关键词: 毛细支气管炎, 痰热闭肺证, 祛痰宣肺汤, 儿童, 气道炎症

Abstract:

Objective　To explore the efficacy of Qutan Xuanfei decoction combined with Western medicine in treating pediatric bronchiolitis (Phlegm shuts lung card hotly). Methods　A total of 96 children with bronchiolitis, all diagnosed with Phlegm shuts lung card hotly, were selected from the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine between January 2023 and June 2024. The children were randomly divided into two groups, with 48 patients in each group. In the observation group, there were 29 males and 19 females, aged 6 (3, 14) months and the disease duration was (2.85±0.57) d, including 17 mild and 31 moderate cases. In the control group, there were 30 males and 18 females, aged 6 (3, 15) months and the disease duration was (2.81±0.55) d, including 15 mild and 33 moderate cases. The control group received nebulized budesonide + ambroxol hydrochloride + terbutaline + normal saline, administered for 10-15 minutes, twice daily, along with symptomatic treatment. The observation group received Qutan Xuanfei decoction in addition to the treatment given to the control group, with dosages adjusted based on the child's age, administered three times daily. Both groups underwent treatment for 7 days. The study compared traditional Chinese medicine (TCM) syndrome scores, inspiratory/expiratory ratio (Ti/Te), tidal volume per kilogram (VT/kg), respiratory resistance, and airway inflammation indicators [interleukin (IL)-4, IL-8, and tumor necrosis factor-alpha (TNF-α)] before and after treatment, as well as clinical efficacy and adverse reactions between the two groups. Statistical analysis was performed using Fisher's exact probability method, corrected χ² test, χ² test, rank-sum test, and t test. Results　After treatment, the scores for primary symptoms, secondary symptoms, tongue and pulse signs, and total scores in the observation group were (3.09±0.62, 2.28±0.42, 0.72±0.15, 6.09±1.21) points, compared to (4.56±0.91, 2.93±0.55, 1.02±0.18, 8.51±1.35) points in the control group. The Ti/Te and VT/kg values in the observation group were higher than those in the control group [0.85±0.18 vs. 0.72±0.14 and (9.36±1.45) ml/kg vs. (8.35±1.35) ml/kg], while the respiratory resistance was lower in the observation group [(3.26±0.62) kPa/(s·L) vs. (4.47±0.82) kPa/(s·L)]. The levels of IL-4, IL-8, and TNF-α in the observation group were (4.03±0.82, 28.64±5.41, 55.62±10.22) ng/L, compared to (5.10±1.05, 37.94±7.01, 71.52±12.74) ng/L in the control group; all differences were statistically significant (all P<0.05). The overall effective rate in the observation group was 97.83% (45/46), higher than the 82.22% (37/45) in the control group (P=0.015). The total incidence of adverse reactions in both groups was [10.87% (5/46) vs. 6.67% (3/45)], with no statistically significant difference (corrected χ²=0.114, P=0.736). Conclusion　The therapeutic effect of Qutan Xuanfei decoction combined with western medicine in the treatment of children with bronchiolitis (Phlegm shuts lung card hotly) is ideal and it is safety.

Key words: Bronchiolitis,  , Phlegm shuts lung card hotly,  , Qutan Xuanfei , decoction,  , Children,  , Airway inflammation