关键词:

咳嗽变异性哮喘, 异丙托溴铵, 槐杞黄颗粒, 免疫功能, 肺功能, 儿童

Abstract:

Objective　To investigate the clinical efficacy and safety of inhaled compound ipratropium bromide combined with Lycium Barbarum L. granules in treating pediatric cough-variant asthma (CVA). Methods　This study was a randomized controlled trial. A total of 106 children with CVA admitted to Sun Simiao Hospital, Beijing University of Chinese Medicine from January 2022 to December 2023 were enrolled and were divided into two groups using the random number table method. In group B, 27 boys and 26 girls, aged (9.64±2.89) years, with a duration of disease of (3.72±1.03) months, were given inhaled compound ipratropium bromide at 0.5 mg/time, 15 min/time, twice a day, on the basis of conventional treatment. In group A, 28 boys and 25 girls, aged (9.37±2.93) years, with a duration of disease of (3.84±1.12) months, were in combination with Lycium Barbarum L. granules taken orally on the basis of group B, 10 g/time, twice a day. Both groups were treated for 2 weeks. The efficacy and the changes of Cough Evaluation Test (CET) score, Leicester Cough Questionnaire (LCQ) score, indicators of immune function [CD3⁺, CD4⁺, CD8⁺, immunoglobulin A (IgA), ad IgM], and pulmonary function test results [forced expiratory volume in 1 second (FEV₁), forced vital capacity (FVC), and FEV₁/FVC], and inflammatory factors [interleukin-6 (IL-6), IL-8, and substance P (SP)] before and after treatment were compared between the two groups, and the adverse reactions were recorded. Statistical analysis was performed using t test and χ² test. Results　After 2 weeks of treatment, the total effective rate of group A was 96.23% (51/53), which was higher than that of group B [77.36% (41/53)], with a statistically significant difference (χ²=8.230, P=0.004); the CET scores in both groups were decreased, and that in group A was lower than that in group B [(2.97±0.47) points vs. (4.62±0.91) points] (t=11.728, P<0.001); the LCQ scores in both groups were improved, and that in group A was higher than that in group B [(18.00±1.60) points vs. (16.35±2.80) points] (t=3.725, P<0.001); the levels of CD8⁺ were decreased in both groups, and that in group A was lower than that in group B (all P<0.05); the levels of CD3⁺, CD4⁺, IgA, and IgM were increased in both groups, and those in group A were higher than those in group B (all P<0.05); the FEV₁, FVC, and FEV₁/FVC in both groups were increased, and those in group A were higher than those in group B [(1.70±0.22) L vs. (1.45±0.19) L, (2.53±0.37) L vs. (2.26±0.68) L, (67.19±6.23)% vs. (64.16±5.44)%] (all P<0.05); serum levels of IL-6, IL-8, and SP were decreased in both groups, and those in group A were lower than those in group B [(0.72±0.43) µg/L vs. (1.50±1.08) µg/L, (1.89±0.21) ng/L vs. (3.74±0.48) ng/L, (2.15±1.65) nmol/L vs. (3.70±2.35) nmol/L] (all P<0.05). There was no statistically significant difference in the incidence of mild adverse reactions between the two groups [5.66% (3/53) vs. 7.55% (4/53)] (χ²=0.153, P=0.696), and no serious adverse reactions were reported. Conclusion　In the treatment of pediatric CVA, inhaled compound ipratropium bromide combined with Lycium Barbarum L. granules can significantly improve the cough symptoms, quality of life, immune function, and lung function, reduce the inflammation level, and has good safety.

Key words:

Cough variant asthma, Ipratropium bromide, Lycium Barbarum L. granules, Immune function, Lung function, Children