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Article(id=1322923852686307900, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.06.041, 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=1793339225217, onlineDateStr=2026-10-30, pubDate=1749484800000, pubDateStr=2025-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339225217, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339225216, creator=13701087609, updateTime=1793339225216, 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=200, endPage=203, ext={EN=ArticleExt(id=1322923852933771838, articleId=1322923852686307900, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Effects of Xuanbai Chengqi Decoction（宣白承气汤）Combined with Budesonide Formoterol Inhalant on Lung Function and Related Inflammatory Factors in Children with Rhinitis in Remission of Bronchial Asthma, columnId=1256183365644968140, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Platform of Provincial Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the effects of Xuanbai Chengqi Decoction（宣白承气汤）combined with budesonide formoterol inhalant on lung function and related inflammatory factors in children with rhinitis in remission of bronchial asthma.

Methods

A total of 188 children with asthma combined with rhinitis admitted to the hospital from January to December 2020 were divided into control group（94 cases，budesonide formoterol inhalant）and observation group（94 cases，Xuanbai Chengqi Decoction combined with budesonide formoterol inhalant）according to different treatment methods.The patients were treated for consecutive 8 weeks.The clinical efficacy（rale resolution time，cough resolution time and gasping relief time），lung function［lung capacity（FVC），forced expiratory volume at the end of the first second（FEV1），peak expiratory flow rate（PEF）］and inflammatory indicators［C-reactive protein（CRP），interleukin-6（IL-6），tumor necrosis factor-α（TNF-α）］of the two groups were observed and compared.Murray Lung injury score，acute physiological and chronic health score，serum leukotriene（LTD4），nerve growth factor（NGF）and TCM symptom and sign scores were compared.

Results

The time of rales disappearance，cough disappearance and gasping relief in the observation group were faster than those in the control group（P<0.05）.After treatment，the levels of FVC，FEV1 and PEF in the observation group were significantly increased compared with those in the control group（P<0.05）.After treatment，the levels of CRP，IL-6 and TNF-αin the observation group were significantly decreased compared with those in the control group（P<0.05）.After treatment，Murray lung injury score and APACHEⅡscore of the two groups were lower than those before treatment，and the difference between the two groups was statistically significant（P<0.05）.Compared with those before treatment，the levels of LTD4 and NGF in both groups were significantly decreased after treatment（P<0.05），and the levels of LTD4 and NGF in the observation group were significantly decreased（P<0.05）.The scores of phlegm，nasal discharge，cold limbs，tongue quality and tongue coating in the observation group were significantly lower than those in control group（P<0.05）.

Conclusion

Xuanbai Chengqi Decoction combined with budesonide formoterol inhalation has a significant effect in the treatment of children with bronchial asthma complicated with rhinitis，and can quickly relieve the clinical symptoms，improve the lung function，reduce the levels of inflammatory factors，Murray lung injury score and TCM symptom and sign scores.

, authors=Luying XU, Ping LI, Huifen WU, authorsList=Luying XU, Ping LI, Huifen WU, authorCompany=null, correspAuthors=Ping 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=1322923854301114957, articleId=1322923852686307900, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=宣白承气汤联合布地奈德福莫特罗吸入剂对支气管哮喘缓解期合并鼻炎患儿肺功能及相关炎症因子的影响, columnId=1256183369033965799, journalTitle=中华中医药学刊, columnName=省级项目平台, runingTitle=null, highlight=null, articleAbstract=
目的

探讨宣白承气汤联合布地奈德福莫特罗吸入剂对支气管哮喘缓解期合并鼻炎患儿肺功能及相关炎症因子的影响。

方法

选取医院2020年1—12月收治的188例哮喘合并鼻炎患儿，按照治疗方法的不同分为对照组（94例，给予布地奈德福莫特罗吸入剂）和观察组（94例，给予宣白承气汤联合布地奈德福莫特罗吸入剂），连续治疗8周。观察并比较两组临床疗效（肺部啰音消失时间、咳嗽消失时间及气促缓解时间），肺活量（FVC）、第1 s末用力呼气量（FEV1）及呼气峰流速（PEF）和血清C反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子（TNF-α），Murray肺损伤评分、急性生理与慢性健康评分、血清白细胞三烯（LTD4）、神经生长因子（NGF）水平及中医症状体征积分。

结果

观察组患儿肺部啰音消失时间、咳嗽消失时间及气促缓解时间均快于对照组（P<0.05）；治疗后，观察组患者FVC、FEV1、PEF均较对照组显著提高（P<0.05）；治疗后，观察组患者CRP、IL-6及TNF-α水平均较对照组显著降低（P<0.05）。两组治疗后Murray肺损伤评分较治疗前降低，APACHEⅡ评分降低，且组间相比差异有统计学意义（P<0.05）。与治疗前比较，治疗后两组患者LTD4和NGF水平均显著下降（P<0.05），且观察组LTD4和NGF水平下降更为显著（P<0.05）。观察组的咯痰、清涕、畏寒肢冷、舌质和舌苔症状积分显著低于对照组（P<0.05）。

