To observe the efficacy of Modified Sijunzi Decoction (四君子汤化裁方) combined with budesonide in the treatment of children with phlegm and stasis accumulating in lung type of occlusive fine bronchitis.

One hundred and sixteen children with occlusive fine bronchiolitis identified by traditional Chinese medicine as phlegm and stasis accumulating in lung type admitted from April 2021 to April 2024 were selected and randomly divided into two groups by using the envelope method. The control group was given budesonide treatment and the observation group was given Modified Sijunzi Decoction on its basis. The differences in TCM symptom scores between the two groups were assessed, the time of improvement of symptoms and signs as well as the time of oxygen intake, hospitalization and adverse reactions were recorded and the immune function, inflammatory factors [interleukin-4 (IL-4), interleukin-12 (IL-12), interleukin-17 (IL-17), tumor necrosis factor-α(TNF-α), interferon-γ(IFN-γ)] and lung function [percentage of forced expiratory volume in one second (FEV1%), maximum mid-expiratory flow (MMEF), tidal volume (VT), inspiratory time/expiratory time (Ti/Te)] were compared.

Comparing with those before treatment, there was no difference in TCM symptom scores or immune function between the two groups (P>0.05). Comparing with those before and after treatment, the TCM symptom scores and the CD8⁺ level of the two groups were lower, and the results of the observation group were lower than those of the control group (P<0.05). The levels of CD4⁺ and CD3⁺ of the two groups of the observation group were higher, and the results of the observation group were higher than those of the control group (P<0.05). The time for fever reduction and cough suppression, oxygen intake time, shortness of breath and disappearance of pulmonary rales and hospitalisation time of the observation group were shorter than those of the control group with differences (P<0.05). Comparing with those before treatment, there was no difference in inflammatory factors or lung function between the two groups (P>0.05). Comparing with those before, after treatment, the levels of IL-4, IL-12, IL-17 and TNF-α were lower in both groups, and the levels were lower in the observation group than those in the control group (P<0.05). The IFN-γ level and lung function indexes were higher in both groups, and the results were higher in the observation group than those in the control group (P<0.05).

Modified Sijunzi Decoction combined with budesonide in the treatment of children with phlegm and stasis accumulating in lung type of occlusive fine bronchitis improves the lung function, regulates the inflammatory factors and shortens the course of the disease.