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目的:观察宣肺平喘汤内服和哮喘I方穴位敷贴加离子导入的多途径给药治疗儿童支气管哮喘(寒热错杂证)发作期的临床疗效及对患者白细胞介素-4(IL-4),γ-干扰素(IFN-γ),免疫球蛋白E(Ig E)的影响。方法:采用随机按数字表法将110例患者分为对照组和观察组各55例。对照组采用宣肺平喘汤内服治疗,观察组在对照组治疗的基础上加用哮喘I方穴位敷贴加离子导入。两组疗程均为2周。记录两组患儿咳嗽、喘息和肺部哮鸣音消失时间;检测治疗前后肺功能,包括最大呼气流量(PEF)和第1秒钟用力呼气容积与用力肺活量比值(FEV1/FVC);采用哮喘控制问卷(ACQ)评价哮喘控制情况;检测治疗前后IL-4,IFN-γ和Ig E水平。结果:治疗后观察组临床显效率为92.73%,对照组为78.18%,观察组优于对照组(P<0.05);观察组在咳嗽、喘息消失、肺部哮鸣音消失时间均明显短于对照组(P<0.01);治疗后观察组PEF和FEV1/FVC均高于对照组(P<0.01);治疗后观察组IL-4和Ig E水平低于对照组,IFN-γ水平高于对照组(P<0.01);经卡方检验,观察组哮喘控制情况优于对照组(P<0.05)。结论:宣肺平喘汤内服和哮喘I方穴位敷贴加离子导入的多途径给药治疗儿童支气管哮喘(寒热错杂证)发作期的临床疗效优于单一中药内服,其作用机制可能是通过调节免疫系统紊乱,减轻炎症反应来实现的。
OBJECTIVE: To observe the clinical efficacy of Xuanfei Pingchuan Decoction and multi-channel administration of I-point of asthma in patients with bronchial asthma (cold and heat miscellaneous syndromes) during the onset of attack and the effect on the levels of interleukin-4 (IL-4) ), γ-interferon (IFN-γ), and immunoglobulin E (Ig E). Methods: A total of 110 patients were divided into control group and observation group randomly by digital table method. The control group adopted Xuanfei Pingchuan Decoction treatment, the observation group in the control group based on the treatment plus the application of asthma I acupoint plus ion implantation. Two groups of treatment are 2 weeks. The duration of cough, wheezing and disappearance of lung wheeze were recorded in both groups. Pulmonary function, including maximum expiratory flow (PEF), forced expiratory volume and forced vital capacity (FEV1 / FVC), was measured before and after treatment. The Asthma Control Questionnaire (ACQ) was used to evaluate the control of asthma. The levels of IL-4, IFN-γ and Ig E were measured before and after treatment. Results: After treatment, the clinical effective rate was 92.73% in the observation group and 78.18% in the control group, and the observation group was superior to the control group (P <0.05). The observation group had shorter cough and wheezing disappearance time, (P <0.01). After treatment, PEF and FEV1 / FVC in the observation group were higher than those in the control group (P <0.01). After treatment, the levels of IL-4 and Ig E in the observation group were lower than those in the control group (P <0.01). The chi square test showed that the asthma control in the observation group was better than that in the control group (P <0.05). Conclusion: The clinical curative effect of xuanfei pingchuan decoction and multi-channel administration of iontophoresis and iontophoresis on children with bronchial asthma (miscellaneous cold and heat syndrome) is superior to single Chinese medicine orally, and its mechanism may be through the regulation Immune system disorders, reduce inflammation to achieve.