2023 年第 5 期 第 18 卷

中西药联合三球呼吸训练法对咳嗽变异性哮喘缓解期患者的治疗效果

Effect of Chinese and western medicine combined with three-ball breathing training method on patients with cough variant asthma in remission stage

作者：代婷徐维国杨爱萍胥琴李欣

英文作者：Dai Ting Xu Weiguo Yang Aiping Xu Qin Li Xin

单位：四川省绵阳市中心医院呼吸与危重症医学科，绵阳621000

英文单位：Department of Respiratory and Critical Care Medicine Mianyang Central Hospital Sichuan Province Mianyang 621000 China

关键词：咳嗽变异性哮喘；补中益肾固肺方；沙美特罗替卡松粉吸入剂；三球呼吸训练法

英文关键词：Coughvariantasthma;BuzhongYishenGufeidecoction;Salmeterolxinafoateandfluticasonepropionatepowderforinhalation;Three-ballbreathingtrainingmethod

• 摘要：

• 目的 研究中西药联合三球呼吸训练法对咳嗽变异性哮喘（CVA）缓解期患者的治疗效果。方法 选取2019年10月至2021年12月于四川省绵阳市中心医院治疗的150例CVA缓解期患者作为研究对象，按照随机数字表法分为A组、B组和C组，各50例。所有患者均接受三球呼吸训练法治疗，在此基础上，A组给予沙美特罗替卡松粉吸入剂治疗，B组给予补中益肾固肺方治疗，C组给予沙美特罗替卡松粉吸入剂和补中益肾固肺方治疗，3组均连续治疗4周。疗程结束后比较3组临床疗效、肺功能指标、免疫功能指标和不良反应发生情况，并比较治疗后3个月内感冒次数和CVA复发率。结果  治疗后，C组总有效率高于A、B组，差异有统计学意义（P＜0.001）。治疗后，3组第1秒用力呼气容积（FEV1）、用力肺活量（FVC）、FEV1/FVC比值均高于治疗前，且C组均高于A、B组［（2.42±0.43）L比（1.57±0.31）、（1.82±0.34）L，（3.12±0.21）L比（2.38±0.20）、（2.65±0.19）L，（74±6）%比（63±5）%、（67±6）%］，差异均有统计学意义（均P＜0.05）。治疗后，3组CD+4 T细胞、免疫球蛋白A（IgA）、IgG、IgM水平和CD+4/CD+8 T细胞比值均高于治疗前，且C组均高于A、B组，3组CD+8 T细胞、IgE水平均低于治疗前，且C组均低于A、B组，差异均有统计学意义(均P＜0.05)。治疗期间3组不良反应发生率比较差异无统计学意义（P=0.773）。治疗后3个月内，B、C组感冒次数及CVA复发比例均低于A组，差异均有统计学意义（均P＜0.001）。结论   中西药联合三球呼吸训练法治疗CVA缓解期患者安全有效，可改善肺功能和免疫功能。

• Objective  To study the effect of Chinese and western medicine combined with three-ball breathing training method on patients with cough variant asthma (CVA) in remission stage. Methods From October 2019 to December 2021， a total of 150 patients with CVA in remission stage admitted to Mianyang Central Hospital, Sichuan Province were enrolled. They were divided into group A, group B and group C according to the random number table method, with 50 cases in each group. All of patients were treated with three-ball breathing training method. In addition, group A was given salmeterol xinafoate and fluticasone propionate powder for inhalation, group B was given Buzhong Yishen Gufei decoction, and group C was given salmeterol xinafoate and fluticasone propionate powder for inhalation combined with Buzhong Yishen Gufei decoction. All of patients were treated for 4 weeks. The clinical efficacy, pulmonary function and immune function were compared among the three groups. The follow-up and adverse reactions were recorded. ResultsAfter treatment, the total effect rate of group C was higher than that of group A and group B (P<0.001). The first second forced expiratory volume (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio of the three groups after treatment were higher than those before treatment, and the above of group C were higher than those of group A and group B ［（2.42±0.43）L vs （1.57±0.31）,（1.82±0.34）L;（3.12±0.21）L vs （2.38±0.20）,（2.65±0.19）L;（74±6）% vs （63±5）%,（67±6）%］(all P<0.05). Levels of CD+4 T cell, immunoglobulin A (IgA), IgG, IgM, and CD+4/CD+8 T cell ratio of three groups after treatment were higher than those before treatment, and the levels of group C were higher than those of group A and group B, levels of CD+8 T cell and IgE of the three groups after treatment were lower than those before treatment, and the levels of group C were lower than those of group A and group B (all P<0.05). There were no significant differences in the incidence of adverse reactions among the three groups (P=0.773). Within 3 months after treatment, the time of cold and the rate of CVA recurrence of group B and group C were lower than those of group A (all P<0.001). Conclusion Chinese and western medicine combined with three-ball breathing training method is effective and safe on treating patients with CVA in remission stage, with improving the lung function and immune function.