【摘要】 目的 探讨玉屏风散联合穴位贴敷治疗小儿哮喘并发反复呼吸道感染(Recurrent respiratory tract infections, RRTI)的疗效，并观察其对患儿炎症因子、免疫功能的影响。方法 选取2018年3月—2021年3月期间高州市中医院门诊收治的哮喘并发RRTI患儿138例，按随机数字表法分为对照组和治疗组，每组各69例。对照组给予常规西医治疗，治疗组在对照组基础上给予玉屏风散联合穴位贴敷治疗。治疗2个月后，观察比较两组患儿临床疗效，治疗前后肺通气功能[最高呼气流速(Peak expiratory flow, PEF)、用力肺活量(Forced vital capacity, FVC)、第1秒用力呼气量(Forced expiratory volume in first second, FEV1)占预测值的百分比],血清炎症因子[肿瘤坏死因子(Tumor necrosis factorα,TNF-α)、白介素-6(Interleukin 6,IL-6)、白介素-8(Interleukin 8,IL-8)]水平，免疫功能[血清免疫球蛋白A(Immunoglobulin A,IgA)、免疫球蛋白G(Immunoglobulin G,IgG)、免疫球蛋白M(Immunoglobulin M,IgM)]。记录并比较两组患儿治疗期间不良反应。治疗后随访6个月，比较两组患儿随访期间呼吸道感染次数、哮喘发作次数、发热天数、抗生素使用天数。结果 治疗后治疗组总有效率86.36%(57/66)高于对照组65.67%(44/67),差异有统计学意义(P<0.05)。治疗后两组患儿PEF、FVC、FEV1占预测值的百分比均高于治疗前，差异有统计学意义(P<0.05);且治疗组均高于对照组，差异有统计学意义(P<0.05)。治疗后两组患儿血清TNF-α、IL-6、IL-8水平均低于治疗前，差异有统计学意义(P<0.05);且治疗组均低于对照组，差异有统计学意义(P<0.05)。治疗后治疗组血清IgA、IgG、IgM水平均高于治疗前，差异有统计学意义(P<0.05);且治疗组均高于对照组，差异有统计学意义(P<0.05)。治疗期间，两组不良反应总发生率比较，差异无统计学意义(P>0.05)。6个月随访期间，治疗组呼吸道感染次数、哮喘发作次数、发热天数、抗生素使用天数均低于对照组，差异均有统计学意义(P<0.05)。结论 玉屏风散联合穴位贴敷佐治支气管哮喘并发RRTI患儿可明显提高临床疗效，改善肺功能、炎症反应和免疫功能，控制哮喘、呼吸道感染的发作，安全性好，值得临床推广。更多还原

【Abstract】 Objective To explore the effect of Yupingfeng Granules combined with acupoint application onchildren with asthma and recurrent respiratory tract infection(RRTI),and to observethe influence on inflammatory factors and immune function.Methods A total of 138 children with asthma complicated by RRTI who were admitted to the Outpatients of Gaozhou Hospital of Traditional Chinese Medicine from March 2018 and March 2021 were selected and classified into the control group(n=69)and the treatment group(n=69)according to a random number table.The control group received conventional western medicine therapy, and the treatment group was treated with conventional western medicine therapy, Yupingfeng Granules, and acupoint application.The treatment lasted 2 months for both groups.After treatment, the clinical outcomes, and pulmonary ventilation function[percentages of peak expiratory flow(PEF),forced vital capacity(FVC),and forced expiratory volume in one second(FEV1)to the respective predicted value],serum inflammatory factors[tumor necrosisfactor-α(TNF-α),interleukin-6(IL-6),and interleukin-8(IL-8)],immune function[serum immunoglobulin A(IgA),immunoglobulin G(IgG),and immunoglobulin M(IgM)]before and after treatment were compared between the two groups.The incidence of adverse reactions during treatment was recorded and compared between the two groups.After treatment, the children were followed up for 6 months, and the incidence of respiratory tract infections, asthma attacks, fever days, and antibiotic use days during the follow-up period were compared between the two groups.Results A total of 2 cases in the control groupand 3 cases in the treatment group dropped out.The total effective rate of the treatment group was 86.36%(57/66),as compared with the 65.67%(44/67)of the control group(P<0.05).After treatment, the percentages of PEF,FVC,and FEV1 to the predicted values were higherthan before treatment in both groups(P<0.05),and higher in the treatment group than in the control group(P<0.05).After treatment, the serum levels of TNF-α,IL-6,and IL-8 were lower than those before treatment in both groups(P<0.05),and the levels were lower in the treatment group than in the control group(P<0.05).After treatment, the serum levels of IgA,IgG,and IgM in both groups were higher than those before treatment(P<0.05)and the levels in the treatment group were higher than those in the control group(P<0.05).The total incidence of adverse reactions showed no significant difference between the two groups(P>0.05).During the 6-month follow-up period, the incidence of respiratory tract infection, asthma attacks, fever days, and antibiotic use days were lower/fever in the treatment group than in the control group(P<0.05).Conclusion The combination of Yupingfeng Granules and acupoint applicationcan significantly improve the clinical efficacy, lung function, inflammatory response, and immune function, and reduce attacks of asthma and respiratory tract infections in the treatment of children with bronchial asthma and RRTI.It is safe and is worthy of clinical promotion.更多还原