目的 探討槐杞黃顆粒聯(lián)合布地奈德福莫特羅粉吸入劑治療兒童咳嗽變異性哮喘的臨床療效。方法 選取2013年3月-2016年6月青海省人民醫(yī)院收治的咳嗽變異性哮喘患兒450例進行研究，按隨機數(shù)字表法將患兒分為布地奈德福莫特羅組、槐杞黃顆粒組和聯(lián)合治療組，每組各150例。布地奈德福莫特羅組吸入布地奈德福莫特羅粉吸入劑，1吸/次，2次/d?；辫近S顆粒組口服槐杞黃顆粒，2~3歲：5 g/次，4~12歲：10 g/次，2次/d。聯(lián)合治療組給予布地奈德福莫特羅粉吸入劑和槐杞黃顆粒，方法同上。各組患兒均連續(xù)治療3個月。觀察3組的臨床療效，比較3組的肺功能，炎癥反應和免疫功能。結果 治療后，布地奈德福莫特羅組、杞黃顆粒組和聯(lián)合治療組的總有效率分別為78.00%、65.33%、92.00%，聯(lián)合治療組總有效率與其他兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療后，3組FEV1%和PEF%均明顯上升，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且聯(lián)合治療組這些觀察指標明顯高于布地奈德福莫特羅組和槐杞黃顆粒組，差異具有統(tǒng)計學意義（P<0.05）。治療后，3組hs-CRP、TNF-α和IL-6水平顯著下降，IL-10水平顯著升高，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且聯(lián)合治療組這些觀察指標的改善程度明顯優(yōu)于布地奈德福莫特羅組和槐杞黃顆粒組，差異具有統(tǒng)計學意義（P<0.05）。治療后，3組IgE、CD⁴⁺、CD⁴⁺/CD⁸⁺明顯降低，CD⁸⁺明顯升高，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且聯(lián)合治療組這些觀察指標的改善程度明顯優(yōu)于布地奈德福莫特羅組和槐杞黃顆粒組，差異具有統(tǒng)計學意義（P<0.05）。結論 槐杞黃顆粒聯(lián)合布地奈德福莫特羅粉吸入劑治療兒童咳嗽變異性哮喘具有較好的臨床療效，能改善肺功能，調(diào)節(jié)免疫功能和炎癥反應，具有一定的臨床推廣應用價值。

Objective To investigate the effects of Huaiqihuang Granules combined with Budesonide and Formoterol Fumarate Powder for inhalation in treatment of cough variant asthma in children. Methods Children (450 cases) with cough variant asthma in Qinghai Provincial People's Hospital from March 2013 to June 2016 were randomly divided into budesonide and formoterol, Huaiqihuang Granules and combined therapy groups, and each group had 150 cases. Children in the budesonide and formoterol group were inhalation administered with Budesonide and Formoterol Fumarate Powder for inhalation, 1 suction/time, twice daily. Children in the Huaiqihuang Granules group were po administered with Huaiqihuang Granules, 2-3 ages:5 g/time, 4-12 ages:10 g/time, twice daily. Children in the combined therapy group were given Budesonide and Formoterol Fumarate Powder for inhalation and Huaiqihuang Granules as above. Children in three groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and lung function, inflammatory response, and immune function in three groups were compared. Results After treatment, the clinical efficacies in the budesonide and formoterol, Huaiqihuang Granules, and combined therapy groups were 78.00%, 65.33% and 92.00%, respectively, and there was difference among three groups (P<0.05). After treatment, FEV1% and PEF% in three groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the combined therapy group were significantly higher than those in the budesonide and formoterol and Huaiqihuang Granules groups, with significant difference among three groups (P<0.05). After treatment, the levels of hs-CRP, TNF-α, and IL-6 in three groups were significantly decreased, but the levels of IL-10 in three groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the combined therapy group were significantly better than those in the budesonide and formoterol and Huaiqihuang Granules groups, with significant difference among three groups (P<0.05). After treatment, IgE, CD⁴⁺, and CD⁴⁺/CD⁸⁺ in three groups were significantly decreased, but the CD⁸⁺ in three groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the combined therapy group were significantly better than those in the budesonide and formoterol and Huaiqihuang Granules groups, with significant difference among three groups (P<0.05). Conclusion Huaiqihuang Granules combined with Budesonide and Formoterol Fumarate Powder for inhalation has clinical curative effect in treatment of cough variant asthma in children, can improve lung function, regulate immune function and inflammatory reaction, which has a certain clinical application value.