固肺止咳汤联合孟鲁司特钠治疗儿童慢性咳嗽的疗效及对患儿免疫功能、炎症反应的影响

方芳; 叶龙

doi:10.16766/j.cnki.issn.1674-4152.004374

固肺止咳汤联合孟鲁司特钠治疗儿童慢性咳嗽的疗效及对患儿免疫功能、炎症反应的影响

doi: 10.16766/j.cnki.issn.1674-4152.004374

方芳^,,
叶龙

温州市中西医结合医院中医儿科，浙江温州 325000

基金项目:

浙江省中医药科技计划项目 2024ZL999

详细信息

通讯作者:
方芳，E-mail：691236072@qq.com

中图分类号: R725.6 R441.5
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出版历程
- 收稿日期: 2025-03-18
- 网络出版日期: 2026-04-11

The efficacy of Gufei Zhike Decoction combined with Montelukast Sodium in children with chronic cough and its influence on immune function and inflammation

FANG Fang^,,
YE Long

Department of Traditional Chinese Pediatrics, Wenzhou Hospital of Integrated Chinese and Western Medicine, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的儿童慢性咳嗽症状缠绵难愈应予以重视，本研究分析固肺止咳汤联合孟鲁司特钠治疗儿童慢性咳嗽(肺脾两虚型)的疗效及对患儿免疫功能、炎症反应的影响。方法采用随机数字表法将2023年7月—2024年6月温州市中西医结合医院儿科收治的180例慢性咳嗽儿童分为西药组和中西药结合组，各90例。西药组给予孟鲁司特钠治疗，中西药结合组给予固肺止咳汤+孟鲁司特钠治疗。治疗1个月后比较2组临床疗效、咳嗽改善情况、中医证候积分、免疫功能[免疫球蛋白(IgG、IgM、IgA)]及炎症反应[呼出气一氧化氮(FeNO)、血清超敏C反应蛋白(hs-CRP)、白细胞介素4(IL-4)]。结果中西药结合组总有效率高于西药组[85.56%(77/90) vs.70.00%(63/90)，χ²=6.300，P=0.012]。中西药结合组咳嗽缓解、咳嗽消失时间均短于西药组[(15.23±3.41)d vs. (18.47±3.65)d、(22.19±1.93)d vs.(24.86±2.05)d，P < 0.05]；治疗1个月后，2组中医证候积分、FeNO、hs-CRP、IL-4水平均降低，且中西药结合组低于西药组(P < 0.05)；治疗1个月后，2组IgG、IgM、IgA水平均升高，且中西药结合组高于西药组(P < 0.05)。结论固肺止咳汤联合孟鲁司特钠可有效治疗儿童慢性咳嗽，改善患儿症状，提高免疫功能，缓解炎症反应。
- 儿童慢性咳嗽 /
- 固肺止咳汤 /
- 孟鲁司特钠 /
- 免疫功能 /
- 炎症反应
Abstract: Objective Attention should be paid to the lingering symptoms of chronic cough in children. This study analyzed the efficacy of Gufei Zhike Decoction combined with Montelukast sodium in the treatment of chronic cough in children (lung and spleen deficiency type) and the influence on immune function and inflammation. Methods A total of 180 children with chronic cough admitted to the Department of Pediatrics of Wenzhou Hospital of Integrated Chinese and Western Medicine from July 2023 to June 2024 were divided into the western medicine group (montelukast sodium) and the combined Chinese and Western medicine group (Gufei Zhike Decoction + montelukast sodium) by random number table method, with 90 cases each, with 1 month of treatment. The clinical efficacy, cough improvement, traditional Chinese medicine (TCM) syndrome score, immune function [immunoglobulin (IgG, IgM, IgA)], and inflammatory response [exhaled nitric oxide (FeNO), serum hypersensitive C-reactive protein (hs-CRP), and interleukin-4 (IL-4)] were compared between the two groups. Results The total effective rate of the combination group was higher than that of the western group [85.56% (77/90) vs. 70.00% (63/90), χ²=6.300, P=0.012]. The duration of cough remission and cough disappearance in the combined group was shorter than that in the western medicine group[(15.23±3.41) d vs. (18.47±3.65) d, (22.19±1.93) d vs. (24.86±2.05) d, P < 0.05]. After 1 month of treatment, TCM syndrome score, FeNO, hs-CRP, and IL-4 levels in both groups decreased, and the combined Chinese and Western medicine group was lower (P < 0.05), while the levels of IgG, IgM, and IgA in both groups increased, and the combined Chinese and Western medicine group was higher (P < 0.05). Conclusion Gufei Zhike Decoction combined with Montelukast sodium can effectively treat chronic cough in children, improve symptoms, improve immune function, and relieve inflammation.
- Chronic cough in children /
- Gufei Zhike Decoction /
- Montelukast sodium /
- Immune function /
- Inflammatory response

