目的 探討喘可治注射液聯(lián)合細(xì)辛腦注射液治療小兒毛細(xì)支氣管炎的臨床療效。方法 選取2014年9月-2015年9月在深圳市兒童醫(yī)院接受治療的小兒毛細(xì)支氣管炎患兒94例,按治療方法的不同分為對(duì)照組和治療組,每組各47例。對(duì)照組靜脈滴注細(xì)辛腦注射液,0.5mg/kg加入5%葡萄糖溶液250mL,2次/d。治療組在對(duì)照組基礎(chǔ)上霧化吸入喘可治注射液,2mL與3mL生理鹽水混合,2次/d。兩組患兒連續(xù)治療7d。觀察兩組的臨床療效,同時(shí)比較兩組患兒臨床癥狀、肺功能、炎癥變化。結(jié)果 治療后,對(duì)照組和治療組的總有效率分別為82.98%、95.74%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,治療組喘息消失時(shí)間、咳嗽消失時(shí)間、肺部啰音消失時(shí)間和痰鳴音消失時(shí)間明顯短于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患兒RR(呼吸頻率)和吸氣時(shí)間/總呼吸時(shí)間(Ti/Tt)均明顯降低,而潮氣量(TV)、潮氣呼氣峰流速(PTEF)及達(dá)峰時(shí)間比(tPTEF/tE)均明顯升高,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)改善程度明顯優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患兒血清IL-10水平均明顯降低,而IL-12水平明顯升高,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)改善程度明顯優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患兒氣道細(xì)胞總數(shù)、淋巴細(xì)胞、嗜酸性粒細(xì)胞和中性粒細(xì)胞水平均明顯降低,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)改善程度明顯優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 喘可治注射液聯(lián)合細(xì)辛腦注射液治療小兒支氣管炎的臨床療效較好,能明顯改善患兒的臨床癥狀、肺功能及炎癥狀態(tài),具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Chuankezhi Injection combined with Asarone Injection in treatment of bronchiolitis in children. Methods Children (94 cases) with bronchiolitis in Shenzhen Children's Hospital from September 2014 to September 2015 were randomly were enrolled in this study. According to the different treatment plan, patients were divided into the control and treatment groups, and each group had 47 cases. Children in the control group were iv administered with Asarone Injection, 0.5 mg/kg added into 5% glucose 250 mL, twice daily. Children in the treatment group were aerosol inhalation administered with Chuankezhi Injection on the basis of control group, 2 mL mixed with normal saline 3 mL, twice daily. Children in two groups were treated for 7 d. After treatment, the efficacy was evaluated, and the changes of clinical symptoms, lung function, and inflammation were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 82.98% and 95.74%, respectively, and there was difference between two groups (P < 0.05). After treatment, the disappearance time of wheezing, cough, pulmonary rales, and wheezy phlegm in the treatment group were significantly shorter than those in the control group, and there were differences between two groups (P < 0.05). After treatment, the RR and Ti/Tt in two groups were significantly decreased, but the TV, PTEF, and tPTEF/tE in two groups were significantly increased, and the differences were statistically significant in the same group (P< 0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P< 0.05). After treatment, the levels of IL-10 in two groups were significantly decreased, but the levels of IL-12 in two groups were significantly increased, and the differences were statistically significant in the same group (P< 0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P< 0.05). After treatment, the inflammatory cell, leukomonocyte, eosinophile granulocyte, and neutrophile granulocyte at airway in two groups were significantly decreased, and the differences were statistically significant in the same group (P< 0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P< 0.05). Conclusion Chuankezhi Injection combined with Asarone Injection has clinical curative effect in treatment of bronchiolitis in children, and can obviously improve the clinical symptoms, lung function, and inflammatory state, which has a certain clinical application value.