结论

宣白承气汤联合布地奈德福莫特罗吸入剂治疗支气管哮喘合并鼻炎患儿，疗效显著，可快速缓解临床症状，改善患儿的肺功能，降低炎症因子水平、Murray肺损伤评分及中医症状体征积分。

, authors=徐璐莹, 李萍, 吴慧芬, authorsList=徐璐莹, 李萍, 吴慧芬, authorCompany=null, correspAuthors=李萍, authorNote=

徐璐莹（1982-），女，浙江杭州人，检验师，学士，研究方向：检验医学。

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李萍（1987-），女，浙江杭州人，副主任检验师，研究方向：检验医学。E-mail：。
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徐璐莹（1982-），女，浙江杭州人，检验师，学士，研究方向：检验医学。

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徐璐莹（1982-），女，浙江杭州人，检验师，学士，研究方向：检验医学。

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journalId=1255847919539208197, articleId=1322923852686307900, language=CN, orderNo=5, keyword=肺功能), Keyword(id=1322923857878856307, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, language=CN, orderNo=6, keyword=炎症因子)], refs=[Reference(id=1322923859065844353, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, doi=null, pmid=null, pmcid=null, year=2022, volume=38, issue=16, pageStart=3, pageEnd=null, url=null, language=null, rfNumber=［1］, rfOrder=0, authorNames=董敏, 乔赟, journalName=甘肃科技, refType=null, unstructuredReference=董敏，乔赟. “肺鼻同治”法治疗小儿哮喘的中药复方应用研究进展［J］. 甘肃科技，2022，38（16）：3., articleTitle=“肺鼻同治”法治疗小儿哮喘的中药复方应用研究进展, refAbstract=null), Reference(id=1322923859183284866, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, doi=null, pmid=null, pmcid=null, year=2021, volume=16, issue=2, pageStart=4, pageEnd=8, url=null, language=null, rfNumber=［2］, rfOrder=1, 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unstructuredReference=王知兵，于克静，刘倩倩，等. 加味宣白承气汤辅助治疗重症创伤呼吸机相关性肺炎痰热壅肺证患者30例临床观察［J］. 中医杂志，2023，64（3）：269-274., articleTitle=加味宣白承气汤辅助治疗重症创伤呼吸机相关性肺炎痰热壅肺证患者30例临床观察, refAbstract=null), Reference(id=1322923863146902172, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, doi=null, pmid=null, pmcid=null, year=2022, volume=33, issue=12, pageStart=2957, pageEnd=2959, url=null, language=null, rfNumber=［28］, rfOrder=27, authorNames=任玉梅, 张霞, 高敏, journalName=时珍国医国药, refType=null, unstructuredReference=任玉梅，张霞，高敏，等. 宣白承气汤合麻杏石甘汤加减治疗儿童大叶性肺炎的效果及对链球菌感染的作用研究［J］. 时珍国医国药，2022，33（12）：2957-2959., articleTitle=宣白承气汤合麻杏石甘汤加减治疗儿童大叶性肺炎的效果及对链球菌感染的作用研究, refAbstract=null), Reference(id=1322923863218205341, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, doi=null, pmid=null, pmcid=null, year=2022, volume=37, issue=22, pageStart=4197, pageEnd=4201, url=null, language=null, rfNumber=［29］, rfOrder=28, authorNames=陈玉梅, journalName=光明中医, refType=null, unstructuredReference=陈玉梅. 基于肺肠同治理论探讨宣白承气汤治疗慢性阻塞性肺疾病作用机制研究进展［J］. 光明中医，2022，37（22）：4197-4201., articleTitle=基于肺肠同治理论探讨宣白承气汤治疗慢性阻塞性肺疾病作用机制研究进展, refAbstract=null), Reference(id=1322923863297897118, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, doi=null, pmid=null, pmcid=null, year=2022, volume=38, issue=10, pageStart=1741, pageEnd=1743, url=null, language=null, rfNumber=［30］, rfOrder=29, authorNames=李赛, 张凌锋, 郑刘哲, journalName=实用中医药杂志, refType=null, unstructuredReference=李赛，张凌锋，郑刘哲. 宣白承气汤加减辅治重症肺炎临床观察［J］. 实用中医药杂志，2022，38（10）：1741-1743., articleTitle=宣白承气汤加减辅治重症肺炎临床观察, refAbstract=null), Reference(id=1322923863369200287, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, doi=null, pmid=null, pmcid=null, year=2022, volume=33, issue=10, pageStart=1386, pageEnd=1393, url=null, language=null, rfNumber=［31］, rfOrder=30, authorNames=孙明月, 兰明月, 杨阳, journalName=中药新药与临床药理, refType=null, unstructuredReference=孙明月，兰明月，杨阳，等. 宣白承气汤治疗支气管哮喘的网络药理学分析［J］. 中药新药与临床药理，2022，33（10）：1386-1393., articleTitle=宣白承气汤治疗支气管哮喘的网络药理学分析, refAbstract=null), Reference(id=1322923863432114848, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, doi=null, pmid=null, pmcid=null, year=2023, volume=50, issue=5, pageStart=126, pageEnd=129, url=null, language=null, rfNumber=［32］, rfOrder=31, authorNames=邢楠, journalName=辽宁中医杂志, refType=null, unstructuredReference=邢楠. 三拗汤辨证加减联合阿奇霉素治疗小儿支原体肺炎的临床观察［J］. 辽宁中医杂志，2023，50（5）：126-129., articleTitle=三拗汤辨证加减联合阿奇霉素治疗小儿支原体肺炎的临床观察, refAbstract=null), Reference(id=1322923863507612321, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, doi=null, pmid=null, pmcid=null, year=2022, volume=51, issue=3, pageStart=132, pageEnd=134, url=null, language=null, rfNumber=［33］, rfOrder=32, authorNames=杨芸, 高瞻鹏, journalName=黑龙江中医药, refType=null, unstructuredReference=杨芸，高瞻鹏. 探讨痰热壅肺型重症肺炎经宣白承气汤加减治疗的效果［J］. 黑龙江中医药，2022，51（3）：132-134., articleTitle=探讨痰热壅肺型重症肺炎经宣白承气汤加减治疗的效果, refAbstract=null)], funds=[Fund(id=1322923858960986752, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, awardId=2016ZB109, language=CN, fundingSource=浙江省中医药科技计划项目(2016ZB109), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1322923854611493456, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, xref=null, ext=[AuthorCompanyExt(id=1322923854628270673, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, companyId=1322923854611493456, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Xiaoshan Hospital of Traditional Chinese Medicine，Hangzhou 311201，Zhejiang，China), AuthorCompanyExt(id=1322923854636659282, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, 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组别例数肺部啰音消失时间咳嗽消失时间气促缓解时间
对照组945.80±1.457.70±2.453.18±0.98
观察组944.09±1.28b5.05±2.10b2.10±0.58b
), ArticleFig(id=1322923858050822773, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, language=CN, label=表1, caption=

