目的 研究寒喘祖帕顆粒聯(lián)合孟魯司特鈉治療咳嗽變異性哮喘患兒的效果。方法 選取2017年1月-2019年12月唐山市豐潤(rùn)區(qū)人民醫(yī)院收治的200例咳嗽變異性哮喘患兒作為研究對(duì)象，根據(jù)就診順序?qū)⒒純悍謩e納入對(duì)照組與觀察組，各100例。對(duì)照組睡前口服孟魯司特鈉咀嚼片，5 mg/次，1次/d。觀察組在對(duì)照組的基礎(chǔ)上口服寒喘祖帕顆粒，6 g/次，2次/d。兩組患兒療程均為4周。觀察兩組患者的臨床療效，同時(shí)比較兩組治療前后的咳嗽癥狀評(píng)分、中醫(yī)證候積分、生活質(zhì)量評(píng)分（LCQ）、血清中嗜酸性粒細(xì)胞陽(yáng)離子蛋白（ECP）、白細(xì)胞介素（IL）-2、IL-4、IL-13、巨噬細(xì)胞炎性蛋白-1α（MIP-1α）、白三烯B4（LTB4）和免疫球蛋白E（IgE）水平。結(jié)果 治療后，觀察組總有效率為91.00%，顯著高于對(duì)照組的74.00%，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組日間與夜間咳嗽評(píng)分均顯著降低（P<0.05）；且觀察組顯著低于對(duì)照組（P<0.05）。治療后，兩組各項(xiàng)中醫(yī)證候積分與總分均顯著降低（P<0.05）；且觀察組顯著低于對(duì)照組（P<0.05）。治療后，兩組生理積分、心理積分、社會(huì)積分與總分均顯著升高（P<0.05）；治療后，觀察組生理積分、心理積分、社會(huì)積分與總分均顯著高于對(duì)照組（P<0.05）。治療后，兩組血清ECP、IL-4、IL-13、MIP-1α、IgE和LTB4水平均顯著降低，IL-2水平顯著升高（P<0.05）；且觀察組血清ECP、IL-2、IL-4、IL-13、MIP-1α、IgE和LTB4水平顯著優(yōu)于對(duì)照組（P<0.05）。結(jié)論 采用寒喘祖帕顆粒聯(lián)合孟魯司特鈉治療咳嗽變異性哮喘，療效值得肯定，能夠有效改善患兒咳嗽癥狀，提高生活質(zhì)量，并可抑制氣道炎癥，降低血清IgE、LTB4水平，具有較好臨床應(yīng)用價(jià)值。

Objective Study the effect of Hanchuan Zupa Granules combined with montelukast sodium in treatment of children with cough variant asthma. Methods A total of 200 children with cough variant asthma treated in Tangshan Fengrun People's Hospital from January 2017 to December 2019 were selected as the research subjects. According to the order of treatment, the children were included in the control group and the observation group, with 100 cases in each group. Patients in the control group were po administered with Montelukast Sodium Tablets, 5 mg/time, once daily. Patients in the observation group were po administered with Hanchuan Zupa Granules on the basis of control group, 6 g/time, twice daily. The course of treatment for both groups was four weeks. The clinical efficacy of two groups was observed. The cough symptom score, TCM syndrome score, LCQ score, serum levels of ECP, IL-2, IL-4, IL-13, MIP-1α, LTB4, and IgE before and after treatment between two groups were compared. Results After treatment, the total effective rate of the observation group was 91.00%, which was significantly higher than 74.00% of the control group, the difference being statistically significant (P<0.05). After treatment, the cough scores in day and night in two groups were significantly decreased (P<0.05). The observation group was significantly lower than the control group (P<0.05). After treatment, the TCM syndrome scores and total scores in two groups were significantly decreased (P<0.05), and observation group was significantly lower than control group (P<0.05). After treatment, physiological scores, psychological scores, social scores, and total scores in two groups were significantly increased (P<0.05). After treatment, the physiological scores, psychological scores, social scores and total scores of observation group were significantly higher than those of control group (P<0.05). After treatment, the serum levels of ECP, IL-4, IL-13, MIP-1α, IgE and LTB4 in two groups were significantly decreased, while the level of IL-2 was significantly increased (P<0.05). The levels of ECP, IL-2, IL-4, IL-13, MIP-1α, IgE and LTB4 in the observation group were significantly better than those in the control group (P<0.05). Conclusion The curative effect of Hanchuan Zupa Granules combined with Montelukast sodium in treatment of cough variable asthma is worthy of affirmability. It can effectively improve cough symptoms and improve life quality, inhibit airway inflammation, reduce serum IgE and LTB4 levels, and has good clinical application value.

R974

河北省中醫(yī)藥管理局科研計(jì)劃項(xiàng)目（2020404）