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表 1 2组慢性咳嗽儿童临床总有效率比较[例(%)]

Table 1. Comparison of the overall clinical effectiveness rates between the two groups of children with chronic cough [cases (%)]

组别	例数	痊愈	显效	有效	无效	总有效
中西药结合组	90	18(20.00)	35(38.89)	24(26.67)	13(14.44)	77(85.56)
西药组	90	12(13.33)	22(24.45)	29(32.22)	27(30.00)	63(70.00)
注：2组总有效率比较，χ²=6.300，P=0.012。

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表 2 2组慢性咳嗽儿童咳嗽改善情况比较(x±s，d)

Table 2. Comparison of cough improvement between the two groups of children with chronic cough (x±s, d)

组别	例数	咳嗽症状缓解时间	咳嗽症状消失时间
中西药结合组	90	15.23±3.41	22.19±1.93
西药组	90	18.47±3.65	24.86±2.05
t值		6.154	8.996
P值		< 0.001	< 0.001

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表 3 2组慢性咳嗽儿童中医证候积分比较(x±s，分)

Table 3. Comparison of TCM syndrome scores between the two groups of children with chronic cough (x±s, points)

组别	例数	主症		t值	P值	次症		t值	P值
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
中西药结合组	90	12.48±1.71	4.22±1.23	53.307	< 0.001	6.31±1.45	2.05±0.52	41.029	< 0.001
西药组	90	12.53±1.83	5.96±1.37	38.955	< 0.001	6.24±1.43	2.89±0.64	30.706	< 0.001
统计量		0.189^a	8.966^b			0.326^a	9.664^b
P值		0.850	< 0.001			0.745	< 0.001
注：^a为t值，^b为F值。

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表 4 2组慢性咳嗽儿童免疫功能比较(x±s，g/L)

Table 4. Comparison of immune function between the two groups of children with chronic cough (x±s, g/L)

组别	例数	IgG		t值	P值	IgM		t值	P值	IgA		t值	P值
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
中西药结合组	90	5.28±1.14	9.62±1.45	31.794	< 0.001	1.22±0.31	2.37±0.48	27.620	< 0.001	1.11±0.25	1.83±0.37	22.034	< 0.001
西药组	90	5.35±1.18	8.12±1.34	20.856	< 0.001	1.25±0.33	2.09±0.44	20.699	< 0.001	1.08±0.22	1.61±0.33	18.284	< 0.001
统计量		0.405^a	7.208^b			0.629^a	4.079^b			0.855^a	4.210^b
P值		0.686	< 0.001			0.530	< 0.001			0.394	< 0.001
注：^a为t值，^b为F值。

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表 5 2组慢性咳嗽儿童炎症反应比较(x±s)

Table 5. Comparison of inflammatory reactions between the two groups of children with chronic cough (x±s)

组别	例数	FeNO(ppb，体积分数)		t值	P值	hs-CRP(mg/L)		t值	P值	IL-4(ng/L)		t值	P值
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
中西药结合组	90	44.52±5.16	28.77±3.15	35.961	< 0.001	7.85±1.32	3.26±1.04	36.902	< 0.001	46.25±5.48	30.59±4.15^a	30.854	< 0.001
西药组	90	45.17±5.12	32.78±3.65	26.805	< 0.001	7.81±1.27	4.11±1.08	29.873	< 0.001	45.92±5.34	33.76±4.53^a	23.376	< 0.001
统计量		0.848^a	7.890^b			0.207^a	5.378^b			0.409^a	4.895^b
P值		0.397	< 0.001			0.836	< 0.001			0.683	< 0.001
注：^a为t值，^b为F值。

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