两组支气管哮喘患儿临床症状缓解时间比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数肺部啰音消失时间咳嗽消失时间气促缓解时间
对照组945.80±1.457.70±2.453.18±0.98
观察组944.09±1.28b5.05±2.10b2.10±0.58b
), ArticleFig(id=1322923858109543030, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数FVC/（L）FEV1/（L）PEF/（L/s）
治疗前治疗后治疗前治疗后治疗前治疗后
对照组942.75±0.353.08±0.41a1.65±0.332.47±0.37a2.10±0.602.89±0.81a
观察组942.71±0.373.97±0.45ab1.67±0.363.12±0.45ab2.13±0.623.78±0.91ab
), ArticleFig(id=1322923858176651895, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, language=CN, label=表2, caption=

两组支气管哮喘患儿治疗前后肺功能指标比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数FVC/（L）FEV1/（L）PEF/（L/s）
治疗前治疗后治疗前治疗后治疗前治疗后
对照组942.75±0.353.08±0.41a1.65±0.332.47±0.37a2.10±0.602.89±0.81a
观察组942.71±0.373.97±0.45ab1.67±0.363.12±0.45ab2.13±0.623.78±0.91ab
), ArticleFig(id=1322923858268926584, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数CRP/（ng/L）IL-6/（ng/L）TNF-α/（μg/L）
治疗前治疗后治疗前治疗后治疗前治疗后
对照组94412.32±35.21189.26±20.13a14.29±2.437.05±1.72a182.38±20.17149.27±17.21a
观察组94409.28±38.12162.39±12.39ab13.88±2.174.52±1.06ab184.26±21.09130.28±15.14ab
), ArticleFig(id=1322923858344424057, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, language=CN, label=表3, caption=

两组支气管哮喘患者治疗前后炎症因子水平比较（±s）

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组别例数CRP/（ng/L）IL-6/（ng/L）TNF-α/（μg/L）
治疗前治疗后治疗前治疗后治疗前治疗后
对照组94412.32±35.21189.26±20.13a14.29±2.437.05±1.72a182.38±20.17149.27±17.21a
观察组94409.28±38.12162.39±12.39ab13.88±2.174.52±1.06ab184.26±21.09130.28±15.14ab
), ArticleFig(id=1322923858419921530, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间Murray肺损伤评分APACHEⅡ评分
观察组94治疗前2.53±0.5322.52±5.45
治疗后1.64±0.46a13.74±3.45a
对照组94治疗前2.63±0.6821.52±5.35
治疗后2.35±0.63ab17.46±4.26ab
), ArticleFig(id=1322923858499613307, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, language=CN, label=表4, caption=

