呼吸康复采用有氧运动及呼吸训练结合的方案，有氧运动可根据患儿自身兴趣情况选择游泳、跑步、跳绳等，强度应不小于30～60 min/次，1次/d；呼吸训练包括缩唇呼吸及腹式呼吸，强度应不小于10 min/次，2次/d。
1.5　观察指标
1.5.1　症状消失时间
记录患儿治疗后哮鸣音、啰音、喘憋及咳嗽症状的消失时间。
1.5.2　肺功能检测
于患儿治疗前后使用肺功能仪测定强迫呼气一秒量（Forced Expiratory Volume in 1 second，FEV1）、用力肺活量（Forced Vital Capacity，FVC），并计算FEV1/FVC比值。
1.5.3　炎性因子
于患儿治疗前后采集空腹外周静脉血，离心处理后采用酶联免疫吸附法测定血清C-反应蛋白（C-reactive protein，CRP）、转化生长因子β1（Transforming Growth Factor Beta 1，TGF-β1）、肿瘤坏死因子α（Tumor Necrosis Factor-alpha，TNF-α）、白细胞介素-4（Interleukin-4，IL-4）水平。
1.5.4　免疫功能
于患儿治疗前后取静脉血5 mL，进行离心处理后采用酶联免疫吸附法测定血清免疫球蛋白G（Immunoglobulin G，IgG）、免疫球蛋白A（Immunoglobulin A，IgA）、免疫球蛋白M（Immunoglobulin M，IgM）。
1.6　疗效标准[7]
痊愈：喘憋、咳嗽等临床症状消失，肺部哮鸣音消失，肺功能正常；显效：喘憋、咳嗽等临床症状明显好转，肺部哮鸣音明显减轻，肺功能明显改善；有效：喘憋、咳嗽等临床症状有所改善，肺部哮鸣音减轻，肺功能有所改善但未达正常水平；无效：临床症状及肺功能无改善，甚至加重。总有效率（%）＝（痊愈+显效+有效）/总例数×100%。
1.7　统计学分析
使用SPSS 22.0统计软件对研究数据进行处理，计数资料行χ2检验，计量资料行t检验，P<0.05表明差异具有统计学意义。
2　结果
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2.1　两组患儿临床疗效的对比
观察组治疗总有效率为90.67%，显著高于对照组的73.33%（P<0.05）。见表1。
2.2　两组患儿症状消失时间的对比
观察组治疗后哮鸣音、啰音、喘憋及咳嗽症状的消失时间均显著少于对照组（P<0.05）。见表2。
2.3　两组患儿治疗前后肺功能的对比
两组患儿经治疗后FEV1、FVC及FEV1/FVC水平均显著提升（P<0.05），观察组各指标改善情况显著优于对照组（P<0.05）。见表3。
2.4　两组患者治疗前后炎性因子水平的对比
两组患儿经治疗后CRP、TGF-β1、TNF-α、IL-4水平均较治疗前降低显著（P<0.05），观察组各项指标改善情况显著优于对照组（P<0.05）。见表4。
2.5　两组患儿治疗前后免疫功能的对比
两组患儿经治疗后IgG、IgA、IgM水平均较治疗前显著升高（P<0.05），观察组各项指标改善显著优于对照组（P<0.05）。见表5。
3　讨论
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小儿支气管哮喘的发病原因复杂，可能涉及遗传、环境、免疫及感染等多种因素[8]。病理学基础主要表现为气道炎症、气道高反应性和气道重塑[9]。气道炎症涉及T淋巴细胞、嗜酸性粒细胞等炎性细胞的活化和释放炎性介质，导致气道黏膜水肿、黏液分泌增加和平滑肌收缩增强，这些病理学改变导致气道狭窄，引起支气管哮喘发作和症状[10-12]。目前，小儿支气管哮喘的常规治疗方案主要包括控制性治疗和急性发作处理[13]。控制性治疗常用的药物包括吸入糖皮质激素、长效β2受体激动剂和白三烯受体拮抗剂等，旨在减轻气道炎症和阻塞，稳定气道功能[14]。急性发作处理主要采用短效β2受体激动剂和口服糖皮质激素等，以迅速缓解支气管痉挛和炎症[15]。吸入用糖皮质激素在小儿支气管哮喘中具有重要的药理作用。它通过抑制炎症细胞的活化和炎性介质的释放，减轻气道炎症，减少黏液分泌，从而改善气道通透性，降低气道高反应性和阻塞，缓解支气管哮喘症状，提高生活质量[16]。吸入用糖皮质激素相对于口服糖皮质激素，减少了全身激素的不良反应，尤其适用于小儿患者[17]。然而，目前的治疗方案仍然存在一些限制，一方面，长期使用糖皮质激素可能会导致全身性不良反应，如生长抑制、免疫抑制和骨密度降低等，尤其对于儿童患者更为关注[18-19]；另一方面，有些患者对糖皮质激素治疗不敏感，或者出现耐药现象，导致治疗效果不佳[20]。
