健脾宣肺化痰方联合盐酸氨溴索吸入治疗儿童迁延性细菌性支气管炎的疗效观察

Efficacy observation on the treatment for protracted bacterial bronchitis in children with self-made Jianpi Xuanfei Huatan recipe combined with inhaled ambroxol hydrochloride solution

摘要

目的 观察自拟健脾宣肺化痰方联合吸入用盐酸氨溴索溶液治疗儿童迁延性细菌性支气管炎（痰湿蕴肺型）的临床疗效。方法 选取2023年1月至2025年4月江西中医药大学第二附属医院儿科收治的迁延性细菌性支气管炎（痰湿蕴肺型）患儿90例为研究对象, 随机分为对照组和观察组各45例。对照组患儿采用敏感抗生素联合吸入用盐酸氨溴索溶液治疗, 而观察组患儿在对照组基础上给予自拟健脾宣肺化痰方治疗。经上述治疗2周后, 比较两组患儿临床疗效、中医证候积分、咳嗽症状积分、血清炎性因子、血清T细胞亚群水平、不良反应及6个月后复发例数。结果 观察组临床总有效率为95.56%（43/45）, 明显高于对照组82.22%（37/45）, 差异有统计学意义（P<0.05）。治疗后两组中医证候积分、咳嗽症状评分均低于治疗前, 且观察组下降较对照组更显著, 差异有统计学意义（P<0.05）。治疗后两组白细胞总数、中性粒细胞计数、C反应蛋白及降钙素原水平比较差异无统计学意义（P>0.05）；免疫功能方面, 治疗后两组血清CD3⁺、CD4⁺及CD4⁺/CD8⁺均升高, 且观察组升高较对照组更显著, 差异有统计学意义（P<0.05）。治疗期间两组患儿不良反应发生率比较差异无统计学意义（P>0.05）。随访6个月, 观察组复发率为4.65%（2/43）, 明显低于对照组18.92%（7/37）, 差异有统计学意义（P<0.05）。结论 自拟健脾宣肺化痰方联合吸入用盐酸氨溴索溶液治疗儿童迁延性细菌性支气管炎（痰湿蕴肺型）有效且安全, 可改善患儿免疫状态, 降低复发率。

Abstract

Objective To observe the clinical efficacy of self-made Jianpi Xuanfei Huatan recipe combined with inhaled ambroxol hydrochloride solution in the treatment of protracted bacterial bronchitis (PBB) (the type of phlegm-dampness accumulating in lung) in children. Methods From January 2023 to April 2025, 90 cases of PBB (the type of phlegm-dampness accumulating in lung) received treatment in the Pediatric Department of the Second Affiliated Hospital of Jiangxi University of TCM, and they were selected as research subjects and randomly divided into a control group and an observation group, with 45 cases in each group. The control group was treated with sensitive antibiotics combined with inhaled ambroxol hydrochloride solution, while the observation group was given self-made Jianpi Xuanfei Huatan recipe on this basis. The clinical efficacy, TCM syndrome score, cough symptom score, serum inflammatory factors, T-lymphocyte subset level, adverse reactions and recurrence rate after 6 months were compared between the two groups after 2 weeks of treatment. Results The total effective rate was 95.56%（43/45） in the observation group, significantly higher than that in the control group （82.22%, 37/45）, and the difference was statistically significant (P<0.05). The TCM syndrome score and cough symptom score of the two groups were lower after treatment than before treatment, and the score in the observation group was even lower (P<0.05). After treatment, there was no significant difference in the levels of total white blood cells (WBC), neutrophils (NRUT), C-reactive protein (CRP) or procalcitonin (PCT) between the two groups（P>0.05）. In terms of immune function, CD3⁺, CD4⁺ and CD4⁺/CD8⁺ were elevated after treatment, and the increase was more significant in the observation group. There was no statistical difference in the incidence rate of adverse reactions between the two groups during the treatment (P>0.05）. The recurrence rate of the observation group in the 6-month follow-up was 4.65%（2/43）, obviously lower than that of the control group (18.92%, 7/37）, and the difference was of statistical significance (P<0.05). Conclusion The combination of self-made Jianpi Xuanfei Huatan recipe with inhaled ambroxol hydrochloride solution is effective and safe in the treatment of PBB (the type of phlegm-dampness accumulating in lung) in children, which can improve the immune status of children and reduce the recurrence rate.

关键词

迁延性细菌性支气管炎 / 痰湿蕴肺型 / 健脾宣肺化痰方 / T淋巴细胞亚群 / 儿童

Key words

Protracted bacterial bronchitis / Type of phlegm-dampness accumulating in lung / Jianpi Xuanfei Huatan recipe / T-lymphocyte subset / Child

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基金资助

江西省卫生健康委科技计划项目(202310724)