两组支气管哮喘患者治疗前后Murray肺损伤评分和APACHEⅡ评分对比（±s）

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组别例数时间Murray肺损伤评分APACHEⅡ评分
观察组94治疗前2.53±0.5322.52±5.45
治疗后1.64±0.46a13.74±3.45a
对照组94治疗前2.63±0.6821.52±5.35
治疗后2.35±0.63ab17.46±4.26ab
), ArticleFig(id=1322923858587693692, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数LTD4/（ng/mL）NGF/（pg/mL）
治疗前治疗后治疗前治疗后
对照组9417.34±2.2412.74±1.64a101.43±16.1385.35±10.64a
观察组9417.75±2.537.54±1.24ab100.46±15.4567.54±7.53ab
), ArticleFig(id=1322923858663191165, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, language=CN, label=表5, caption=

两组支气管哮喘患者治疗前后LTD4和NGF水平比较

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组别例数LTD4/（ng/mL）NGF/（pg/mL）
治疗前治疗后治疗前治疗后
对照组9417.34±2.2412.74±1.64a101.43±16.1385.35±10.64a
观察组9417.75±2.537.54±1.24ab100.46±15.4567.54±7.53ab
), ArticleFig(id=1322923858768048766, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
证候例数时间喘息哮鸣音咳嗽咯痰清涕畏寒肢冷面色淡白舌质舌苔
观察组94干预前1.43±0.672.77±1.102.33±0.632.40±0.701.25±0.780.87±0.220.40±0.250.79±0.470.84±0.42
干预后0.41±0.26a0.64±0.71a1.31±0.54a0.84±0.39ab0.18±0.11ab0.14±0.11ab0.11±0.08a0.26±0.12ab0.08±0.10ab
对照组94干预前1.61±0.882.95±1.042.16±0.572.26±0.641.16±0.790.79±0.310.35±0.180.72±0.380.79±0.52
干预后0.38±0.22a0.59±0.82a1.04±0.76a1.42±0.52a0.92±0.40a0.36±0.44a0.14±0.06a0.58±0.34a0.38±0.43a
), ArticleFig(id=1322923858856129151, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923852686307900, language=CN, label=表6, caption=

两组支气管哮喘患儿治疗前后中医证候积分比较（±s）

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证候例数时间喘息哮鸣音咳嗽咯痰清涕畏寒肢冷面色淡白舌质舌苔
观察组94干预前1.43±0.672.77±1.102.33±0.632.40±0.701.25±0.780.87±0.220.40±0.250.79±0.470.84±0.42
干预后0.41±0.26a0.64±0.71a1.31±0.54a0.84±0.39ab0.18±0.11ab0.14±0.11ab0.11±0.08a0.26±0.12ab0.08±0.10ab
对照组94干预前1.61±0.882.95±1.042.16±0.572.26±0.641.16±0.790.79±0.310.35±0.180.72±0.380.79±0.52
干预后0.38±0.22a0.59±0.82a1.04±0.76a1.42±0.52a0.92±0.40a0.36±0.44a0.14±0.06a0.58±0.34a0.38±0.43a
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宣白承气汤联合布地奈德福莫特罗吸入剂对支气管哮喘缓解期合并鼻炎患儿肺功能及相关炎症因子的影响
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徐璐莹 , 李萍 , 吴慧芬
中华中医药学刊 | 省级项目平台 2025,43(6): 200-203
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中华中医药学刊 |省级项目平台 2025 , 43 (6) : 200 -203
宣白承气汤联合布地奈德福莫特罗吸入剂对支气管哮喘缓解期合并鼻炎患儿肺功能及相关炎症因子的影响
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徐璐莹, 李萍 , 吴慧芬
作者信息
  • 浙江中医药大学附属江南医院，浙江 杭州 311201
通讯作者:
李萍（1987-），女，浙江杭州人，副主任检验师，研究方向：检验医学。E-mail：。
作者简介:

徐璐莹（1982-），女，浙江杭州人，检验师，学士，研究方向：检验医学。

Effects of Xuanbai Chengqi Decoction（宣白承气汤）Combined with Budesonide Formoterol Inhalant on Lung Function and Related Inflammatory Factors in Children with Rhinitis in Remission of Bronchial Asthma
Luying XU, Ping LI , Huifen WU
Affiliations
  • Xiaoshan Hospital of Traditional Chinese Medicine，Hangzhou 311201，Zhejiang，China
出版时间: 2025-06-10 doi: 10.13193/j.issn.1673-7717.2025.06.041
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摘要
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目的