中医对小儿支气管哮喘的治疗具有独特的认识。中医理论认为小儿支气管哮喘的发病原因包括肺脾肾三脏功能失调、风寒湿邪侵袭和体质较弱等多个因素。由于先天禀赋不足，脏腑功能失衡导致宿痰聚积于肺经，是形成哮喘的根本原因[21]。许多患者自幼即有哮喘症状，这与体内隐藏的痰饮密切相关。外在因素会在内在因素的基础上诱发哮喘，其中风寒之邪是常见的外在原因，尤其是气候转冷时易受风寒影响而发作。长期受风寒缠绵，邪气积聚于体内，激发潜伏的痰湿或痰热而导致发病，治则当以急则治标、温化寒痰、宣肺止喘为准。本研究使用的肺平哮汤由射干、麻黄、细辛、生姜、桂枝、炒杏仁、陈皮、法半夏、五味子、炙甘草共10味药组成，其中以射干、麻黄为君药，宣肺平哮；以桂枝、细辛、生姜温肺化痰；陈皮、半夏以理气化痰；五味子、杏仁敛阴止咳；炙甘草调和诸药。上药共奏温肺化痰、止咳平喘之效。现代药理研究表明，本方中射干、麻黄等含有的麻黄碱、桂皮素、黄酮类等成分能起到抗炎、抗氧化、扩张支气管等作用[22-24]。呼吸康复是目前国内外运用十分广泛的一种干预方式，在哮喘、慢性阻塞性肺炎等疾病中能够显著改善患者肺功能，并提升患者预后，对儿童支气管哮喘的病情稳定有着积极的临床作用[25-26]。
肺功能、免疫功能和炎性因子等指标在小儿支气管哮喘中具有重要意义。肺功能指标反映患者气道通畅程度，是评估病情和治疗效果的重要依据，研究结果显示使用肺平汤联合呼吸康复后，能有效改善患者肺功能，且显著优于对照组。免疫功能指标如免疫球蛋白、淋巴细胞亚群等，反映患者免疫状态，与病程及预后密切相关，研究结果发现，观察组及对照组治疗后IgG、IgA和IgM水平均较治疗前显著改善，观察组提升显著优于对照组。炎性因子如白细胞介素、肿瘤坏死因子等，参与病理过程，影响病情发展，两组患儿经治疗后CRP、TGF-β1、TNF-α、IL-4水平均较治疗前降低显著，观察组各项指标改善情况显著优于对照组。
综上所述，肺平哮汤联合呼吸康复显著提高小儿支气管哮喘临床治疗效果，促进患儿临床症状的改善，降低炎性因子水平，改善患儿肺功能及免疫功能，值得临床推广应用。
基金
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  • 国家中医药管理局全国中药特色技术传承人才培训项目(国中医药人教函〔2020〕43)
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2025年第43卷第6期
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doi: 10.13193/j.issn.1673-7717.2025.06.016
  • 首发时间：2026-10-30
  • 出版时间：2025-06-10
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国家中医药管理局全国中药特色技术传承人才培训项目(国中医药人教函〔2020〕43)
作者信息
    1.贵州医科大学，贵州 贵阳 550004
    2.六盘水市妇幼保健院，贵州 六盘水 553001
    3.贵州医科大学附属医院，贵州 贵阳 550004

通讯作者:

谢甦（1969-），女，贵州贵阳人，主任医师，硕士研究生导师，博士，研究方向：中医药在儿童康复治疗领域的基础及临床。E-mail：。
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https://castjournals.cast.org.cn/joweb/zhzyyxk/CN/10.13193/j.issn.1673-7717.2025.06.016
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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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