探讨宣白承气汤联合布地奈德福莫特罗吸入剂对支气管哮喘缓解期合并鼻炎患儿肺功能及相关炎症因子的影响。

方法

选取医院2020年1—12月收治的188例哮喘合并鼻炎患儿，按照治疗方法的不同分为对照组（94例，给予布地奈德福莫特罗吸入剂）和观察组（94例，给予宣白承气汤联合布地奈德福莫特罗吸入剂），连续治疗8周。观察并比较两组临床疗效（肺部啰音消失时间、咳嗽消失时间及气促缓解时间），肺活量（FVC）、第1 s末用力呼气量（FEV1）及呼气峰流速（PEF）和血清C反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子（TNF-α），Murray肺损伤评分、急性生理与慢性健康评分、血清白细胞三烯（LTD4）、神经生长因子（NGF）水平及中医症状体征积分。

结果

观察组患儿肺部啰音消失时间、咳嗽消失时间及气促缓解时间均快于对照组（P<0.05）；治疗后，观察组患者FVC、FEV1、PEF均较对照组显著提高（P<0.05）；治疗后，观察组患者CRP、IL-6及TNF-α水平均较对照组显著降低（P<0.05）。两组治疗后Murray肺损伤评分较治疗前降低，APACHEⅡ评分降低，且组间相比差异有统计学意义（P<0.05）。与治疗前比较，治疗后两组患者LTD4和NGF水平均显著下降（P<0.05），且观察组LTD4和NGF水平下降更为显著（P<0.05）。观察组的咯痰、清涕、畏寒肢冷、舌质和舌苔症状积分显著低于对照组（P<0.05）。

结论

宣白承气汤联合布地奈德福莫特罗吸入剂治疗支气管哮喘合并鼻炎患儿，疗效显著，可快速缓解临床症状，改善患儿的肺功能，降低炎症因子水平、Murray肺损伤评分及中医症状体征积分。

儿童哮喘  /  鼻炎  /  宣白承气汤  /  布地奈德  /  肺功能  /  炎症因子
Objective

To investigate the effects of Xuanbai Chengqi Decoction（宣白承气汤）combined with budesonide formoterol inhalant on lung function and related inflammatory factors in children with rhinitis in remission of bronchial asthma.

Methods

A total of 188 children with asthma combined with rhinitis admitted to the hospital from January to December 2020 were divided into control group（94 cases，budesonide formoterol inhalant）and observation group（94 cases，Xuanbai Chengqi Decoction combined with budesonide formoterol inhalant）according to different treatment methods.The patients were treated for consecutive 8 weeks.The clinical efficacy（rale resolution time，cough resolution time and gasping relief time），lung function［lung capacity（FVC），forced expiratory volume at the end of the first second（FEV1），peak expiratory flow rate（PEF）］and inflammatory indicators［C-reactive protein（CRP），interleukin-6（IL-6），tumor necrosis factor-α（TNF-α）］of the two groups were observed and compared.Murray Lung injury score，acute physiological and chronic health score，serum leukotriene（LTD4），nerve growth factor（NGF）and TCM symptom and sign scores were compared.

Results

The time of rales disappearance，cough disappearance and gasping relief in the observation group were faster than those in the control group（P<0.05）.After treatment，the levels of FVC，FEV1 and PEF in the observation group were significantly increased compared with those in the control group（P<0.05）.After treatment，the levels of CRP，IL-6 and TNF-αin the observation group were significantly decreased compared with those in the control group（P<0.05）.After treatment，Murray lung injury score and APACHEⅡscore of the two groups were lower than those before treatment，and the difference between the two groups was statistically significant（P<0.05）.Compared with those before treatment，the levels of LTD4 and NGF in both groups were significantly decreased after treatment（P<0.05），and the levels of LTD4 and NGF in the observation group were significantly decreased（P<0.05）.The scores of phlegm，nasal discharge，cold limbs，tongue quality and tongue coating in the observation group were significantly lower than those in control group（P<0.05）.

Conclusion

Xuanbai Chengqi Decoction combined with budesonide formoterol inhalation has a significant effect in the treatment of children with bronchial asthma complicated with rhinitis，and can quickly relieve the clinical symptoms，improve the lung function，reduce the levels of inflammatory factors，Murray lung injury score and TCM symptom and sign scores.

children asthma  /  rhinitis  /  Xuanbai Chengqi Decoction（宣白承气汤）  /  budesonide  /  lung function  /  inflammatory factor
徐璐莹, 李萍, 吴慧芬. 宣白承气汤联合布地奈德福莫特罗吸入剂对支气管哮喘缓解期合并鼻炎患儿肺功能及相关炎症因子的影响. 中华中医药学刊, 2025 , 43 (6) : 200 -203 . DOI: 10.13193/j.issn.1673-7717.2025.06.041
Luying XU, Ping LI, Huifen WU. Effects of Xuanbai Chengqi Decoction（宣白承气汤）Combined with Budesonide Formoterol Inhalant on Lung Function and Related Inflammatory Factors in Children with Rhinitis in Remission of Bronchial Asthma[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (6) : 200 -203 . DOI: 10.13193/j.issn.1673-7717.2025.06.041
正文
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支气管哮喘是由多种细胞和细胞组分参与的气道慢性炎症性疾病，这种慢性炎症与气道高反应性相关，通常出现广泛而多变的可逆性气流受限，导致反复发作的喘息、气促、胸闷和咳嗽等症状，多在夜间和清晨发作、加剧，多数患者可自行缓解或经治疗缓解。据统计，全球支气管哮喘患病率约为1%～4%[1]，据报告美国约有7%的人有支气管哮喘史.地中海居民支气管哮喘发病率高达32%[2]。据2019年《柳叶刀》数据显示，中国20岁及以上人群哮喘患病率为4.2%，患者总数达4570万[3]。同年，中国儿童哮喘患病率调查显示，14岁以下人群哮喘患病率为3.02%，哮喘患儿约有1500万[4]。哮喘是儿童时期最常见的呼吸道感染疾病，也是一种慢性炎症性疾病，主要临床表现为胸闷、气短、咳嗽、痰多，严重影响患儿的身心健康。支气管哮喘缓解期，也称为稳定期，通过药物治疗后症状得以控制的支气管哮喘，缓解期虽然症状不会发作，但是仍需治疗。流行病学研究显示，80%～95%的哮喘同时患过敏性鼻炎，而过敏性鼻炎将近40%同时有哮喘[5]。鼻炎是机体暴露于变应原后主要由IgE介导的鼻黏膜非感染性慢性炎性疾病，主要表现为阵发性反复发作的喷嚏、鼻痒、水样涕和鼻塞[6]。保守估计全球的鼻炎患者超过5亿[4]，中国鼻炎患病率上升较快，有文献综述认为中国大陆地区鼻炎的患病率4%～38%[5]。鼻炎为上气道慢性炎症性疾病，而哮喘为下气道慢性炎症性疾病，两者发病率都比较高，哮喘与鼻炎关系密切，约40%鼻炎患者伴有哮喘[6]，有60%～78%哮喘患者合并鼻炎，是健康人群的5～7倍[7]。布地奈德是常用的糖皮质激素，可有效抑制炎性因子水平。宣白承气汤出自《温病条辨》，“喘促不宁，痰涎壅盛，右寸实大，肺气不降者，宣白承气汤主之”[8]。本研究宣白承气汤联合布地奈德福莫特罗吸入剂对支气管哮喘缓解期患儿肺功能及相关炎症因子的影响，现报道如下。
1　资料与方法
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1.1　一般资料
选取2020年1月—2020年12月浙江中医药大学附属医院收治的哮喘患儿188例，均符合《中国儿童慢性咳嗽诊断与治疗指南》[9]。188例哮喘患儿中男90例，女98例；年龄：3～12岁，平均（8.84±1.73）岁；病程：5个月～5年，平均（2.16±0.75）年；体质量：14～35 kg，平均（28.35±5.85）kg。按照入院的先后顺序随机分为对照组和观察组各94例，两组患儿性别、年龄、病程及体质量比较差异无统计学意义（P>0.05），具有可比性。
1.2　方法
两组患儿入院时行常规检查，包括血常规、肺功能和炎症指标；然后给予常规治疗，包括镇静、吸氧、抗感染、纠正酸碱度等常规指标。对照组：在对照组基础上给予布地奈德福莫特罗粉吸入剂（批准文号：H20090773，企业名称：AstraZeneca AB）推荐剂量：成年人和青少年（12岁和12岁以上）80μg/4.5μg/吸：1～2吸/次，2次/d，信必可都保160μg/4.5μg/吸：1～2吸/次，2次/d。在常规治疗中，当2次/d剂量可有效控制症状时，应逐渐减少剂量至最低有效剂量，甚至1次/d给予信必可都保。观察组：在对照组基础上联合宣白承气汤，组成与用法：生石膏15 g，生大黄9 g，杏仁粉6 g，瓜蒌皮4.5 g，水煎，分2次服。两组均连续治疗8周后比较临床疗效。
1.3　观察指标
①观察两组患儿治疗后症状的恢复和改善时间，包括肺部啰音消失时间、咳嗽消失时间及气促缓解时间。②分别于治疗前和治疗8周时测定肺功能指标，采用肺功能检测仪与肺峰流速仪测定肺活量（FVC）、第1 s末用力呼气量（FEV1）及呼气峰流速（PEF）。③分别于治疗前和治疗8周时抽取空腹静脉血4 mL，离心后取血清，采用酶联免疫吸附法对两组患儿血清C反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子（TNF-α）。④评估两组Murray肺损伤评分和急性生理与慢性健康评分。⑤检测并比较两组血清白细胞三烯（LTD4）、神经生长因子（NGF）水平。⑥中医症状体征积分[9]，比较两组治疗前后主症（喘息、哮鸣音）、次症（咳嗽症状、咯痰症状、清涕症状、畏寒肢冷、面色淡白）、舌质和舌苔积分。
1.4　统计学方法
采用SPSS 20.0软件包对数据进行统计学分析，计数资料采用χ2检验，计量资料采用t检验，以P<0.05表示差异有统计学意义。
2　结果
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2.1　临床症状缓解时间比较
观察组患儿肺部啰音消失时间、咳嗽消失时间及气促缓解时间均快于对照组（P<0.05）。见表1。
2.2　肺功能指标比较
治疗后两组患者FVC、FEV1、PEF均较治疗前显著提高（P<0.05），且观察组肺功能指标较对照组改善更为明显（P<0.05）。见表2。
2.3　炎症因子水平比较
治疗后两组患者CRP、IL-6及TNF-α水平均较治疗前显著降低（P<0.05），且观察组炎症因子水平较对照组下降更为明显（P<0.05）。见表3。
2.4　肺损伤改善程度与病情进展APACHEⅡ评分
两组治疗后Murray肺损伤评分较治疗前降低，APACHEⅡ评分降低，且组间相比差异有统计学意义（P<0.05）。见表4。
2.5　LTD4和NGF水平比较
与治疗前比较，治疗后两组患者LTD4和NGF水平均显著下降（P<0.05），且观察组LTD4和NGF水平下降更为显著（P<0.05）。见表5。
经治疗干预后，两组患儿的主症（喘息、哮鸣音）、次症（咳嗽症状、咯痰症状、清涕症状、畏寒肢冷、面色淡白）、舌质和舌苔积分均显著降低（P<0.05），其中观察组的咯痰、清涕、畏寒肢冷、舌质和舌苔症状积分显著低于对照组（P<0.05）。见表6。
3　讨论
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鼻炎是哮喘症状加重的独立危险因素，其关联被称为“同一个气道，同一种疾病”。据报道10%～60%的变应性鼻炎患者伴有哮喘[10]，28% ～85%的哮喘患者伴有变应性鼻炎鼻黏膜和支气管黏膜的病理改变有许多相似之处[11]，均有大量的嗜酸性细胞浸润、淋巴细胞增多、杯状细胞增生、上皮下微循环丰富和血浆的大量渗出[12]。现代医学证实鼻炎的上呼吸道过敏性炎症可向下呼吸道逐渐蔓延，并可相继发生过敏性咽炎、过敏性支气管炎和哮喘病，形成了全呼吸道过敏现象，因此哮喘病的下呼吸道过敏性炎症实际上是鼻炎上呼吸道炎症的延伸[13-15]。鼻炎和哮喘的支气管炎症通常由相同过敏原引起，其发病机制均与Ⅰ型变态反应有关，病理学均是以呼吸道嗜酸性粒细胞增高为特征的过敏性炎症[16]。鼻炎患者对过敏原的易感性，即特应征（Atopy）是哮喘病发病的主要因素，而体现哮喘病患者特应征的主要指标是体内的总IgE和特异性IgE水平增高。鼻炎和哮喘存在着不同的炎症指标，但免疫病理学已经证实在上、下呼吸道的慢性过敏性炎症是相似的，参与的细胞因子是相似的，如IL-4、IL-5、IL-13等多种炎性介质等[17-18]。因此，可将CRP、IL-6及TNF-α三项作为评价炎症反应炎症程度的指标。本研究发现，治疗后两组患者CRP、IL-6及TNF-α水平均较治疗前显著降低（P<0.05），且观察组炎症因子水平较对照组下降更为明显（P<0.05）。说明观察组的治疗方案可显著降低儿童哮喘患儿的炎症反应。分析原因：宣白承气汤出自《温病条辨》卷二第17条：“阳明温病，下之不通，其证有五：应下失下，正虚不能运药，不运药者死，新加黄龙汤主之[19-23]。喘促不宁，痰涎壅盛，右寸实大，肺气不降者，宣白承气汤主之……其因肺气不降，而里证又实者，必喘促寸实，则以杏仁、石膏宣肺气之痹，以大黄逐肠胃之结，此脏腑合治法也”。温病邪热易于炼液为痰，痰热互结则气机阻塞，导致肺失肃降，腑气不通。肺与大肠相表里，主宣发肃降，腑气则赖肺气的肃降得以畅通，且“清肺需通腑，腑气通肺气宣”，故此时应考虑宣上通下，“肺肠合治”，达到“釜底抽薪”的效果。肺在五行属金，在五色与白相应。宣白承气汤中，“宣白”指宣通肺气；“承气”谓承顺腑气，主治阳明温病，下之不通，喘促不宁，痰涎壅滞，大便秘结，脉右寸实大，证属肺气不降者。现代临床可用于治疗肺炎，支气管感染，支气管哮喘，肺热等。方用生石膏、杏仁清肺热、平喘促，生大黄、栝蒌皮导热通便，使肺热从大肠解泄；表里兼顾，标本并治，为其配伍特点。诸药同用，可使肺气宣降，腑气畅通，痰热得清，咳喘可止。
肺功能的检测可充分体现人体呼吸系统的真实生理功能，帮助哮喘患儿判断及鉴别疾病，有助于反映哮喘病情的严重程度[13]。本研究中治疗后两组患者FVC、FEV1、PEF均较治疗前显著提高（P<0.05），且观察组肺功能指标较对照组改善更为明显（P<0.05），提示布地奈德联合孟鲁司特钠可改善哮喘患儿的肺功能。另外由表1可见，观察组患儿肺部啰音消失时间、咳嗽消失时间及气促缓解时间均快于对照组（P<0.05），两组治疗后Murray肺损伤评分较治疗前降低，APACHEⅡ评分降低，且组间相比差异有统计意义（P<0.05）。与治疗前比较，治疗后两组患者LTD4和NGF水平均显著下降（P<0.05），且观察组LTD4和NGF水平下降更为显著（P<0.05）。观察组的咯痰、清涕、畏寒肢冷、舌质和舌苔症状积分显著低于对照组（P<0.05）。提示，宣白承气汤以石膏清泄肺热，瓜蒌壳降火涤痰，二药去热痰壅滞。鼻炎和支气管哮喘分别属于中医“鼻鼽”和“哮病”范畴。两者虽划分为不同的病种，但本质上皆属肺系疾病。肺主气，司呼吸，上连气道、喉咙，开窍于鼻。多因禀赋素虚，易感外邪，肺气上逆，肺失宣降，津液输布、代谢失常，伏痰留滞，在外则表现鼻鼽的症状，即鼻痒、喷嚏、流清涕、鼻塞等；在内则可使气道挛急，喉间痰鸣，发为哮病，久病肺虚及肾，气失摄纳，气不得续，动则喘甚[24-25]。鼻鼽病位在鼻，治疗上多采用益气固表、温阳散寒、清热通阳等法；哮病病位在肺，自仲景以后皆以“痰饮”为宿根，治则当以温阳化饮，降气平喘，补肺益肾为主[26]。两病同时存在时，需要分清标本缓急，并遵循以下原则辨证施治。患者素体虚弱，脾肾阳虚，痰饮伏于肺中，每遇外感邪气触冒，气逆痰涌而发病，治疗全程当重视补肺、健脾、补肾；发作期常见寒饮伏肺、痰热蕴肺、风痰阻肺等证型，治则以祛邪化痰、降逆通窍为主；缓解期治则扶正为主、兼清余邪，患者常见肺肾气虚、脾虚不足，治疗当以改善患者气虚、阳虚体质为主，常用补土生金、补肾填精的方法，同时兼顾清除余邪，此期的治疗是本病得以长期有效控制的基础[27-30]。近年来中西医结合治疗本病，收到了不错的临床疗效。杏仁宣降肺气，气得宣降则津随气布而不凝聚为痰，津随气下则肠道不燥肺气不逆而喘促可平，腑气顺降而大便自通。复用大黄泻热通便，共呈宣肺通腑之法。此方瓜蒌壳、杏仁虽然重在宜降肺气，但因通过宣降肺气有助于腑气通调，治上即可治下；大黄虽然重在泻热通便，但因通过泻下亦有助于肺气下行，治下即可治上，反映了脏腑合治的配方法度[31-33]。
综上所述，宣白承气汤联合布地奈德福莫特罗吸入剂治疗支气管哮喘合并鼻炎患儿，疗效显著，可快速缓解临床症状，改善患儿的肺功能，降低炎症因子水平、Murray肺损伤评分及中医症状体征积分。
基金
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  • 浙江省中医药科技计划项目(2016ZB109)
文献
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2025年第43卷第6期
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doi: 10.13193/j.issn.1673-7717.2025.06.041
  • 首发时间：2026-10-30
  • 出版时间：2025-06-10
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浙江省中医药科技计划项目(2016ZB109)
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    浙江中医药大学附属江南医院，浙江 杭州 311201

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李萍（1987-），女，浙江杭州人，副主任检验师，研究方向：检验医学。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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